ABSTRACT
ObjectiveTo observe the effects of Youguiwan on bone metabolism and bone morphogenetic protein-2 （BMP-2）/Smad signaling pathway in ovaries-removed rats with osteoporosis and study the mechanism of Youguiwan in the prevention and treatment of osteoporosis. MethodA postmenopausal rat model of osteoporosis was prepared by bilateral ovariectomy. The 40 female SD rats were randomly divided into five groups， including sham operation group， model group， alendronate sodium group （0.1 mg·kg-1）， and high-dose and low-dose （5.36 and 2.68 g·kg-1） groups of Youguiwan. The drug was given seven days after modeling， once a day for 12 weeks. After the treatment， the changes in femur tissue structure were observed by micro-CT， including bone mineral density （BMD）， bone volume/total volume （BV/TV）， trabecular number （Tb.N）， trabecular thickness （Tb.Th）， bone surface/bone volume （BS/BV）， and trabecular separation （Tb.Sp）. Ossification was observed by saffrane-solid green staining， and serum levels of bone metabolism markers， including bone alkaline phosphatase （BALP）， osteocalcin （BGP）， type Ⅰ procollagen amino terminal propeptide （PINP）， and tartrate-resistant acid phosphatase 5b （TRACP-5b）， were determined by enzyme-linked immunosorbent assay （ELISA）. The protein and mRNA expression levels of Runx2， BMP-2， and Smad1 in rat femur were detected by Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the sham operation group， bone trabecula in the model group was sparse. BMD， BV/TV， Tb.N， and Tb.Th were decreased （P<0.05， P<0.01）. BS/BV （P<0.05） and Tb.Sp were increased. The content of BGP， BALP， PINP， and TRACP-5b in serum was significantly increased （P<0.01）. The mRNA and protein expressions of Runx2， BMP-2， and Smad1 in rat femur were significantly decreased （P<0.05， P<0.01）. Compared with the model group， the number of bone trabeculae in the high-dose and low-dose groups of Youguiwan was increased， and the bone microstructure was improved. BMD， BV/TV， Tb.N， and Tb.Th were increased significantly （P<0.05， P<0.01）， and BS/BV and Tb.Sp were increased. The content of bone metabolic markers decreased （P<0.05， P<0.01）. ConclusionYouguiwan has certain preventive and therapeutic effects on postmenopausal osteoporosis， and its mechanism may be related to promoting bone formation by regulating the BMP-2/Smad signaling pathway.
ABSTRACT
Objective:To investigate the hemodynamic characteristics and dynamic cerebral autoregulation(dCA) of patients with severe carotid stenosis before carotid endarterectomy(CEA), and to analyze their correlations with hyperperfusion after CEA.Methods:A total of 63 patients with unilateral severe carotid artery atherosclerotic stenosis who underwent CEA were consecutively recruited prospectively in Xuanwu Hospital, Capital Medical University from January 2021 to August 2021. According to postoperative hyperperfusion, patients were divided into hyperperfusion group (13 cases) and non-hyperperfusion group (50 cases). The general clinical data and hemodynamic parameters were compared between the two groups. The dCA was evaluated by the transfer function analysis that measured the fluctuation amplitude of mean cerebral blood flow velocity(CBFV) with blood pressure change, the time difference of phase with blood pressure change, and the correlation between mean CBFV and blood pressure change. The value of dCA for predicting postoperative hyperperfusion was analyzed through the ROC curve and the area under the curve(AUC).Results:①The proportion of hypertension in hyperperfusion group was higher than that in non-hyperperfusion group ( P<0.05). ②The peak systolic velocity (PSV) at the stenosis lesion of the internal carotid artery, the end-diastolic velocity (EDV) at the stenosis lesion of the internal carotid artery and the ratio of PSV at the stenosis lesion of the internal carotid artery to the distal internal carotid artery in the hyperperfusion group were higher than the non-hyperperfusion group.And the PSV of the ipsilateral middle cerebral artery in the hyperperfusion group was lower than the non-hyperperfusion group (all P<0.05). ③In the very low-frequency and low-frequency region, the phase in the hyperperfusion group was lower than that in the non-hyperperfusion group (all P<0.05), while there was no significant difference in the high-frequency regions( P>0.05). In the three regions of very low-frequency, low-frequency and high-frequency, there were no significant differences in the gain and coherence between the two groups(all P>0.05). ④The best cutoff value of phase in the very low-frequency was 33.28 for predicting hyperperfusion after CEA (AUC=0.766, 95% CI=0.629-0.904, P=0.03), with the specificity of 0.700, and sensitivity of 0.846. Conclusions:There are differences in hemodynamics and dCA between the hyperperfusion group and the non-hyperperfusion group after CEA. The impaired preoperative dynamic cerebral autoregulation is an independent predictor of postoperative hyperperfusion.
ABSTRACT
Objective:To study the correlation between the quartering of nerve root subsidence sign (NRS) and the cross-sectional area (CSA) of the narrow segment thecal sac in patients with lumbar spinal stenosis (LSS).Methods:The data of 203 LSS patients in the Fourth People′s Hospital of Hengshui from January 2020 to December 2021 were retrospectively analyzed. All patients underwent MRI cross sectional scanning. The patients were divided into positive type a group ( n=62), positive type b group ( n=32), positive type c group ( n=51), and negative group ( n=58) by NRS quartering method. The minimum CSA, median sagittal diameter (PAD), and lateral recess sagittal diameter of each group were compared. The correlation between NRS quartering classification and the minimum CSA and related indicators of lumbar spinal stenosis was analyzed. Results:The minimum CSA, PAD, and sagittal diameter of the lateral recess in the positive a group, positive b group, and positive c group were all smaller than those in the negative group, while the Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI) were higher than those in the negative group; The minimum CSA, PAD, and sagittal diameter of the lateral recess in the positive b type and positive c type groups were smaller than those in the positive a type group, while the VAS score and ODI index were higher than those in the positive a type group; The minimum CSA, PAD, and sagittal diameter of the lateral recess in the positive c type group were smaller than those in the positive b type group; The VAS score and ODI index were higher than those of the positive b type group; The differences were statistically significant (all P<0.05). 203 patients were divided into 54 normal cases, 58 mild stenosis cases, 49 moderate stenosis cases, and 42 severe stenosis cases based on the minimum CSA. The coincidence rate between negative NRS and minimal CSA diagnosis as normal was 94.44%(51/54), the coincidence rate between positive type a and minimal CSA diagnosis as mild stenosis was 84.48%(49/58), the coincidence rate between positive type b and minimal CSA diagnosis as moderate stenosis was 53.06%(26/49), and the coincidence rate between positive type c and minimal CSA diagnosis as severe stenosis was 90.48%(38/42). Using the kappa consistency test, the kappa value for quantitative diagnosis of minimum CSA stenosis in NRS and LSS patients was 0.743, indicating good consistency. The kappa values for quantitative diagnosis of NRS, sagittal diameter of lateral recess, and PAD stenosis were 0.271 and 0.335, with poor consistency. NRS typing was negatively correlated with CSA and PAD ( r=-0.723, -0.581, all P<0.001), and positively correlated with VAS score and ODI index ( r=0.473, 0.640, all P<0.001). Conclusions:The NRS quartering method has a good consistency in diagnosing the severity of LSS patients and the minimum CSA of stenosis segments, suggesting that the NRS quartering method can better reflect the degree of Spinal stenosis, which can not only be used as an auxiliary indicator for qualitative diagnosis of LSS, but also has a high value in quantitative diagnosis.
ABSTRACT
Epilepsy is a disorder of the brain charac-terized by abnormal neuron excitability.However,the underlying molecular mechanism of neuron excitability modulation remains elusive.With the help of bioinformatic methods,we have identified receptor-type tyrosine-pro-tein phosphatase-like N(PTPRN)as a critical gene dur-ing epileptogenesis.PTPRN recruits NEDD4L ubiquitin E3 ligase to NaV1.2 sodium channels,facilitating NEDD4L-mediated ubiquitination and endocytosis.Knockout of PTPRN endows hippocampal granule cells with augmented depolarization currents and higher intrinsic excitability,which is reflected by increased seizure susceptibility of transgenic mice.On the contrary,reduced neuron excit-ability and decreased seizure susceptibility are observed after PTPRN overexpression.Meanwhile,we find that a 133 aa fragment recaptures modulation effect of PTPRN full-length,and this fragment shows therapeutic potential towards epilepsy caused by NaV1.2 gain of function vari-ants.In brief,our results demonstrate PTPRN playsa criti-calroleinregulatingneuronexcitability,providing a poten-tial therapeutic approach for epilepsy.
ABSTRACT
Objective:To analyze the influential factors of post-stroke depression and investigate the effects of changes in serum bilirubin and high-sensitivity C-reactive protein on post-stroke depression.Methods:A total of 199 patients with stroke admitted to Qinghai Provincial People's Hospital from December 2019 to December 2020 were included in this study. These patients were divided into the Xining urban group (2 000-3 000 meters above sea level; n = 165) and the Xining prefecture and county group (over 3 000 meters above sea level; n = 34) according to their long-term residence. They were also divided into the post-stroke depression group ( n = 56, including 45 patients in the Xining urban group and 11 patients in the Xining prefecture and county group) and non-post-stroke depression group ( n = 143, including 120 patients in the Xining urban group and 23 patients in the Xining prefecture and county group). Related scales were used to evaluate neurologic deficits and the degree of depression in the two groups. Serum levels of total bilirubin, direct bilirubin, and high-sensitivity C-reactive protein were measured in each group. Neurologic deficits and the degree of depression were correlated with serum levels of total bilirubin, direct bilirubin, and high-sensitivity C-reactive protein. Results:Serum levels of total bilirubin, direct bilirubin, and high-sensitivity C-reactive protein in the post-stroke depression group were (19.95 ± 7.22) mmol/L, (3.98 ± 1.49) mmol/L, and (1.40 ± 2.29) mg/L, respectively, which were significantly higher than (16.20 ± 7.61) mmol/L, (3.19 ± 1.62) mmol/L, and (0.63 ± 1.33) mg/L in the non-post-stroke depression group ( t = 3.17, 3.18, 2.35, all P < 0.05). There was a significant difference in serum level of high-sensitivity C-reactive protein between stroke patients with mild and moderate depression and stroke patients with severe depression ( t = 2.48, P < 0.05). Conclusion:Serum levels of bilirubin and high-sensitivity C-reactive protein play an important role in the pathogenesis of post-stroke depression and there is a significant correlation between the two.
ABSTRACT
Objective:To learn about the iodine nutritional status of children aged 8 to 10 years in Xiamen City after the reform of salt industry system, and to provide scientific basis for reasonable prevention and control of iodine deficiency disorders.Methods:From 2017 to 2019, 6 districts were selected each year in Xiamen City 5 sampling districts were divided according to the oriation of east, west, south, north and center in each district. One town (street, hereinafter refered as to town) was selected from each sampling district. One primary school was selected from each town. For each primary school, at least 40 non-boarding children aged 8 to 10 years (age balanced, half male and half female) were selected. Edible salt samples in the households and random urine samples of children aged 8 to 10 years were collected, and salt iodine and urinary iodine contents were measured, while thyroid volume was examined by B-ultrasound.Results:From 2017 to 2019, the coverage rate of iodized salt in Xiamen City was 97.34% (1 206/1 239), 96.89% (1 214/1 253), and 93.33% (1 175/1 259), respectively; the consumption rate of qualified iodized salt was 96.13% (1 191/1 239), 95.61% (1 198/1 253), and 91.58% (1 153/1 259), respectively; the median urinary iodine was 182.90, 182.81, 164.00 μg/L, respectively. The prevalence of goiter of boys and girls was 1.01% (19/1 889) and 2.26% (42/1 862), respectively.Conclusions:After the reform of salt industry system, the iodine nutritional status of children aged 8 to 10 years is generally at an appropriate level in Xiamen City. However, the consumption rate of qualified iodized salt is reduced, which increases the risk of iodine deficiency for residents. Therefore, we should strengthen the propaganda of scientific iodine supplement, maintain a high consumption rate of qualified iodized salt, and prevent the harm of iodine deficiency.
ABSTRACT
Objective:To explore the feasibility of applying BOPPPS (B-bridge in, O-objective, P-pre-assessment, P-participatory learning, P-post-assessment, S-summary) course design mode in the teaching of internal medicine practice for nursing undergraduates.Methods:A total of 73 nursing interns of Kunming Medical University were selected as subjects and divided into the experimental group ( n=30) and the control group ( n=43). The experimental group adopted the practice teaching method based on BOPPPS model, while the control group adopted the traditional teaching method. Students' evaluation was collected by questionnaire. The students' comprehensive reasoning ability, holistic nursing skills ability and clinical nursing evaluation ability were evaluated by taking out questions from the question bank. And the results of teachers' evaluation on the participation of case study and problem solving in the process of students' internship were collected. SPSS 20.0 was used for t-test. Results:The students' evaluation of the practice process in the experimental group (86.81±2.85) was significantly better than that in the control group (82.61±3.82) ( P<0.001). The experimental group was significantly better than the control group in comprehensive reasoning of clinical thinking and assessment of holistic nursing ability ( P <0.001). Teachers' evaluation in the experimental group was better than that in the control group ( P <0.05). The overall effect of the experimental group (20.60±1.73) was significantly better than that of the control group (17.84±1.70) ( P <0.001). Conclusion:BOPPPS mode is helpful for teachers to carry out and demonstrate holistic nursing teaching with symptoms as the core according to the overall teaching objectives of nursing internal medicine, optimize the time arrangement and knowledge structure, improve the practice efficiency, and promote the establishment of holistic nursing thinking mode of students.
ABSTRACT
Trace amines(TAs)are metabolically related to catecholamine and associated with cancer and neuro-logical disorders.Comprehensive measurement of TAs is essential for understanding pathological pro-cesses and providing proper drug intervention.However,the trace amounts and chemical instability of TAs challenge quantification.Here,diisopropyl phosphite coupled with chip two-dimensional(2D)liquid chromatography tandem triple-quadrupole mass spectrometry(LC-QQQ/MS)was developed to simul-taneously determine TAs and associated metabolites.The results showed that the sensitivities of TAs increased up to 5520 times compared with those using nonderivatized LC-QQQ/MS.This sensitive method was utilized to investigate their alterations in hepatoma cells after treatment with sorafenib.The significantly altered TAs and associated metabolites suggested that phenylalanine and tyrosine metabolic pathways were related to sorafenib treatment in Hep3B cells.This sensitive method has great potential to elucidate the mechanism and diagnose diseases considering that an increasing number of physiological functions of TAs have been discovered in recent decades.
ABSTRACT
The complete chloroplast genome of medicinal plant Asarum caudigerum Hance and its close relative A. cardiophyllum Franchet were sequenced using Illumina Hiseq technology, and assembled, annotated, and characterized by bioinformatic methods in this study. Then phylogenetic analysis of the complete chloroplast genomes of A. caudigerum, A. cardiophyllum, and twelve published species was conducted. The results indicated that the chloroplast genomes ranged from 186 215-186 985 bp in length, with a large single copy (LSC, 89 445-90 169 bp) and two inverted repeats (IRa/IRb, 48 387-48 408 bp). The overall GC content was 37.4%-37.5%. A total of 144 chloroplast genes were annotated, including 98 protein coding genes, 38 tRNA genes and 8 rRNA genes. In addition, complex genomic rearrangements were detected in the chloroplast genome of Asarum. Meanwhile, visual evaluation of the discrete type of the sequence indicated that the variation level of non-coding region was higher than that of coding region. Phylogenetic analyses suggested that A. caudigerum and A. cardiophyllum were clustered into a single clade and A. cardiophyllum, A. sieboldii var. seoulense, A. misandrum and A. maculatum were clustered into another single branch. These two clade were sister species. This study provides a scientific basis for the identification, phylogenetic relationship, molecular breeding of Asarum species.
ABSTRACT
AIM: To investigate the differences in visual recovery, corneal astigmatism, and rotation stability of Toric intraocular lens(TIOL)implantation in cataract patients with different axial lengths.METHODS: Retrospective analysis. A total of 132 patients(132 eyes)with age-related cataract and corneal astigmatism who underwent phacoemulsification cataract extraction combined with TIOL implantation in our hospital's ophthalmology department from February 2021 to September 2022 were selected. They were divided into two groups based on the axial length: the group with axial length ≤24mm(79 cases, 79 eyes)and the group with axial length >24mm(53 cases, 53 eyes). Compare the best corrected distance visual acuity(BCDVA), corneal astigmatism, and TIOL rotation between the two groups of patients at 3mo after surgery.RESULT: After 3mo of surgery, both groups of patients had improved BCDVA and significantly decreased corneal astigmatism compared to those before surgery(P<0.001). However, there was no difference in BCDVA and corneal astigmatism between the two groups(P>0.05), and there was no significant difference in TIOL rotation between the two groups [(5.24±3.72)° vs.(6.36±4.21)°, P=0.110].CONCLUSION: There is no significant difference in visual recovery, corneal astigmatism, and TIOL rotational stability after TIOL implantation in cataract patients with different axial lengths.
ABSTRACT
ObjectiveTo explore the effect of nutrition combined with exercise intervention on stroke patients with sarcopenia. MethodsFrom January to June, 2022, 60 stroke patients with sarcopenia were randomly divided into control group (n = 15), nutrition group (n = 15), exercise group (n = 15) and combined group (n = 15). All the groups received routine rehabilitation training, while the nutrition group received nutrition intervention, the exercise group received exercise intervention, and the combined group received both the nutrition and exercise intervention, for four weeks. Before and after intervention, the muscle index was measured with bioelectrical impedance analysis, gripping strength of the healthy and the affected side was measured with gripping strength meter, and the patients were assessed with modified Barthel Index (MBI) and Berg Balance Scale (BBS). ResultsFour cases in the control group, two in the nutrition group, one in the exercise group, and three in the combined group dropped down. The muscle index, gripping strength, and the scores of MBI and BBS improved in all the groups after intervention (|t| > 3.004, P < 0.05), while all improved more in the combined group than in the other three groups (P < 0.05), and the grip strength of the healthy side was more in the exercise group than in the nutrition group (P < 0.05). ConclusionNutrition or exercise intervention alone can improve the muscle quality, grip strength, activities of daily living and balance of stroke patients with sarcopenia, while the combination is more effective.
ABSTRACT
AIM:To explore the use of attention mechanism and Pix2Pix generative adversarial network to predict the postoperative corneal topography of age-related cataract patients undergone femtosecond laser arcuate keratotomy.METHODS:In this retrospective case series study, the 210 preoperative and postoperative corneal topographies from 87 age-related cataract patients(105 eyes)undergoing femtosecond laser arcuate keratotomy at Shanxi Eye Hospital between March 2018 and March 2020 were selected and divided into a training set(180)and a test set(30)for model training and testing. The peak signal-to-noise ratio(PSNR), structural similarity(SSIM)and Alpins astigmatism vector analysis were used to compare the accuracy of postoperative corneal topography prediction under different attention mechanisms.RESULTS:The model based on attention mechanism and Pix2Pix network can predict postoperative corneal topography, among which the model based on Self-Attention mechanism has the best prediction effect, with PSNR and SSIM reaching 16.048 and 0.7661, respectively. There were no statistically significant differences in the difference vector, difference vector axis position, surgically induced astigmatism, and correction index between real and generated corneal topography on the 3mm and 5mm rings(all P>0.05).CONCLUSION:Based on the Self-Attention mechanism and Pix2Pix network, the postoperative corneal topography can be well predicted, which can provide reference for the surgical planning and postoperative effects of ophthalmic clinicians.
ABSTRACT
Objective To analyze the growth and development status of children with severe β-thalassemia major (β-TM) in Bazhong area and its correlation with hemoglobin concentration (HGB) and serum ferritin (SF) level, and to provide a theoretical basis for the diagnosis and treatment of children with β-TM in Bazhong area. Methods A total of 292 children with β-TM admitted to Bazhong Central Hospital from January 2019 to December 2020 were selected. The Z-score method was used to evaluate the growth and development of the children. According to the growth and development of the children, they were divided into the normal group (normal growth and development, n=163) and delayed group (growth and development delay, n=129). Another 60 healthy children were selected as the control group. The levels of HGB, serum SF, free triiodothyronine (FT3), free tetraiodothyroxine (FT4), and thyroid stimulating hormone (TSH) were compared among the three groups of children, and clinical data such as age, sex and age of onset were collected from the case system. Univariate analysis and logistic regression were used to analyze the independent risk factors of growth and development delay in β-TM children. Pearson correlation was used to analyze the correlation between growth retardation and HGB and serum SF levels in β-TM children. Results The serum SF and TSH levels in the delayed group were significantly higher than those in the normal group and the control group, while the levels of HGB and serum FT4 were significantly lower than those in the normal group and control group (P2000 ng/mL were risk factors for growth retardation in β-TM children (P2000 ng/mL, the height, weight, and HGB and serum SF levels should be monitored regularly.
ABSTRACT
ObjectiveTo investigate the diagnosis and treatment of familial hypokalemic periodic paralysis with acidosis. MethodsThe proband's medical history， clinical manifestations， laboratory examinations and imaging characteristics were retrospectively analyzed， and prevalence situation of family members was investigated in detail. Next generation sequencing technology was used to detect the pathogenic gene loci related to periodic paralysis， and the relevant literatures were summarized. ResultsThe proband was definitely diagnosed as familial hypokalemic periodic paralysis. There was a heterozygous mutation in the SCN4A gene of the proband， which was c.2006G>A， resulting in amino acid changes R669H.The proband's grandfather， father and uncle shared the same variation. ConclusionsFamilial hypokalemic periodic paralysis with paroxysmal acidosis is rare， which is easily misdiagnosed as renal tubular acidosis. c 2006G>A mutation in SCN4A gene is the molecular basis of the disease in this family. The clinical phenotypes of different gene mutations are different， and gene screening is helpful for diagnosis and treatment.
ABSTRACT
In recent years, liver cancer stem cells (LCSC) have been considered one of the main causes of treatment failure and recurrence of hepatocellular carcinoma (HCC). Many studies have shown that LCSC are a small fraction of cells with the abilities of self-renewal, differentiation, and tumorigenesis in HCC tumor, which can initiate the onset of HCC and affect its proliferation, invasion, metastasis, recurrence, and drug resistance. Therapies based on tumor microenvironment (TME) have been developed recently, and a number of studies have found that targeting the relevant elements of TME has a higher therapeutic value than targeting tumor cells themselves. TME is the microenvironment for the growth of LCSC and HCC cells, and it interacts with LCSC and has a synergistic effect, thereby playing a positive role in the development and progression of HCC. This article introduces how various cellular components and non-cellular components in TME interact with LCSC to regulate the development and progression of the HCC. In addition, this article also describes the molecular targets, therapies, and drugs associated with the main components of TME and LCSCs, in order to seek safer and more effective targeted therapies for HCC.
ABSTRACT
Objective: To explore the method and effect of endoscopic assisted functional rhinoplasty for patients with deviated nose and deviated nasal septum, which achieve correction of nasal morphology and ventilation dysfunction. Methods: The clinical data of 226 patients with deviated nose and deviated nasal septum from June 2009 to February 2022 who were treated by endoscopic assisted functional rhinoplasty in the Affiliated Hospital of Qingdao University were analyzed retrospectively. There were 174 males and 52 females, with the age ranging from 7 to 67 years old. The effect was evaluated by subjective and objective evaluation methods. SPSS 27.0 software was used for statistical analysis. Results: All patients were followed up for 6 to 24 months, 174 cases were cured (174/226, 76.99%), 52 cases were effective (52/226, 23.01%), and the total effective rate was 100% (226/226). The difference between preoperative and postoperative facial appearance deviation was statistically significant ((6.84±2.25)mm vs (1.82±1.05)mm, t=38.94, P<0.001), and the nasal ventilation function of all patients was improved. Conclusions: Endoscopic assisted functional rhinoplasty for the patients with deviated nose combined with deviated nasal septum has the advantages of clear surgical field, fewer complications, and good result. It can achieve the purpose of simultaneous correction of nasal and ventilation dysfunction, which is recommended for popularizing in clinical application.
ABSTRACT
Objective:To compare the effects of pressure controlled ventilation (PCV) and volume controlled ventilation (VCV) on respiratory mechanics, hemodynamics and biochemical metabolism in patients undergoing laparoscopic colorectal cancer surgery.Methods:The clinical data of 78 patients underwent laparoscopic colorectal cancer surgery from August 2019 to June 2020 in Inner Mongolia People′s Hospital were retrospectively analyzed. Among them, 39 patients were treated with PCV (PCV group), and 39 were treated with VCV (VCV group). The respiratory mechanics, hemodynamics and biochemical metabolism indexes 10 min after anesthesia induction (T 1), 10 min after pneumoperitoneum + low head and foot height (T 2), 60 min after pneumoperitoneum + low head and foot height (T 3) and 120 min after pneumoperitoneum + low head and foot height (T 4) were recorded. The respiratory mechanical indexes included mean airway pressure (P mean), airway peak pressure (P peak), pressure of end tidal carbon dioxide (P ETCO 2) and dynamic lung compliance (C Ldyn); hemodynamic indexes included mean arterial pressure (MAP) and heart rate; and biochemical metabolic indexes included base excess, serum natrium, serum potassium, negative logarithm of the hydrogen ion concentration (pH) and blood glucose. Results:The P mean, P peak and P ETCO 2 T 1 to T 4 in PCV group were significantly lower than those in VCV group, P mean: (7.12 ± 1.37) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (8.54 ± 1.84) cmH 2O, (9.80 ± 2.26) cmH 2O vs. (11.63 ± 2.87) cmH 2O, (9.51 ± 2.17) cmH 2O vs. (11.72 ± 2.90) cmH 2O, (7.04 ± 1.34) cmH 2O vs. (8.65 ± 1.88) cmH 2O; P peak: (13.41 ± 2.68) cmH 2O vs. (15.06 ± 3.05) cmH 2O, (20.92 ± 3.11) cmH 2O vs. (23.45 ± 4.02) cmH 2O, (21.14 ± 3.50) cmH 2O vs. (23.69 ± 4.26) cmH 2O, (15.03 ± 2.74) cmH 2O vs. (16.45 ± 3.21) cmH 2O; P ETCO 2: (30.59 ± 1.57) mmHg (1 mmHg = 0.133 kPa) vs. (32.04 ± 2.11) mmHg, (35.02 ± 4.15) mmHg vs. (39.88 ± 4.76) mmHg, (35.90 ± 4.22) mmHg vs. (40.11 ± 4.87) mmHg, (34.33 ± 4.17) mmHg vs. (37.65 ± 2.69) mmHg; the C Ldyn was significantly higher than that in VCV group: (40.68 ± 3.98) ml/cmH 2O vs. (35.47 ± 2.56) ml/cmH 2O, (30.25 ± 3.21) ml/cmH 2O vs. (22.40 ± 2.75) ml/cmH 2O, (29.78 ± 3.06) ml/cmH 2O vs. (22.60 ± 2.81) ml/cmH 2O, (40.32 ± 4.25) ml/cmH 2O vs. (33.61 ± 2.81) ml/cmH 2O, and there were statistical differences ( P<0.01 or <0.05). The MAP and heart rate T 1 to T 4 in PCV group were significantly lower than those in VCV group, and there was statistical difference ( P<0.01 or <0.05). The base excess, serum natrium, serum potassium and pH T 1 to T 4 in PCV group were significantly higher than those in VCV group, while the blood glucose was significantly lower than that in VCV group, and there was statistical difference ( P<0.01 or <0.05). Conclusions:Compared with VCV, PCV can promote the recovery of respiratory mechanics index, stabilize hemodynamics and improve biochemical metabolism index in patients undergoing laparoscopic colorectal cancer surgery.
ABSTRACT
Objective:To analyze and compare the corneal higher order aberration (HOA) after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE).Methods:A non-randomized controlled study was conducted.Sixty myopic patients (60 eyes) who underwent FS-LASIK or SMILE correction at Shandong Eye Hospital from April 2018 to January 2020 were enrolled and the data from the right eye were collected for analysis.Thirty cases (30 eyes) who received FS-LASIK in FS-LASIK group and 30 cases (30 eyes) who received SMILE in SMILE group had a preoperative equivalent spherical diopter of (-5.36±1.11)D and (-4.93±1.03)D, respectively.The HOA of the 6-mm anterior surface, posterior surface, and whole cornea were measured before surgery and at 1, 3, 6, and 12 months after surgery using Pentacam.The root mean square values (μm) of total corneal HOA, spherical aberration, coma and trefoil were obtained.Differences in the above root mean square values at different time points were compared between the two groups.The study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Shandong Eye Hospital (No.SDSYKYY20180306). Written informed consent was obtained from each subject.Results:The preoperative and 1-, 3-, 6-, 12-month postoperative total HOA of the anterior corneal surface were (0.428±0.126), (0.775±0.169), (0.811±0.194), (0.759±0.214), (0.704±0.199)μm in the FS-LASIK group and (0.409±0.094), (0.656±0.148), (0.681±0.161), (0.668±0.175), (0.648±0.160)μm in the SMILE group, with a significant overall difference ( Fgroup=5.652, P=0.024; Ftime=107.169, P<0.01). Compared with SMILE group, the postoperative total HOA of anterior corneal surface and spherical aberration at different time points were increased in FS-LASIK group, showing statistically significant differences (all at P<0.05). Compared with before surgery, the postoperative total HOA of the anterior corneal surface and spherical aberration at different time points were increased in both groups, showing statistically significant differences (all at P<0.05). In the two groups, the 6- and 12-month postoperative total HOA of the anterior corneal surface were reduced in comparison with the 3-month postoperative ones of the anterior corneal surface, and the 12-month postoperative spherical aberrations of the anterior corneal surface were significantly reduced in comparison with the 1- and 3-month postoperative ones of the anterior corneal surface, showing statistically significant differences (all at P<0.05). There were significant differences in the coma and trefoil of the anterior corneal surface between before and after the operation (coma: Ftime=47.848, P<0.01; trefoil: Ftime=2.497, P=0.046). Compared with before surgery, the postoperative coma was significantly increased in the two groups (all at P<0.05). There were significant differences in total corneal HOA and spherical aberration at different postoperative time points between the two groups (total HOA: Fgroup=8.093, P=0.008; Ftime=125.019, P<0.01.spherical aberration: Fgroup=4.771, P=0.037; Ftime=34.033, P<0.01). Compared with SMILE group, the total corneal HOA and spherical aberration were significantly increased in FS-LASIK group at different postoperative time points (all at P<0.05). Compared with before surgery, postoperative total HOA of the anterior corneal surface and spherical aberration at different postoperative time points were significantly increased in both groups (all at P<0.05). In both groups, the 12-month postoperative corneal spherical aberration was significantly reduced in comparison with the 1- and 3-month postoperative ones (all at P<0.05). There was a significant difference in coma between before and after surgery ( Ftime=30.829, P<0.01). Compared with before surgery, the postoperative coma was significantly increased at different time points in both groups (all at P<0.05). Conclusions:Both FS-LASIK and SMILE increase the HOA of the anterior corneal surface and the whole cornea.Compared with FS-LASIK, SMILE introduces less HOA of the anterior corneal surface and the whole cornea as well as spherical aberrations.
ABSTRACT
Objective:To observe the clinical effect of modified Shishi Niubangzi Decoction combined with strengthening muscle-waist exercise on lumbar disc herniation (LDH).Methods:Randomized controlled trial. A total of 60 patients with LDH admitted to the Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, were enrolled as the research objects between September 2020 and September 2021. According to the random number table, they were randomly divided into the treatment group and control group, 30 in each group. Both groups were given routine basic treatments (strengthening tendons-waist exercise and three-position six-step manipulation). On this basis, the treatment group was treated with modified Shishi Niubangzi Decoction, while the control group was treated with non-steroidal anti-inflammatory drugs (ibuprofen codeine sustained-release tablets). Both groups were treated for 4 weeks. The responsive rates, back pain intensity, leg pain and numbness by Visual Analogue Scale (VAS) and lumbar function by Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) were compared between the two groups.Results:The response rate of treatment group was significantly higher than that of control group (93.3% vs. 73.3%; χ2=4.32, P=0.038). After treatment, scores of JOA (subjective symptoms, signs, activities of daily living) in the treatment group were significantly higher than those in the control group ( t=3.86, 2.71, 2.21, P<0.05). After treatment, scores of back pain (2.12±0.21 vs. 3.02±0.32, t=12.88), leg pain (2.04±0.64 vs. 2.64±0.66, t=3.58), lower limb numbness (1.75±0.24 vs. 2.41±0.70, t=4.89) in the treatment group were significantly lower than those in the control group ( P<0.01). At 1 week and 1 month after treatment, ODI scores in treatment group were significantly lower than those in control group ( t=10.22, 5.59; P<0.05). Conclusion:The modified Shishi Niubangzi Decoction combined with strengthening tendons-waist exercise can improve responsive rates, improve lumbar pain and function in LDH patients.
ABSTRACT
Objective To investigated the effect of stenosis characteristics (vascular elasticity and plaque properties) on myocardial ischemia. Methods An ideal geometric multi-scale coronary stenosis model based on fluid-structure interaction was established, and the fractional flow reserve (FFR) was simulated to evaluate myocardial ischemia. The effects of vascular elastic wall (elastic modulus of 1 MPa) and rigid wall, plaque types (lipid-rich plaque and calcified plaque) and plaque volume on myocardial ischemia were considered separately. Results The FFRCT simulation result of vessels with elastic wall was larger than that with rigid wall under all stenosis situations. The FFRCT of vessels in lipid-rich lesions was higher than that of calcified plaque (P=0.001). The trapezoidal plaque volume was larger than the cosine plaque volume, and the FFRCT of vessels in trapezoidal plaque was smaller than that of cosine plaque (P=0.001). Conclusions Vascular elasticity is a critical factor to simulate vascular hemodynamics. In moderate stenosis, calcified plaques are more likely to induce myocardial ischemia due to the larger luminal deformation and dilation of rich lipid plaque. When the stenosis is constant, the smaller the plaque volume, the higher the FFRCT and the smaller the possibility of myocardial ischemia.