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Major infectious diseases have the characteristics of sudden, group and harmfulness. Isolation is widely used in the field of infectious disease prevention and control as an emergency management tool to control the source of infection and protect susceptible populations in emergencies. However, while it has achieved good results, there are also objective ethical disputes between personal freedom and public health, personal privacy and public knowledge. This paper fully discusses the ethical problems exposed in the implementation stage of isolation, follows the ethical principles of minimum infringement, utility and respect, and puts forward suggestions to strengthen the ethical decision-making ability of grassroots personnel, improve the operation procedures of isolation, and give more humanistic care to the isolated population. On the premise of the unity of public interest and individual rights and interests, we hope to promote the benign interaction between individuals and the public, properly solve the practical problems existing in the disposal of major infectious diseases, and give full play to the optimal function of public policy objectives.
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Objective:To explore the relationship between AluYb8 insertion in the MUTYH gene and the risk of decreased left ventricular diastolic function in the elderly.Methods:In the retrospective analysis, 498 elderly patients with decreased left ventricular diastolic function(the disease group)and 155 people without left ventricular diastolic function(the control group)were recruited.Polymerase chain reaction was employed to analyze the genotype distribution of AluYb8 insertion in MUTYH gene.Cardiac function was measured by high-resolution color Doppler ultrasound.Results:The frequencies of the A/A, A/P and P/P genotypes were 30.1%(150/498), 48.4%(241/498)and 21.5%(107/498)in patients with decreased left ventricular diastolic function, and 27.7%(43/155), 54.8%(85/155)and 17.5%(27/155)in the control group, respectively.There were no significant differences in genotype( χ2=2.162, P=0.339)and allele frequency( χ2=1.342, P=0.794)between the two groups.Further analysis after stratification revealed that there were statistically significant differences in genotype( χ2=7.173, P=0.028)and allele frequency( χ2=8.352, P=0.015). Multivariate Logistic regression analysis showed that, in elderly patients with diabetes, P-allele carriers had a higher risk of decreased left ventricular diastolic function than non-carriers( OR=3.450, 95% CI: 1.148-10.372, P=0.027). Conclusions:AluYb8 insertion in the MUTYH gene may be associated with the risk of decreased left ventricular diastolic function in the elderly with diabetes.
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Objective:To observe the characteristics of macular telangiectasia (MacTel) in multi-color and multi-mode fundus images.Methods:An abservational case series study was conducted.Sixteen eyes of 12 patients diagnosed with MacTel by fluorescein fundus angiography (FFA) from January to November 2019 in Shandong Eye Hospital were analyzed.There were 8 cases (8 eyes) with MacTel type Ⅰ, among which 4 cases were male and 4 cases were female, with an average age of (62.3±12.5) years.The other 4 cases (8 eyes) had MacTel type Ⅱ, all of which were female, with an average age of (58.7±10.5) years.Best corrected visual acuity, slit lamp microscopy, color fundus photography, multicolor scanning laser imaging, FFA, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were carried out in all the patients.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shandong Eye Institute (No.2019S003).Results:In color fundus images of MacTel type Ⅰ eyes, annular macular exudation with macular edema occurred in 6 eyes, macular edema without hard exudates in 1 eye, and hard macular exudates without macular edema in 1 eye.However, the transparency of retina in temporal fovea in MacTel type Ⅱ eyes decreased, showing a gray color.In multi-color fundus images of MacTel type Ⅰ eyes, punctate granular yellow macular exudation and yellow-green macular edema were observed, which were clearer than those in color fundus images.Punctate exudation was seen in both the blue and green reflectance images, which was clearest in green reflectance image, followed by blue reflectance image and then the infrared reflectance image.In OCT images of MacTel type Ⅰ eyes, cystoid edema of inner retina or uneven reflection signal of outer plexiform retina were observed.Loss of inner and outer retinal structures and cavities were observable in MacTel type Ⅱ eyes, and outer retinal atrophy appeared in 2 eyes.In OCTA images, the destruction of superficial and deep capillary plexus in macular area were observed in both MacTel typeⅠand type Ⅱ eyes, and the destruction of deep capillary plexus was more obvious.In addition, more obviously increased vascular space, decreased vessel density, and increased foveal avascular zone were found in MacTel type Ⅱ eyes.In early stage of FFA, delayed capillary filling near fovea was seen in MacTel typeⅠeyes, and dilated temporal vessels in fovea, some of which showed tumor-like dilation, and the limited tumor-like dilation was enhanced in the later stage.Different degrees of dilated parafoveal blood vessels in the early stage, and the capillary in the temporal side of the macula showing diffuse strong fluorescence in the late stage of FFA was observed in MacTel type Ⅱ eyes.Conclusions:Multi-color scanning laser imaging can be used to observe the morphological characteristics of MacTel, and the imaging features of different types of MacTel are significantly different.
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ObjectiveTo investigate the effects of micro-fertilizer containing rare earth of different types and concentrations on the growth，yield and quality of Angelica sinensis. MethodOn the basis of the single-factor randomized block design， the growth and index components of Angelica sinensis were determined with rare earth-containing nitrate and chloride micro-fertilizers of different concentrations as foliar fertilizers. ResultSpraying 0.8 g·mL-1 rare earth-containing chloride micro-fertilizer could increase the economic yield of A. sinensis， with the fresh yield per mu （1 mu≈667 m2） reaching 855.4 kg and the dry yield per mu 350.7 kg，which increased by 15.16% and 28.70% respectively compared with that in the control group CK1. Spraying 1.2 g·mL-1 rare earth-containing nitrate micro-fertilizer could promote the growth and development of A. sinensis and significantly increase the content of index components， with the plant height reaching 93.05 cm，the stem diameter 15.60 mm，the root diameter 16.10 mm，the main root length 36.5 cm，and the number of leaves 11.25 pieces per plant， which increased by 32.76%，31.98%，41.98%，53.36%，and 45.16%， respectively， compared with those in the control group CK2. Besides， the content of ferulic acid，volatile oil，ligustilide， and extract was 0.96%，0.41%，0.30% and 48.76%，respectively，which increased by 12.94%，17.14%，11.11%， and 12.07%，respectively，compared with that in the control group CK2. ConclusionSpraying 0.8 g·mL-1 rare earth-containing chloride micro-fertilizer and 1.2 g·mL-1 rare earth-containing nitrate micro-fertilizer can promote the growth and development of A. sinensis，improve the medicinal properties，and increase yield and quality. Rare earth-containing micro-fertilizers can be applied in the standardization of A. sinensis cultivation， which can change the production status of A. sinensis that depends on chemical fertilizers and single fertilization， and promote the green， organic and ecological cultivation of A. sinensis.
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Objective:To evaluate the effect of chicoric acid on oxidative stress during myocardial injury in sepsis rats and the relationship with nuclear factor E2-related factor 2 (Nrf2) signaling pathway.Methods:Forty healthy male Sprague-Dawley rats, aged 8-12 weeks, weighing 220-250 g, were divided into 5 groups ( n=8 each) using a random number table method: control group (group C), lipopolysaccharide (LPS) group (group LPS), LPS+ chicoric acid group (group LPS+ CA), LPS+ Nrf2 inhibitor ML385 group (group LPS+ ML) and LPS+ chicoric acid+ ML385 group (group LPS+ CA+ ML). LPS 15 mg/kg was intraperitoneally injected to induce sepsis.Immediately after intraperitoneal injection of LPS, chicoric acid 10 mg/kg or ML385 15 mg/kg (in dimethyl sulfoxide) was intraperitoneally injected in group LPS+ CA and group LPS+ ML, respectively, and ML385 15 mg/kg and chicoric acid 10 mg/kg were intraperitoneally injected in LPS+ CA+ ML group.The equal volume of dimethyl sulfoxide was given instead in group C. At 48 h after establishment of the model, blood samples were collected from the aorta for measurement of concentration of serum interleukin-6 (IL-6) and the activities of lactate dehydrogenase (LDH) and creatine kinase isoenzyme (CK-MB) (by enzyme-linked immunosorbent assay). The animals were then sacrificed, and myocardial tissues were obtained for microscopic examination of pathological changes (by HE staining), for determination of activities of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) and contents of reactive oxygen species(ROS) and iron (by colorimetry), for calculation of the ratio of oxidized nicotinamide adenine 2 nucleotides to reduced nicotinamide adenine 2 nucleotides (NAD + /NADH), and for detection of the expression of Nrf2, NADPH quinone oxidoreductase 1 (NQO1), glutathione peroxidase 4 (GPX4) and nicotinamide adenine dinucleotide phosphate oxidase 1 (NOX1) (by Western blot). Results:Compared with C group, the activities of serum LDH and CK-MB and concentration of IL-6 were significantly increased, the contents of ROS and iron and the ratio of NAD + /NADH were increased, activities of GSH-Px and SOD were decreased, expression of Nrf2, NQO1 and GPX4 was down-regulated, and NOX1 expression was up-regulated in the other four groups ( P<0.05). Compared with group LPS, the activities of serum LDH and CK-MB and concentration of IL-6 were significantly decreased, the contents of ROS and iron and the ratio of NAD + /NADH were decreased, activities of GSH-Px and SOD were increased, expression of Nrf2, NQO1 and GPX4 was up-regulated, NOX1 expression was down-regulated ( P<0.05), and the pathological changes of cardiomyocytes were significantly reduced in group LPS+ CA, and the activities of serum LDH and CK-MB and concentration of IL-6 were significantly increased, the ratio of NAD + /NADH were increased, activities of GSH-Px and SOD were decreased, expression of Nrf2, NQO1 and GPX4 was down-regulated, NOX1 expression was up-regulated ( P<0.05), and the pathological changes of cardiomyocytes were accentuated in group LPS+ ML.Compared with group LPS+ CA, the activities of serum LDH and CK-MB and concentration of IL-6 were significantly increased, the contents of ROS and iron and the ratio of NAD + /NADH were increased, activities of GSH-Px and SOD were decreased, expression of Nrf2, NQO1 and GPX4 was down-regulated, NOX1 expression was up-regulated ( P<0.05), and the pathological changes of cardiomyocytes were accentuated in group LPS+ CA+ ML. Conclusion:The mechanism by which chicoric acid reduces myocardial injury in sepsis rats may be related to activating Nrf2 signaling pathway and inhibiting oxidative stress.
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Objective:To analyze the imaging characteristics of invasive fibromatosis from breast parenchyma, and to explore the clinical value of multimodal ultrasound.Methods:The two-dimensional, color Doppler and elastic imaging sonographic manifestations and pathological features of 12 cases of breast invasive fibromatosis included in the Affiliated Hospital of Jining Medical College from October 2015 to October 2020 were studied retrospectively.Results:Two dimensional ultrasound showed that 12 cases of breast invasive fibromatosis grew in parallel, with different sizes, unclear boundary and no complete capsule. The edge morphology of 7 cases (7/12) showed crab foot like changes; The tumor showed solid heterogeneous hypoechoic, punctate hyperechoic in 3 cases (3/12), and echo attenuation behind the tumor in 3 cases (3/12); The blood flow in the tumor was mainly grade 1-2 (9/12). Twelve tumors were examined quantitatively by virtual touch tissue quantifification. The shear wave velocity was (3.08±0.75)m/s. The diagnostic accuracy of multimodal ultrasound in invasive fibromatosis of breast (10/12) was significantly higher than that of conventional ultrasound (3/12, χ 2=8.224, P=0.004). The gross manifestation of the tumor: the section was gray or gray yellow, with unclear boundary and no capsule; Microscopic findings: fascicular fibroblasts and myofibroblasts proliferated, accompanied by varying degrees of glassy degeneration, acellular atypia, nuclear division and necrosis. Conclusions:Conventional ultrasound is difficult to distinguish invasive fibromatosis and malignant tumor of breast, and its ultrasonic manifestations are closely related to pathological features. The combined application of multimodal ultrasound can significantly improve the diagnostic coincidence rate of the disease and has high clinical application value.
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Objective:To investigate the therapeutic effect of Yanghe decoction combined with Tounongpowder on patients with acute plasma cell mastitis and its influence on inflammatory factors.Methods:A total of 120 patients with acute plasma cell mastitis admitted to Yantai Affiliated Hospital of Binzhou Medical College from May 2019 to May 2020 were selected, and divided into control group (60 cases) and combination group (60 cases). The control group was treated with western medicine, and the combination group was treated with Yanghe decoction and Tounongpowder on the basis of the control group. Seven days was 1 course and a total of 4 courses were continued. The scores of symptoms and signs and clinical effects of the two groups before treatment and 1 month after treatment were compared. The serum interleukin(IL)-1β and IL-6 were measured by radioimmunoassay, and tumor necrosis factor-α(TNF-α) was measured by enzyme-linked immunosorbent assay.Results:After 1 month of treatment, the scores of breast swelling, breast lumps, breast pain, breast fistula symptoms and signs in the two groups were significantly decreased, the scores of above index in the combination group were significantly lower than those in the control group, and the differences were statistically significant ( P<0.05). The total effective rate in the combined group was higher than that in control group: 91.7%(55/60) vs. 76.7% (46/60), and the difference was statistically significant ( χ2 = 8.456, P<0.05). After 1 month of treatment, the serum levels of IL-1β, IL-6 and TNF-α in the two groups were significantly reduced, and the serum levels of above 3 index in the combination group were significantly lower than those in the control group: (3.24 ± 0.92) ng/L vs. (3.81 ± 1.02) ng/L, (1.12 ± 0.42) ng/L vs. (1.41 ± 0.35) ng/L, (32.27 ± 19.03) ng/L vs. (43.04 ± 21.58) ng/L, and the differences were statistically significant ( P<0.05). After treatment, the liver and kidney functions of the two groups were not abnormal, and the differences in adverse reactions such as headache, dizziness, nausea and vomiting were not statistically significant ( P>0.05). Conclusions:Yanghe decoction combined with Tounongpowder can significantly improve the clinical symptoms of patients with acute plasma cell mastitis, with a definite clinical effect. Its mechanism of action may be related to reducing the levels of IL-1β, IL-6, and TNF-α and reducing the inflammatory response.
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Objective@#To understand the status of e-cigarette use among junior high school students in Zhengzhou City and its associated factors, and to provide support for tobacco control intervention for junior high school students.@*Methods@#From March to May 2019 in Zhengzhou, a stratified cluster random sampling method was used to investigate 3 624 junior high school students using a self-made e-cigarette questionnaire, including demographic information, attitudes towards e-cigarettes, usage behavior, smoking behaviors of parents and friends.@*Results@#The usage rate of e-cigarettes for junior high school students in Zhengzhou was 5.5%, parents and 51.5% of junior high school students purchased e-cigarettes online, 28.3% purchased them through stores, and 20.2% purchased e-cigarettes through other methods. Regarding the item use of e-cigarettes was harmful to others, the proportion of students with an approved attitude was lower than that with negative attitudes, the difference was statistically significant(χ2=4.33, P<0.05). Logistic regression analysis showed that e-cigarette was difficult to quit, the use of e-cigarettes won t make people feel relaxed, e-cigarette smoke was harmful to others , e-cigarette use did not make young people more attractive were negatively correlated with the use of e-cigarettes by middle school students(OR=0.46, 0.28, 0.57, 0.41, P<0.01).@*Conclusion@#The use of e-cigarettes by junior high school students in Zhengzhou is relatively serious, and multiple measures should be taken to strengthen health education and reduce the use rate of e-cigarettes.
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Objective: Abdominal aortic aneurysm is mainly treated with endovascular aortic repair (EVAR), but the incidence of endoleak after EVAR is high. The main purpose of follow-up is to monitor the occurrence of endoleak after EVAR. Ultrasonic examinations have the advantages of convenient operation, low price, no ionizing radiation and high sensitivity and specificity for detecting endoleak. The advancements of ultrasonography in detecting endoleak after EVAR were reviewed in this article.
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Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial pneumonia characterized by progressive accumulation of fibroblastic foci and destruction of the alveolar structure. Due to an incomplete understanding of the mechanism of the occurrence and progression of IPF, currently no effective means have been available for its early screening or treatment. With a poor overall prognosis, the patients with IPF have a median survival of only 2-4 years. In recent years, several studies have confirmed that dozens of molecules are involved in the development of IPF and can be used as potential biomarkers. These biomarkers play important roles in early diagnosis (such as SP-D, MMP-7, and osteopontin), prognostic evaluation (such as telomerase length, KL-6, mtDNA, HSP-70, LOXL2, CXCL13, miRNA, ICAM-1, and CCL18), and guiding treatment of IPF (such as TOLLIP rs3750920 genotype, SAMS score, and SP-D), and also provide potential therapeutic targets (such as TERT, TERR, RTEC, and PARN).
Subject(s)
Humans , Amino Acid Oxidoreductases , Biomarkers , Disease Progression , Idiopathic Pulmonary Fibrosis , Intracellular Signaling Peptides and Proteins , Matrix Metalloproteinase 7 , PrognosisABSTRACT
Objective:To evaluate the effectiveness of strengthening management in the bronchial asthma control among community patients.Methods:One hundred and eighteen community patients with bronchial asthma were recruited from January 2017 to January 2018. The patients were divided into community strengthening management group ( n=60) and control group ( n=58), the annual times of acute attack, time to first exacerbation and annual medical expenses were compared between the two groups. The proportion of inhaled corticosteroid (ICS) administration was documented; the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), Leicester Cough Questionnaire (LCQ), Fractional exhaled nitric oxide(FeNO) and pulmonary function were evaluated in two groups. Results:The management group had greater improvements in the proportion of ICS administration [45(75.0%) vs.36(62.1%), χ 2=4.143], ACT [(20.7±3.9) vs.(18.1±4.1), t=3.213], LCQ [(13.5±5.3) vs.(10.8±3.0), t=2.603], FeNO [(29.8±12.8) vs. (37.1±11.1), t=2.018] than the control group after six months of management (all P<0.05). There were significantly greater improvements in proportion of ICS treating [50(83.3%) vs. 34(58.6%), χ 2=5.748], ACT [(22.1±2.8) vs. (19.5±2.3), t=2.241], LCQ [(16.5±4.2) vs. (11.6±3.2),=5.603], miniAQLQ [(83.2±11.1) vs.(68.1±13.3), t=3.186] and FeNO [(28.2±13.1) vs.(38.1±16.3), t=2.176] in management group than those in control group after one year of management (all P<0.05); but no differences were seen in FEV 1%, FVC%, FEV 1/FVC (all P>0.05) between two groups. The LCQ score [(16.5±4.2) vs. (13.5±5.3), t=3.186] and the MiniAQLQ score [(83.2±11.1) vs. (69.1±14.3), t=5.603] of the management group were significantly improved after 1 year of management than those after 6 months. There was significant improvement in time to first exacerbation [182(92, 284) vs. 92(58, 176), Z=4.384] and the annual exacerbation was significantly reduced [0(0, 1) vs. 2(1, 3), Z=-3.187], annual medical costs of management group were significantly lower than those of control group [(10 523.0±550.5)Yuan vs. (15 787.1±1 421.2)Yuan, t=2.653]. Conclusion:The strengthening management can effectively improve the control rate of bronchial asthma, reduce acute exacerbation, improve clinical symptoms and improve the quality of life in community patients with bronchial asthma.
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Objective The purpose of this study was to produce an arginylglycylaspartic acid (RGD) peptide-modified ultra-small superparamagnetic iron oxide (FeO) nanoparticles (NPs) for targeted magnetic resonance (MR) imaging of hepatocellular carcinoma (HCC) cells and verify its utility as a T1 positive MRI imaging contrast agent and .Methods The carboxylated FeO NPs stabilized with sodium citrate were conjugated with polyethylene glycol (PEG)-linked RGD nanoparticles to form a novel target contrast agent FeO-PEG-RGD NPs. The specificity of FeO-PEG-RGD to bind RGD receptor was investigated by HepG2 cellular uptake and cell MR imaging, and by MR imaging of subcutaneous HepG2 tumors of nude mice.Results The formed FeO-PEG-RGD NPs displayed good biocompatibility, and the ultrahigh r1 relaxivity was 1.37 mM S . The synthesized FeO-PEG-RGD NPs were demonstrated spherical-like with an approximate diameter of 2.7 nm in similar size. The targeting effect to HepG2 cells was confirmed by cellular uptake and cell MR imaging. The MR imaging of nude mice demonstrated that the MR signal intensity enhancement of HepG2 tumor in FeO-PEG-RGD NPs treated mice was significantly higher than in mice treated with non-targeted FeO-mPEG NPs at the same post-administration time point. Conclusion The results indicate that the FeO-PEG-RGD particles have potential utility as T1 positive contrast agent in targeted MR imaging.
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Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial pneumonia characterized by progressive accumulation of fibroblastic foci and destruction of the alveolar structure. Due to an incomplete understanding of the mechanism of the occurrence and progression of IPF, currently no effective means have been available for its early screening or treatment. With a poor overall prognosis, the patients with IPF have a median survival of only 2-4 years. In recent years, several studies have confirmed that dozens of molecules are involved in the development of IPF and can be used as potential biomarkers. These biomarkers play important roles in early diagnosis (such as SP-D, MMP-7, and osteopontin), prognostic evaluation (such as telomerase length, KL-6, mtDNA, HSP-70, LOXL2, CXCL13, miRNA, ICAM-1, and CCL18), and guiding treatment of IPF (such as TOLLIP rs3750920 genotype, SAMS score, and SP-D), and also provide potential therapeutic targets (such as TERT, TERR, RTEC, and PARN).
Subject(s)
Humans , Amino Acid Oxidoreductases , Metabolism , Biomarkers , Disease Progression , Idiopathic Pulmonary Fibrosis , Diagnosis , Therapeutics , Intracellular Signaling Peptides and Proteins , Metabolism , PrognosisABSTRACT
Objective: To summarize and evaluate the existing animal models of pharyngitis, in order to provide a theoretical basis for its treatment and research of traditional Chinese medicine (TCM) for throat impediment. Method: Nearly 5 years of literatures were retrieved form databases of Chinese national knowledge infrastructure (CNKI), SinoMed and Pubmed, with throat impediment, pharyngitis, and animal model as medicine subject headings terms. Result: At present, rats, rabbits, guinea pigs and macaques are available as model animals. The main methods for reproduction of pharyngitis animal model were direct ammonia molding, ammonia and turpentine combined molding and bacterial injection molding. The rarely used methods, such as pyridine induction method, capsaicin induction method and sand dust induction method, have their own characteristics. The pharyngitis animal models with the combination of TCM syndrome include YIN-deficiency type and stagnation of liver-Qi with deficiency of spleen type. These models evaluation indexes were diverse, including apparent behavior, histopathology, biochemical indicator and hemorheology. The problems of these modeling methods included the differences in etiology and mechanism between the methods of modeling and the formation of clinical patients, the lack of molecular level of pathological mechanism elaboration, the non-uniform standard for concentration, frequency and cycle of drug administration during modeling, the subjectivity in judging partial evaluation indexes and the deficiency of the pharyngitis animal model with the combination of TCM syndrome. Conclusion: Firstly, the existing models needed to be further improved by such means as the exploration of the correlation or consistency between the molecular pathology mechanism and the clinical pathogenesis, and the concentration and frequency of uniform model administration and uniform standard for evaluation indexes. Secondly, the pharyngitis animal model with the combination of TCM syndrome and modern medicine disease was urgently needed to be explored, in order to facilitate the development of basic research in TCM.
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Objective To investigate the risk factors for postoperative cognitive dysfunction (POCD)after gynecologic laparoscopic surgery in elderly female patients,and to establish a risk model for prognosis.Methods Mini-Mental State Examination(MMSE) was used to evaluate the cognitive function of 280 elderly women who underwent gynecologic laparoscopic surgery from April 2014 to March 2016 in four tertiary-level hospitals in Hubei Province.Thirty-two cases were excluded due to withdrawal or loss of follow-up,and 248 cases with complete and valid data were collected for analysis.According to the degree of cognitive impairment on the 7th day after operation,subjects were grouped into a POCD group and a non-POCD group.Logistic regression was used to determine risk factors and establish a prognostic model for POCD.Results Of the 248 subjects enrolled,62 (25.0％) were diagnosed with POCD on the 7th day after operation.Multivariate Logistic regression analysis showed that American Society of Anesthesiologists(ASA) grade(OR =4.578,95％CI:1.156 ～18.139,P =0.030),age (OR =1.465,95％ CI:1.230 ～ 1.745,P =0.000),and duration of anesthesia(OR =1.030,95 ％ CI:1.005 ～ 1.056,P =0.017) were independent risk factors for POCD,and intraoperative administration of dexmedetomidine (OR =0.069,95 ％ CI:0.508 ～ 14.094,P =0.011),dexamethasone (OR =0.135,95 ％ CI:0.200 ～ 0.928,P =0.042),and maintenance of deep anesthesia(OR =0.761,95 ％ CI:0.630 to 0.919,P =0.005) were protective factors.A prognostic model was established based on the principle of logistic regression equation.The receiver operating characteristic(ROC)curve determined Y=4.291 as the best risk value,and the expected sensitivity and specificity were 90.3％ and 97.8％,respectively.Additionally,another 50 independent cases were included to verify the predictive efficacy of the model.It showed that the overall correct rate was 86.0％,and the sensitivity and specificity were 81.8％ and 87.2％,respectively.Conclusions Increased ASA grade,advanced age,prolonged anesthesia time are independent risk factors for POCD,and intraoperative administration of dexmedetomidine,dexamethasone,maintenance of deep anesthesia play a protective role.The prognosis model of POCD has certain clinical value.
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A 56-year-old female patient was admitted to a hospital because of repeated fatigue, anorexia, fever for more than one year, recurrence for 2 months and sudden left limb twitch for 10 days. In 2017, patient was diagnosed with infective endocarditis, then underwent aortic valve replacement, valve biopsy showed Candida parapsilosis, she took medicine regularly after operation and withdrew medicine after three consecutive negative blood culture. Fever and multiple organ infarction occurred again in 2018, Candida parapsilosis was isolated again from blood culture, it is suggested that fungal endocarditis may be latent and recurrence in human body for a long time, exfoliation of vegetation may embolize various organs and lead to corresponding clinical manifestations, surgery combined with drug therapy and subsequent maintenance of antifungal therapy are extremely important to improve the prognosis of patients.
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OBJECTIVE@#To explore the method and effect of ultrasound-guided suprascapular nerve block combined with acupuncture in the treatment of calcified tendinitis of rotator cuff.@*METHODS@#From January 2015 to December 2017, total 30 patients with calcified tendinitis, including 23 cases of supraspinatus tendon, 5 cases of infraspinatus tendon and 2 cases of subscapular tendon, were treated with ultrasound-guided suprascapular nerve block combined with acupuncture. There were 7 males and 23 females, ranging in age from 36 to 71 years old, with an average of 51.6 years old. There were 17 cases on the right and 13 cases on the left. VAS pain score, Constant-murley score, UCLA score and X-ray examination were used to evaluate the clinical results before and after surgery.@*RESULTS@#The mean follow-up was 14.3 months (6 to 30 months). The preoperative VAS score was 3.82±1.13, Constant-Murley score was 36.91±7.95 and UCLA score was 11.35±2.17. The final follow-up scores were 1.32±1.06, 90.61±2.89 and 33.22±1.51, respectively. The final follow-up scores were improved significantly(<0.05).@*CONCLUSIONS@#Conservative treatment of calcified rotator cuff tendinitis is ineffective. Suprascapular nerve block guided by ultrasound combined with acupuncture has a good therapeutic effect. It is a minimally invasive, economic, safe and effective method, which is worth promoting.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Therapy , Arthroscopy , Nerve Block , Rotator Cuff , Rotator Cuff Injuries , Tendinopathy , Therapeutics , Treatment OutcomeABSTRACT
The analysis of the relationship between personality and depression can facilitate the development of subclinical preventive measures and clinical treatment schemes. Moreover, the personality is associated with a variety of mental diseases, and there is substantial comorbidity between depression and some other mental diseases. So, to reveal pathological relationships between personality and depression is helpful to understand the etiology of the comorbidity between depression and multiple mental disorders. In this review, we first summarize the empirical researches on the relationship between personality and depression from the aspects of behavior and neural mechanisms, and then discuss the hypothetical model to explain the relationship between personality and depression. In a word, high neuroticism, low extroversion and conscientiousness, and other related traits (rumination, self-criticism, dependency, etc.) have a moderate to strong correlation with depression. Among them, neuroticism is the most concerned. To a certain extent, it can predict the onset of depression and affect the duration and treatment outcome of depression. Other traits, such as positive emotionality/ extroversion and effortful control/responsibility, can moderate the relationship between negative emotionality/neuroticism and depression. And after the onset of depression, the neuroticism may change, but the extroversion does not seem to change.
Subject(s)
Humans , Comorbidity , Depression , PersonalityABSTRACT
Cardiac dysfunction, a common consequence of sepsis, is the major contribution to morbidity and mortality in patients. Sodium tanshinone IIA sulfonate (STS) is a water-soluble derivative of Tanshinone IIA (TA), a main active component of Salvia miltiorrhiza Bunge, which has been widely used in China for the treatment of cardiovascular and cerebral system diseases. In the present study, the effect of STS on sepsis-induced cardiac dysfunction was investigated and its effect on survival rate of rats with sepsis was also evaluated. STS treatment could significantly decrease the serum levels of C-reactive protein (CRP), procalcitonin (PCT), cardiac troponin I (cTn-I), cardiac troponin T (cTn-T), and brain natriuretic peptide (BNP) in cecal ligation and puncture (CLP)-induced) septic rats and improve left ventricular function, particularly at 48 and 72 h after CLP. As the pathogenesis of septic myocardial dysfunction is attributable to dysregulated systemic inflammatory responses, several key cytokines, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10) and high mobility group protein B1 (HMGB1), were detected to reveal the possible mechanism of attenuation of septic myocardial dysfunction after being treated by STS. Our study showed that STS, especially at a high dose (15 mg·kg), could efficiently suppress inflammatory responses in myocardium and reduce myocardial necrosis through markedly reducing production of myocardial TNF-α, IL-6 and HMGB1. STS significantly improved the 18-day survival rate of rats with sepsis from 0% to 30% (P < 0.05). Therefore, STS could suppress inflammatory responses and improve left ventricular function in rats with sepsis, suggesting that it may be developed for the treatment of sepsis.
Subject(s)
Animals , Female , Humans , Male , Rats , C-Reactive Protein , Genetics , Allergy and Immunology , Cecum , General Surgery , Drugs, Chinese Herbal , Chemistry , Heart , Interleukin-6 , Genetics , Allergy and Immunology , Ligation , Myocardium , Allergy and Immunology , Phenanthrenes , Chemistry , Punctures , Salvia miltiorrhiza , Chemistry , Sepsis , Drug Therapy , Allergy and Immunology , Troponin T , Genetics , Allergy and Immunology , Tumor Necrosis Factor-alpha , Genetics , Allergy and ImmunologyABSTRACT
Objective To investigate whether the JAK2/STAT3 signaling pathway is involved in the epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells in uremic peritoneal dialysis (PD) rats.Methods A total of 48 male Sprague-Dawley (SD) rats were randomly separated into six groups:normal control group (NC group,n=8),sham group (n=8),uremic group (n=8),PD group (n=8),S3I-201 control group (n=8) and S3I-201 group (n=8).Uremic model generated by 5/6 nephrectomy surgery in rats was established.The rats of PD group,S3I-201 control group and S3I-201 group received daily infusion of 4.25％ glucose-based peritoneal dialysate fluid (3 ml/100 g) from PD catheters for 28 days.Rats of S3I-201 group were injected with STAT3 inhibitor S3I-201 (2.5 mg/kg) solution from the catheters every other day;the same dose of the solvent of S3I-201 was simultaneously given to S3I-201 control group rats.After PD for 28 days,peritoneal function,pathologic changes,and microvessel density (MVD) were evaluated.Creatinine,urea nitrogen and interleukin-6 (IL-6) concentration in blood and dialysate,and protein and mRNA levels of phospho-JAK2 (p-JAK2),phospho-STAT3 (p-STAT3),E-cadherin,alpha-smooth muscle actin (α-SMA) and vascular endothelial growth factor (VEGF) in peritoneum were determined.Results Uremia and peritoneal dialysate could aggravate the peritoneal function and elevate peritoneal thickness and MVD.They could also increased the concentration of IL-6 in blood and dialysate and the expression levels of α-SMA,VEGF,p-JAK2 and p-STAT3 in peritoneum,while lowering E-cadherin expression in peritoneum.These manifestations were even more remarkable in PD group compared to those in uremic group.There was no statistical difference between the S3I-201 control group and the PD group as regards all the index (all P ＞ 0.05).Compared with the S3I-201 control group,the rats treated with S3I-201 showed better peritoneal function.S3I-201 could reduce peritoneal thickness (P＜0.05),MVD (P＜0.05),the concentration of IL-6 in blood and dialysate,the mRNA and protein expression of α-SMA,VEGF,p-JAK2 and p-STAT3 (all P ＜ 0.05),while enhance the mRNA and protein expression of E-cadherin (all P ＜ 0.05).Conclusions After STAT3 is inhibited,the peritoneal thickness,MVD and IL-6 concentration in PD rats are decreased,and EMT is also inhibited,while peritoneal function is improved.The JAK2/STAT3 signaling pathway may thus be involved in the process of EMT of peritoneum in uremic peritoneal dialysis rats by regulating the expression of IL-6.