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ObjectiveThe human angiotensin converting enzyme2 (hACE2) transgenic mouse model was used to clarify the antiviral efficacy of BD-77 against a novel coronavirus SARS-CoV-2 and explore the action mechanism of BD-77 against SARS-CoV-2. MethodSARS-CoV-2 Omicron and Delta variant strains-infected VeroE6 cell models were established and administered with BD-77 to observe the antiviral effect of BD-77 in vitro. A kit was used to detect the effect of BD-77 in vitro on the binding of spike S protein of SARS-CoV-2 virus (Delta/Omicron) to angiotensin converting enzyme2 (ACE2). Chromatography was adopted to detect the binding of BD-77 to the S protein and N protein of the novel coronavirus. hACE2 transgenic C57BL/6 mice were divided into a blank control group, SARS-CoV-2 infection group, BD-77 administration groups of 37.5 mg·kg-1 and 75 mg·kg-1, with eight mice in each group. The pneumonia model of SARS-CoV-2-infected hACE2 transgenic mice was built to observe the survival of the mice, detect the virus titer of the lung tissue of the mice, and observe the lesions in the lung tissue. ResultBD-77 had a certain inhibitory effect on Omicron and Delta variant strains in vitro, with median inhibitory concentration (IC50) of 526.3 mg·L-1 and 653.0 mg·L-1, respectively. BD-77 had no significant inhibitory effect on the binding of the S protein of WT, Omicron, and Delta variant strains of SARS-CoV-2 to ACE2 and had no binding effect with the S protein and N protein of the novel coronavirus. No mice in the blank group died, while the mortality rate of SARS-CoV-2-infected mice was 75%. There was a large amount of virus replication in the lung tissue of the mice and large areas of inflammatory infiltration in the lung tissue and interstitium. Compared with the model group, BD-77 administration groups of 37.5 mg·kg-1 and 75 mg·kg-1 could reduce the mortality of mice, significantly lower the virus titer in the lung tissue of mice (P<0.05), and improve lung lesions. ConclusionBD-77 demonstrated significant inhibitory effects against SARS-CoV-2 virus in vitro and in vivo. However, its mechanism of action did not involve direct inhibition of the virus itself or intervention in the virus-host binding process. This finding suggests that the mechanism of action of BD-77 needs to be thoroughly investigated and elucidated by further experiments.
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ObjectiveTo observe the therapeutic effect of BD-77 by nebulized inhalation on animal models of various respiratory viral infections and investigate the mechanism of broad-spectrum antiviral action of BD-77 using proteomics. MethodThe influenza virus H1N1/FM1 experiment used ICR mice and divided them into a normal group, model group, Tamiflu group, and BD-77 groups of 75 and 37.5 g·L-1 for inhalation of 20 min and 25 min. Human coronavirus 229E and OC43 experiment divided the BALB/c mice into a normal group, model group, chloroquine phosphate group, and BD-77 groups of 75, 37.5, 18.75, and 9.375 g·L-1, with 10 mice in each group. Influenza virus H1N1/FM1 and human coronaviruses 229E and OC43 infection-induced pneumonia models were used to detect mouse lung index, and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect the viral load in lung tissue. Enzyme-linked immunosorbent assay (ELISA) was used to detect related inflammatory factors in lung tissue, and proteomics analysis was performed on the lung tissue of OC43-infected mice. ResultCompared with that in the normal group, the lung index of mice in each infection group was significantly increased (P<0.01), and viral nucleic acid could be detected in the lung tissue of mice infected with human coronaviruses 229E and OC43. The levels of interleukin-6 (IL-6), IL-10, and tumor necrosis factor-α (TNF-α) in the lung tissue of mice infected with human coronavirus 229E were all significantly increased (P<0.01). BD-77 could significantly reduce the lung index of mice infected with influenza virus H1N1/FM1 and human coronaviruses 229E and OC43 (P<0.05, P<0.01), cut down the viral load in the lungs of mice infected with human coronaviruses 229E and OC43 (P<0.01), and lower the contents of IL-6, IL-10, and TNF-α in the lung tissue of mice infected with human coronavirus 229E (P<0.01). Proteomics analysis of the lung tissue of OC43-infected mice showed that BD-77 regulated the AMPK signaling pathway, TNF signaling pathway, NOD-like signaling pathway, IL-17 signaling pathway, Forkhead box protein O (FoxO) signaling pathway, transforming growth factor-β (TGF-β) signaling pathway, and other signaling pathways. ConclusionNebulized inhalation of BD-77 is effective in treating pneumonia caused by influenza virus H1N1/FM1 and human coronaviruses 229E and OC43 infection in mice and may exert its antiviral effects by regulating the balance of cellular metabolism, enhancing the immune function of the host, and attenuating inflammatory responses.
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ObjectiveTo explore the effect of core muscles training based on spinal fine-tuning manipulation on lumbar facet joint disorders. MethodsFrom February, 2021 to February, 2022, 80 patients with lumbar facet joint disorders in Huadong Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and observation group (n = 40) randomly. Both groups received routine treatment and spinal fine-tuning manipulation, while the observation group received core muscles training in addition, for six weeks. They were assessed with Japanese Orthopaedic Association (JOA) scores, Short-Form of McGill Pain Questionnaire and World Health Organization Quality of Life-BREF before and after treatment. The recurrence rate was observed after three months follow-up. ResultsThe scores of all the scales improved after treatment (t > 5.751, P < 0.001), and improved more in the observation group than in the control group (t > 2.051, P < 0.05). After three months follow-up, the recurrence rate was 7.89% (3/38) in the observation group, less than 28.13% (9/32) in the control group (χ2 = 5.005, P = 0.025). ConclusionCombination of core muscles training may improve lumbar function, reduce lumbar pain, reduce recurrence and improve quality of life for patients with lumbar facet joint disorders.
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Background:With the increasing incidence of antibiotic resistance and adverse reactions to Helicobacter pylori(Hp),it is difficult for proton pump inhibitor-based quadruple therapy to meet the actual clinical treatment needs,so it is necessary to seek another effective combination therapy program on this basis.In recent years,the application of microecological preparations represented by Bifid triple viable capsule has been widely valued in clinical practice with its unique advantages.Aims:To evaluate the efficacy and safety of Bifid triple viable capsule combined with quadruple therapy in the treatment of Hp infection.Methods:The databases of CNKI,Wanfang,VIP,CBM,PubMed,Web of Science from January 2012 to April 2023 were searched by computer,to collect the relevant literature published at home and abroad on the treatment of Hp infection with Bifid triple viable capsule combined with quadruple therapy,and to screen the included literature for quality evaluation using the Cochrane risk bias tool,and to extract relevant data.Data were Meta-analyzed with RevMan 5.4.Results:Ten randomized controlled trials were included,including 1 828 patients with or without underlying disease who were Hp positive.Meta-analysis showed that the eradication rate of Hp in Bifid triple viable capsule combined with quadruple therapy was significantly higher than that in quadruple therapy group(RR=1.23,95%CI:1.19-1.29,P<0.000 01),while the incidence of adverse reactions was significantly decreased(RR=0.37,95%CI:0.28-0.48,P<0.000 01).Conclusions:Bifid triple viable capsule combined with quadruple therapy can significantly increase the eradication rate of Hp and reduce the adverse drug reactions,which has practical significance to guide clinical application.
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The study aims to observe the effects and explore the mechanisms of Buyang Huanwu Decoction and Astragali Radix-Angelicae Sinensis Radix combination in the treatment of the inflammatory response of mice with atherosclerosis(AS) via the Toll-like receptor 4(TLR4)/myeloid differentiation primary response protein 88(MyD88)/nuclear factor-κB(NF-κB) signaling pathway. Male ApoE~(-/-) mice were randomly assigned into a model group, a Buyang Huanwu Decoction group, an Astragali Radix-Angelicae Sinensis Radix combination group, and an atorvastatin group, and male C57BL/6J mice of the same weeks old were used as the control group. Other groups except the control group were given high-fat diets for 12 weeks to establish the AS model, and drugs were administrated by gavage. Aortic intimal hyperplasia thickness, blood lipid level, plasma inflammatory cytokine levels, M1/M2 macrophage markers, and expression levels of proteins in TLR4/MyD88/NF-κB pathway in the vessel wall were measured to evaluate the effects of drugs on AS lesions and inflammatory responses. The results showed that the AS model was successfully established with the ApoE~(-/-) mice fed with high-fat diets. Compared with the control group, the model group showed elevated plasma total cholesterol(TC), triglyceride(TG), and low-density lipoprotein cholesterol(LDL-c) levels(P<0.05), thickened intima(P<0.01), and increased plasma tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels(P<0.01). Moreover, the model group showed increased expression of vascular cell adhesion molecule-1(VCAM-1) and inducible nitric oxide synthase(iNOS)(P<0.01), inhibited expression of endothelial nitric oxide synthase(eNOS) and cluster of differentiation 206(CD206)(P<0.01), and up-regulated mRNA and protein levels of TLR4, MyD88, NF-κB inhibitor alpha(IκBα), and NF-κB in the vessel wall(P<0.05). Compared with the model group, Buyang Huanwu Decoction and Astragali Radix-Angelicae Sinensis Radix combination lowered the plasma TC and LDL-c levels(P<0.01), alleviated the intimal hyperplasia(P<0.01), and reduced the plasma TNF-α and IL-6 levels(P<0.05). Moreover, the two interventions promoted the expression of eNOS and CD206(P<0.05), inhibited the expression of VCAM-1 and iNOS(P<0.01), and down-regulated the mRNA and protein levels of TLR4, MyD88, IκBα, and NF-κB(P<0.05) in the vessel wall. This study indicated that Buyang Huanwu Decoction and Astragali Radix-Angelicae Sinensis Radix combination could delay the progression of AS, inhibit the polarization of vascular wall macrophages toward M1 type, and attenuate vascular inflammatory response by inhibiting the activation of TLR4/MyD88/NF-κB signaling pathway in the vascular wall. Astragali Radix and Angelicae Sinensis Radix were the main pharmacological substances in Buyang Huanwu Decoction for alleviating the AS vascular inflammatory response.
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Mice , Male , Animals , NF-kappa B/metabolism , Toll-Like Receptor 4/metabolism , NF-KappaB Inhibitor alpha/metabolism , Tumor Necrosis Factor-alpha/metabolism , Interleukin-6/metabolism , Myeloid Differentiation Factor 88/metabolism , Vascular Cell Adhesion Molecule-1/metabolism , Cholesterol, LDL , Hyperplasia , Mice, Inbred C57BL , Atherosclerosis/genetics , Apolipoproteins E/therapeutic use , RNA, MessengerABSTRACT
Objective:To investigate the risk factors and predictive value of early neurological deterioration (END) in patients with minor stroke caused by middle cerebral artery occlusion.Methods:Consecutive patients with minor stroke caused by middle cerebral artery occlusion admitted to Zhangjiagang Hospital Affiliated to Soochow University from October 2021 to May 2023 were retrospectively included. Minor stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5 at admission, and END was defined as an increase of ≥4 from baseline in the NIHSS score within 24 h of admission (excluding intracranial hemorrhage). Multivariate logistic regression analysis was used to determine independent risk factors for END. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of various risk factors on END. Results:A total of 130 patients with minor stroke caused by middle cerebral artery occlusion were included, of which 33 (25.4%) had END and 97 (74.6%) did not. Univariate analysis showed that there were statistically significant differences in NIHSS scores, volume with cerebral blood flow <30%, CT perfusion mismatch volume, baseline blood glucose, and baseline white blood cell count between the END and non-END groups (all P<0.05). Multivariate logistic regression analysis showed that CT perfusion mismatch volume (odds ratio [ OR] 1.010, 95% confidence interval [ CI] 1.003-1.017; P=0.007) and baseline white blood cell count ( OR 1.582, 95% CI 1.200-2.085; P=0.001) were the independent risk factors for END. ROC curve analysis showed that the area under the curves of CT perfusion mismatch volume and baseline white blood cell count for predicting END were 0.748 (95% CI 0.660-0.835; P<0.001) and 0.757 (95% CI 0.659-0.854; P<0.001), respectively. The area under the curve of combined predicting END was 0.821 (95% CI 0.738-0.905; P<0.001). Conclusions:CT perfusion mismatch volume and baseline white blood cell count are independent risk factors for the occurrence of END patients with minor stroke caused by middle cerebral artery occlusion, and the combination of the two has good predictive value for END.
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ObjectiveTo explore the therapeutic effect and mechanism of Qiling Tongluo prescription against idiopathic membranous nephropathy (IMN) in rats based on Toll-like receptor 4/myeloid differentiation factor 88/nuclear transcription factor-κB (TLR4/MyD88/NF-κB) signaling pathway. MethodSixty male SD rats were randomly divided into the normal group, model group, benazepril hydrochloride (10 mg·kg-1) group, and low-,medium-, and high-dose (6.48, 12.95, and 25.9 g·kg-1) Qiling Tongluo prescription groups. The IMN rat model was established by injection of cationized bovine serum albumin (C-BSA) into the tail vein. After the model was successfully prepared, the rats were gavaged with the corresponding drugs, once a day, for four consecutive weeks. After the treatment, the pathological changes in rat kidneys were observed by hematoxylin-eosin (HE) staining, Masson staining, and periodic acid-silver metheramine (PASM) staining, followed by the detection of 24 h urinary total protein (24 h UTP), plasma albumin (ALB), total serum protein (TP), serum creatinine (SCr), urea nitrogen (BUN), and uric acid (UA) levels. The levels of interleukin-1β (IL-1β) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA), and the mRNA and protein expression levels of TLR4, MyD88, and NF-κB in the kidney tissue were assayed by real-time fluorescent quantitative polymerase chain reaction (Real-time PCR), immunohistochemistry (IHC), and Western blot. ResultCompared with the normal group, the model group exhibited elevated 24 h UTP and serum SCr, BUN, UA, IL-1β, and IL-6 (P<0.05, P<0.01), decreased ALB and TP (P<0.01), up-regulated TLR4, MyD88, and NF-κB p65 mRNA and protein expression in kidney tissue (P<0.05, P<0.01), obvious inflammation, disordered glomerular structure with enlarged volume, irregularly thickened basement membrane, inflammatory cell infiltration in the renal interstitium, reduced renal tubular epithelial cells due to shedding and apoptosis, and some vacuolar degeneration. Compared with the model group, benazepril hydrochloride and Qiling Tongluo prescription at the high dose remarkably lowered the serum SCr and UA (P<0.05) and increased ALB and TP (P<0.05). Benazepril hydrochloride and Qiling Tongluo prescription at the low, medium, and high doses down-regulated the 24 h UTP, serum IL-1β and IL-6 levels, and renal TLR4, MyD88, and NF-κB p65 mRNA and protein expression to varying degrees (P<0.05, P<0.01), alleviated IMN inflammatory reaction, glomerular swelling, and volume increase, slightly dilated glomerular capillaries, proliferated mesangial matrix, and relieved pathological and morphological damages in rat kidney, with inflammatory cell infiltration occasionally observed. ConclusionQiling Tongluo prescription may reduce the release and expression of inflammatory factors by regulating the TLR4/MyD88/NF-κB signaling pathway to inhibit the inflammatory response in IMN rats, ameliorate proteinuria and kidney damage, and protect kidney function.
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Metabolic-dysfunction associated fatty liver disease (MAFLD) is a common concomitant disease of breast cancer. It is one of the main causes of liver damage during chemotherapy and also an important cause of liver damage during endocrine therapy or follow-up, which seriously affects the quality of life and prognosis of breast cancer patients. Nonalcoholic fatty liver disease was renamed as MAFLD, which changed the original "exclusive diagnosis" to "inclusive diagnosis" and the non-negligible role of metabolic factors in the occurrence and development of fatty liver disease was recognized, but the clinical attention is not enough at present. More attention should be paid to the diagnosis and treatment of MAFLD in breast cancer patients because the proportion and risk of metabolic disorders are higher than that in general people. In this article, we will focus on the clinical significance, prevention and treatment of the new definition of MAFLD in the comprehensive management of concomitant diseases of breast cancer, so as to further improve the quality of life and prognosis of breast cancer patients.
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Objective:To investigate the safety of Rituximab combined with intensive chemotherapy in the treatment of aggressive mature B-cell lymphoma/leukemia in children.Methods:The clinical data of 77 patients with primary pediatric aggressive mature B-cell lymphoma/leukemia who were treated according to the Chinese Children Cancer Group(CCCG)-mature B-cell lymphoma(BNHL)-2015 protocol at Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiaotong University School from November 1, 2014 to July 31, 2018 were collected.A comparison was drawn on the adverse reactions and recovery of immune function indexes between patients in the Rituximab combined with intensive chemotherapy group (R4 group) and the chemotherapy alone group (R3 group).Results:Rituximab combined with AA was associated with a significantly lower platelet count [79.5%(35/44 cases) vs.54.5%(24/44 cases), χ2=6.223, P=0.011] and a higher incidence of infection [70.5%(31/44 cases) vs.36.4%(16/44 cases), χ2=10.275, P=0.001] compared with AA alone; Rituximab combined BB was associated with a higher incidence of mucositis and infection compared with BB alone [40.8%(20/49 cases) vs.29.3%(22/75 cases) and 85.7%(42/49 cases) vs. 72.0%(54/75 cases), respectively], but the differences were not statistically significant.A greater proportion of patients in the R4 group had a decrease in peripheral blood CD 19 positive cells (no statistically significant difference, P>0.05) and a greater proportion had a decrease in serum IgG ( P<0.05) compared to the R3 group, but there was no significant difference in treatment-related mortality between both groups.For patients in the R4 group, the average recovery time of IgG and IgM level was 13.1 months, and the longest recovery time was 31 months after the end of treatment. Conclusions:Rituximab combined with intensive chemotherapy is generally safe in the treatment of aggressive mature B-cell lymphoma/leukemia in children.However, it is often accompanied with prolonged immunoglo-bulin deficiency and the potential risk of secondary infection.Therefore, the strict control over the indications for its application is required, and the gamma globulin replacement therapy deserves to be investigated in the future.
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Objective:To investigate the levels and influencing factors of serum pertussis toxin (PT)-IgG antibody in children with pertussis.Methods:The clinical data including age, course of disease and vaccination status of children with laboratory-confirmed pertussis and tested for PT-IgG antibody in Shenzhen Children′s Hospital from July 2015 to December 2018 were collected. Venous blood samples were obtained to detect PT-IgG antibody levels. Nasopharyngeal swabs were taken for polymerase chain reaction (PCR) test to detect Bordetella pertussis nucleic acid and culture of Bordetella pertussis. Mann-Whitney U test was used for comparison between two groups.Kruskal-Wallis test was used for comparison among multiple groups. Multiple linear regression was used to analyze the influencing factors of PT-IgG antibody levels. Results:A total of 871 children aged 4(2, 7) months were included, among whom, 592(68.0%) cases were under six months and 754 (86.6%) cases were under one year old. The course of disease was 15 (11, 20) days. Among 871 cases, 864 (99.2%) cases were PCR test and (or) culture positive, including 696 cases positive only for PCR test, 35 cases positive only for culture and 133 cases positive for both PCR test and culture. There were 452 (51.9%) children who were not vaccinated and 346 (39.7%) children vaccinated with at least one dose. In terms of age, the PT-IgG amtibody levels of children aged 0 to two months, three to five months, six months to two years and ≥three years were 0.7 (0, 8.2) IU/mL, 2.3 (0, 23.0) IU/mL, 24.6 (0, 112.3) IU/mL and 24.9 (0, 114.7) IU/mL, respectively. The PT-IgG antibody levels of children after onset of symptoms at 0 to two weeks, more than two to four weeks, more than four to eight weeks and more than eight weeks were 0(0, 7.9) IU/mL, 8.7(0, 56.0) IU/mL, 26.6(5.1, 82.9) IU/mL and 68.0(15.3, 118.8) IU/mL, respectively. The differences were both statistically significant ( H=88.346 and 94.076, respectively, both P<0.01). The PT-IgG antibody levels in children who were unvaccinated and vaccinated with at least one dose were 0.9 (0, 12.7) IU/mL and 14.6(0, 86.3) IU/mL, respectively. The difference was statistically significant ( Z=-8.520, P<0.01) PT-IgG≥80 IU/mL accounted for 16%(139/871) in the whole range of age, 34.3%(12/35) in children ≥three years old. There were 13 patients aged ≥three years old with a disease course >two weeks, among whom, six patients had PT-IgG≥80 IU/mL. Age, course of disease and vaccination status were independent influencing factors of PT-IgG levels ( β=0.108, 0.189 and 0.250, respectively, all P<0.01). Conclusions:The levels of PT-IgG antibody in children with pertussis are influenced by age, course of disease and vaccination status. The single serum PT-IgG of 80 IU/mL as cut-off value in the diagnosis of pertussis may lead to a increase of missed diagnosis. Therefore, it is necessary to further explore the standards suitable for children in China.
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Objective:To investigate the early outcome of endoscopy-assisted percutaneous non-fusion fixation of unilateral C 1 lateral mass screw and C 2 pedicle screw in treatment of type II odontoid fracture in elderly patients. Methods:A retrospective case series study was conducted to analyze clinical data of 12 elderly patients with type II odontoid fracture admitted to Second Affiliated Hospital of Chongqing Medical University from July 2016 to September 2018. There were 5 males and 7 females, aged 66-89 years [(75.2±6.7)years]. American Society of Anesthesiologists (ASA) scores for all patients were greater than 2 points. Ten patients were classified to Grade E and the other two were classified to Grade D by American Spinal Injury Association (ASIA) scale scores. All patients underwent endoscopy-assisted percutaneous non-fusion fixation of unilateral C 1 lateral mass screw and C 2 pedicle screw. The operation time, intraoperative blood loss, hospital stays, intraoperative and postoperative complications were collected. The Neck Disability Index (NDI) scores and ASIA scale scores were compared preoperatively and 6 weeks postoperatively. The visual analogue scales (VAS) were recorded preoperatively, 6 weeks, 3, 6, 9 and 12 months postoperatively. Fracture healing was followed up postoperatively. Results:Operation time was 98-169 minutes [(123.2±17.7)minutes]. Intraoperative blood loss was 20-40 ml [(30.0±7.1)ml]. Hospital stays were 6-9 days [(7.3±0.7)days]. No neurovascular injury was observed intraoperatively and postoperatively. The NDI were 8%-30%[(19.3±6.3)%] 6 weeks postoperatively, significantly lower than 19%-45%[(33.1±9.9)%] preoperatively( P<0.05). All patients' ASIA scale scores reached grade E postoperatively. The VAS constantly decreased from 6-9 points [(7.8±0.9)points] preoperatively to 1-3 points [(1.8±0.6)points] 12 months postoperatively ( P<0.05). All the patients achieved bone healing after 4-11 months [(7.3±2.1)months]. Conclusion:For type II odontoid fracture in elderly patients, endoscopy-assisted percutaneous unilateral atlantoaxial screw non-fusion fixation can relieve pain and achieve rapid recovery of neck function and bone healing.
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Objective:To evaluate the reduced hospitalization time and medical expenses of diagnosis-related groups(DRG) in day surgery, and to provide scientific basis for the accurate selection of day surgery.Methods:Data of medical records from July to November 2018 were extracted from day surgery and ordinary hospitalization. Time consumption and cost consumption indexes between day surgery and ordinary hospitalization of each DRG group were compared. Then the most significant and least significant DRG group and operation type were selected based on the comprehensive index ranking.Results:1 997 patients were included in day operation, the time consumption index was 0.31, and the cost consumption index was 0.55; 10 506 ordinary hospitalization patients were selected, the time consumption index was 1.31, and the cost consumption index was 1.09. The time and cost consumption indexes of surgeries such as skin lesion resection, facial lesion resection, deep cervical lymph node resection were shortened most significantly in day surgery, while the time and cost consumption indexes of minimally invasive mastectomy were decreased least significantly.Conclusions:According to the reducion of time and cost consumption index, DRG group and operation with the most significant reduction can be regarded as the priority of day surgeries under the same security level, while the DRG group with the least significant reduction is not recommended as the priority of day surgery.
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Objective:To analyze the effect of diagnosis-related groups prospective payment system(DRG-PPS) on medical service quality.Methods:Literature on DRG-PPS impact on medical service quality was searched in Chinese and English databases, and inclusion and exclusion criteria were formulated. Meta analysis was performed on the average length of stay, mortality and readmission rate, and the results of other indicators were described and integrated.Results:A total of 33 articles were included for analysis. Meta analysis showed that the implementation of DRG-PPS could shorten the average length of stay, WMD=-0.67(95% CI: -0.91 to-0.43); the implementation of DRG-PPS had no significant impact on the readmission rate( OR=0.97, 95% CI: 0.87-1.08); the implementation of DRG-PPS did not have a significant impact on the death rate of patients( OR=0.98, 95% CI: 0.93-1.03). The results of narrative integration showed that DRG-PPS had no significant effect on the incidence of complications, patient satisfaction, quality of life, service and operation process indicators. Conclusions:DRG-PPS can shorten the average length of stay, but has no significant effect on mortality and readmission rate.
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This study aimed to explore the structural and functional characteristics of the neural network of resting-state brain activities in patients with amnestic mild cognitive impairment (aMCI) by functional magnetic resonance imaging (fMRI) technology. Resting state fMRI scanning was performed on 10 clinically diagnosed aMCI patients and 10 healthy volunteers, and the difference in the resting-state brain activities between aMCI patients and healthy volunteers was compared using the brain function network regional homogeneity (ReHo) analysis method. Results of the ReHo analysis of aMCI patients and healthy volunteers revealed that the ReHo value significantly increased in the posterior cingulate gyrus region, medial frontal lobe, medial cortex of the prefrontal lobe, and part of the parietal lobe. Compared with the normal elderlies, ReHo decreased in aMCI patients in the left temporal lobe (middle temporal gyrus and inferior temporal gyrus), left parahippocampal gyrus, occipital lobe, lingual gyrus, precuneus, and other regions while ReHo increased in regions of the right frontal lobe (inferior frontal gyrus), left superior temporal gyrus, precentral gyrus (frontal lobe), right thalamus, left fusiform gyrus, and other regions. In the resting state, there may be regional abnormalities in brain functional areas in aMCI patients, which may be associated with cognitive impairment.
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Humans , Male , Female , Middle Aged , Aged , Brain/physiology , Cognitive Dysfunction/physiopathology , Image Processing, Computer-Assisted , Brain/diagnostic imaging , Brain Mapping , Magnetic Resonance Imaging , Cognitive Dysfunction/diagnostic imaging , Neural Pathways/physiopathologyABSTRACT
Macrophages play an important role in inflammation, and excessive and chronic activation of macrophages leads to systemic inflammatory diseases, such as atherosclerosis and rheumatoid arthritis. In this paper, we explored the anti-inflammatory effect of broussonin E, a novel phenolic compound isolated from the barks ofBroussonetia kanzinoki, and its underlying molecular mechanisms. We discovered that Broussonin E could suppress the LPS-induced pro-inflammatory production in RAW264.7 cells, involving TNF-α, IL-1β, IL-6, COX-2 and iNOS. And broussonin E enhanced the expressions of anti-inflammatory mediators such as IL-10, CD206 and arginase-1 (Arg-1) in LPS-stimulated RAW264.7 cells. Further, we demonstrated that broussonin E inhibited the LPS-stimulated phosphorylation of ERK and p38 MAPK. Moreover, we found that broussonin E could activate janus kinase (JAK) 2, signal transducer and activator of transcription (STAT) 3. Downregulated pro-inflammatory cytokines and upregulated anti-inflammatory factors by broussonin E were abolished by using the inhibitor of JAK2-STAT3 pathway, WP1066. Taken together, our results showed that broussonin E could suppress inflammation by modulating macrophages activation statevia inhibiting the ERK and p38 MAPK and enhancing JAK2-STAT3 signaling pathway, and can be further developed as a promising drug for the treatment of inflammation-related diseases such as atherosclerosis.
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We report one case of unilateral breast cancer treated with contralateral prophylactic mastectomy simultaneously and confirmed pathologically as synchronous bilateral primary breast carcinoma.The clinical characterization and diagnosis of bilateral primary breast cancer combined with a review of literature were discussed to serve as a reference for early diagnosis and treatment of the disease.
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Objective To explore the clinical effect of 3D printing in vitro modeling for minimally invasive treatment of complex pelvic fractures.Methods From April 2016 to June 2017, 18 cases of complex pelvic fractures were treated by 3D printing in vitro modeling were selected.The operation time and intraoperative bleeding volume were recorded.Fracture reduction was evaluated by X-ray, CT and Matta scores, and functional recovery was assessed by Majeed score.Results All 18 patients were followed up for 12 to 24 months, with an average of 15.8 months.The operation time of 18 patients was 80~160 minutes, with an average of (120±23.1) minutes;the amount of bleeding was75~160 m L, with an average of (113.6±29.1) m L;the length of incision was 7~14 cm, with an average of (9.3±1.8) cm.According to the Matta score, the fracture reduction was excellent in 12 cases, good in 4 cases, fair in 2 cases, the excellent and good rate was 88.9%.Majeed score was used to evaluate functional recovery 6 months after operation, the results showed that 13 cases were excellent, 4 cases were good and 1 case was fair, the excellent and good rate was 94.4%.No complications such as internal fixation loosening or breakage occurred during the follow-up period.Conclusion For complex pelvic fractures, 3D printing in vitro modeling assisted minimally invasive surgery can make the operation more precision with less trauma, reduce the incidence of complications, and speed up the recovery of patients.
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Objective: To investigate the effect of modified Lichongtang combined with 5-fluorouracil (5-FU) on tumor epithelial-mesenchymal transition (EMT) in H22 tumor-bearing mice. Method: Mouse models of transplanted hepatoma were constructed. After tumor formation, they were randomly divided into 4 groups:blank group, 5-FU group(2.5 mg·kg-1 5-FU intraperitoneal injection), modified Lichongtang combined with 5-FU group (5-FU+Chinese medicine group), and modified Lichongtang group (Chinese medicine group,25 g·kg-1 gavage),n=10 in each group. The effect of modified Lichongtang combined with 5-FU on the tumor inhibition rate of subcutaneous transplanted tumor was observed. The gene expression levels of E-cadherin,N-cadherin,Snail,and Twist in transplanted tumor were observed by Real-time PCR. The protein expression levels of E-cadherin,N-cadherin,Snail,and Vimentin were detected by using Western blot. Result: The tumor inhibiting rate was 59.18%,84.42%,and 10.39% respectively in 5-FU group, 5-FU+Chinese medicine group,and Chinese medicine group. All of these can inhibit the growth of liver cancer transplantation tumor, and the tumor inhibiting rate of 5-FU+Chinese medicine group was significantly higher than that in 5-FU group (PPPPPPPPPPPConclusion: Modified Lichongtang, 5-FU and their combination have inhibitory effect on the growth of transplanted tumors of hepatocarcinoma mice, and the combination of the two drugs can enhance the effect of chemotherapy and to some extent inhibit the toxicity of 5-FU. The mechanism may be related to the inhibition of liver cancer EMT.
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Objective: To investigate the effect of modified Lichongtang combined with 5-fluorouracil (5-FU) on epithelial-mesenchymal transition (EMT) of human hepatoma HepG2 cells. Method: The growth of HepG2 cells was detected by methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay, and the effect of Chinese medicine and 5-FU alone or combined use on the growth of HepG2 cells was analyzed by the principle of efficacy. The growth curves of HepG2 cells were plotted to determine the relationship between drug effect and combination index as well as the interaction between drugs. Scratch test was used to detect the effect of modified Lichongtang combined with 5-FU on the migration of HepG2 cells. Cell invasion assay (transwell chamber) was used to detect the effect of modified Lichongtang combined with 5-FU on the invasion ability of HepG2 cells. Real-time quantitative polymerase chain reaction (PCR) was used to detect the effect of modified Lichongtang combined with 5-FU on EMT-related genes E-cadherin, N-cadherin and Zinc finger transcription factors (snail, twist) mRNA expression after 24 hours of treatment on HepG2 cells. The expression levels of E-cadherin, N-cadherin, Snail and Vimentin in HepG2 cells were detected by Western blot after treatment by modified Lichongtang combined with 5-FU for 24 hours. Result: MTT assay showed that with the increase of drug concentration, the inhibitory effect of modified Lichongtang, 5-FU alone or combined use on HepG2 cell growth was also increased. Statistical analysis showed that the combined use of these two drugs at a low dosage could produce better synergistic effect on HepG2 cells after 24 hours of treatment. Therefore, modified Lichongtang and 5-FU were selected to treat HepG2 cells for 24 hours. 25%inhibitory concentration (IC25) was 800 mg·L-1 modified Lichongtang, 3.125 mg·L-15-FU. Blank group, 5-FU group, Lichongtang+5-FU group, and modified Lichongtang group were set for follow-up experiments. Scratch and invasion experiments showed that modified Lichongtang, 5-FU alone and combined use can inhibit HepG2 cell migration and invasion ability (PPPPPPPPPPConclusion: Modified Lichongtang combined with 5-FU can produce a better synergistic effect on HepG2 cells at a low dosage for 24 hours, and can significantly inhibit the migration and invasion of hepatocellular carcinoma cells, up-regulate the expression of E-cadherin, down-regulate the expression of N-cadherin, Snail, Vimentin and Twist in hepatocellular carcinoma cells. Inhibition of tumor cell proliferation, migration, invasion and EMT-related gene expression may be associated with enhancing the efficacy of chemotherapy drugs, and may act as one of the mechanisms for synergistic effect of modified Lichongtang combined with 5-FU.
ABSTRACT
The purpose of the present study was to investigate the effects and underlying mechanism of gonadotropin-releasing hormone agonist (GnRHa) controlled ovarian hyperstimulation (COH) on embryo implantation in mice. Forty female Kunming mice aged 9 weeks were randomly divided into two groups (control and COH groups). The COH group received intraperitoneal (i.p.) injections of aminocyclin acetate (GnRHa), human menopausal gonadotropin (HMG) and human chorionic gonadotropin (hCG), while the control group was given equal amount of physiological saline by i.p. injection. One male mouse and two female mice were put into the same cage at 16:00 on the hCG injection day, and on the fourth day of pregnancy, 10 mice from each group were killed. The levels of serum estradiol (E) and progesterone (P) were measured by radioimmunoassay; HE staining was used to observe the morphology of ovarian and endometrial tissues. The protein expression levels of endometrial leukemia inhibitory factor (LIF), phosphorylated signal transducer and activator of transcription 3 (p-STAT3), heparin-binding epidermal growth factor-like growth factor (HB-EGF) and glycodelin A were detected by Western blot and immunohistochemistry. Ten mice from each group were sacrificed on the eighth day of pregnancy, and the status of the uterus and the average number of blastocysts were observed. The results showed that, compared with control group, the serum E level in COH group was significantly decreased (P < 0.05), while the P level was increased significantly (P < 0.05); the ovarian follicles at different developmental stages were rare, corpus lutea (CL) were visible and multiple, the endometrium was thinned, and the number of endometrial glands was reduced (P < 0.05); the contents of LIF, p-STAT3, HB-EGF and glycodelin A in the endometrium were decreased significantly (P < 0.05) on the fourth day of pregnancy; mouse blastocysts developed slowly and were decreased in number on the eighth day of pregnancy (P < 0.05). The above results suggest that GnRHa COH can affect embryo implantation in mice. The mechanism may be related to the imbalance of gonadal hormone, the changes in the structure of the endometrium and the expressions of LIF, p-STAT3, HB-EGF and glycodelin A in the implantation stage, which may lead to the decrease of endometrial receptivity and the abnormal dialogue between the embryo and the uterus.