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Panax notoginseng is an ancient Chinese medicinal plant that has great clinical value in regulating cardiovascular disease in China. As a single component of panax notoginosides, notoginsenoside R1 (NGR1) belongs to the panaxatriol group. Many reports have demonstrated that NGR1 exerts multiple pharmacological effects in ischemic stroke, myocardial infarction, acute renal injury, and intestinal injury. Here, we outline the available reports on the pharmacological effects of NGR1 in ischemia-reperfusion (I/R) injury. We also discuss the chemistry, composition and molecular mechanism underlying the anti-I/R injury effects of NGR1. NGR1 had significant effects on reducing cerebral infarct size and neurological deficits in cerebral I/R injury, ameliorating the impaired mitochondrial morphology in myocardial I/R injury, decreasing kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in renal I/R injury and attenuating jejunal mucosal epithelium injury in intestinal I/R injury. The various organ anti-I/R injury effects of NGR1 are mainly through the suppression of oxidative stress, apoptosis, inflammation, endoplasmic reticulum stress and promotion of angiogenesis and neurogenesis. These findings provide a reference basis for future research of NGR1 on I/R injury.
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Humans , Reperfusion Injury/prevention & control , Inflammation , China , ApoptosisABSTRACT
Objective:To compare 3D-printing-assisted surgery and conventional surgery in the treatment of Schazker type Ⅵ tibial plateau fractures.Methods:A retrospective study was conducted to analyze the clinical data of 50 patients with type Ⅵ tibial plateau fracture who had been treated from January 2019 to December 2021 at the 5 Departments of Orthopedics in The First Affiliated Hospital of Nanchang University, The First People's Hospital of Jiujiang, Pingkuang General Hospital, Ganzhou People's Hospital, and Nanchang Hongdu Hospital of Traditional Chinese Medicine. The patients were divided into 2 groups according to their different treatment methods. In the 3D printing group of 25 cases treated by 3D-printing-assisted surgery, there were 14 males and 11 females, with an age of (42.5±9.1) years; in the conventional group of 25 cases treated by conventional surgery, there were 13 males and 12 females with an age of (42.2±9.3) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, fracture healing time, postoperative complications, the Rasmussen radiological scores and the American Hospital for Special Surgery (HSS) knee function scores at 6 and 12 months after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The operation time [(125.4±10.6) min], intraoperative blood loss [(206.2±16.3) mL], intraoperative fluoroscopy frequency [(9.2±2.7) times] and fracture healing time [(3.0±0.7) months] in the 3D printing group were all significantly less than those in the conventional group [(168.2±14.1) min, (303.2±20.4) mL, (15.5±3.5) times and (4.1±0.8) months] while the Rasmussen radiological scores (17.6±1.2 and 17.9±0.6) and HSS knee scores (90.8±6.4 and 91.5±5.6) at 6 and 12 months after operation in the 3D printing group were all significantly higher than those in the conventional group (16.2±2.6 and 16.7±2.2; 84.5±9.2 and 87.6±8.0) (all P<0.05). In the 3D printing group, there were 1 case of wound infection and 1 case of wound dehiscence after operation. In the conventional group, there were 2 cases of wound skin necrosis, 3 cases of wound dehiscence, 1 case of traumatic arthritis, 2 cases of wound infection, and 1 case of screw loosening. The incidence of complications in the 3D printing group (8.0%, 2/28) was significantly lower than that in the conventional group (36.0%, 9/25) ( P<0.05). Conclusion:In the treatment of Schatzker type VI tibial plateau fractures, compared with conventional surgery, 3D-printing-assisted surgery can lead to better curative outcomes, because it is conducive to lowering surgical difficulty, reducing postoperative complications, and promoting fracture union and functional recovery of the knee.
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Objective:To observe the clinical efficacy of Qufeng Juanyin Decoction on bronchial asthma in children （syndrome of wind phlegm blocking lung） during the stage of attack， and the regulatory effect on T helper cell 17 （Th17）/regulatory T cell （Treg） and related factors. Method:One hundred and thirty patients were randomly divided into observation group （65 cases） and control group （65 cases） by random number table. In control group， 61 cases completed the treatment， including 1 fell off or lost visit， 3 was eliminated because of breach of protocol. And in observation group， 63 patients completed the treatment， including 2 cases fell off or lost visit. Both of the groups got Budesonide suspension by atomizer， 1 mg/time， 2 times/day， and severe children were added with Terbutaline Sulfate Aerosol every morning and evening， 2 sprays/time. Patients in control group got Suhuang Zhike capsules， 2 grains/time， 3 times/day. Patients in observation group got Qufeng Juanyin Decoction， 1 dose/day. The course of treatment lasted for 7 days. Onset and mitigation times of asthma were recorded. And before and after treatment， pulmonary function was evaluated， and daily variation rate of peak expiratory flow （PEF）， first second expiratory flow as a percentage of expected （FEV<sub>1</sub>%） and ratio of first second forced expiratory volume （FEV<sub>1</sub>） and forced vital capacity （FVC） were recorded， and scores of syndrome of wind phlegm blocking lung and exhaled nitric oxide were detected. At the first week after the treatment， asthma control test in children （C-ACT） was made. Levels of Th17 cells， Treg cells， interleukin-17 （IL-17）， IL-6， IL-10， IL-22 and IL-35 were also detected. And the safety was evaluated. Result:Onset and mitigation times of asthma in observation group were shorter those in control group （<italic>P</italic><0.01）. The daily variation rate of PEF in observation group was lower than that in control group （<italic>P</italic><0.01）， while levels of FEV<sub>1</sub>% and FEV<sub>1</sub>/FVC were higher than those in control group （<italic>P</italic><0.01）. Asthma control in observation group was better than that in control group （<italic>Z</italic>=2.106， <italic>P</italic><0.05）. FeNO and score of syndrome of wind phlegm blocking lung were lower than those in control group （<italic>P</italic><0.01）. Levels of Th17， Th17/Treg， IL-17， IL-6 and IL-22 were lower than those in control group （<italic>P</italic><0.01）， whereas levels of proportion of Treg cells， IL-10 and IL-35 were higher than those in control group （<italic>P</italic><0.01）. The total effective rate in observation group was 96.83% （61/63）， which was better than 85.25% （52/61） in control group （<italic>χ</italic><sup>2</sup>=5.141， <italic>P</italic><0.05）. And the total effective rate of traditional Chinese medicine （TCM） syndrome was 98.41% （62/63）， which was better than 86.89% （53/61） in control group （<italic>χ</italic><sup>2</sup>=4.525， <italic>P</italic><0.05）. And there was no adverse reaction caused by Qufeng Juanyin Decoction. Conclusion:Qufeng Juanyin Decoction can shorten the course of disease， improve the lung function， regulate the expressions of Th17/Treg cells and related factors， promote the immune balance of Th17 / Treg， reduce airway inflammation and airway hyperresponsiveness， and effectively control the attack of asthma， with a good clinical efficacy and safety on bronchial asthma in children （syndrome of wind phlegm blocking lung） during the stage of attack.
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@#Innate immunity plays an important role in viral keratitis. Recently, it has been found that surfactant proteins(SP)A and D in the innate immune system are essential in viral keratitis. SP can inhibit virus adhesion to host cells and further promote phagocytosis of virus through high affinity for virus ligands. In order to ensure the normal function of tissues in the early stage of virus infection, SP regulates immune cells to maintain a non-inflammatory state. However, when pathogen invasion increases, SP promoted inflammation and increased the immune cells to kill the pathogens. SP-A and SP-D could be expressed in cornea, conjunctiva. To play the role of anti-adenovirus, herpes simplex virus, cytomegalovirus and other major eye pathogenic viruses, SP-A and SP-D combine with the virus to prevent entry into cells, promote phagocytosis, and directly kill the virus. SP-A and SP-D may be used as clinical diagnostic tools for viral infection. In the future, recombinant SP is expected to be used as an important means for the treatment of viral keratitis. Here, we review the innate immune function of SP-A and SP-D in ocular viral infection.
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Objective:To investigate the neutrophil to lymphocyte ratio (NLR) and clinical manifestations, imaging manifestations and plasma D-dimer in cerebral venous sinus thrombosis (CVST) patients with headache as the first symptom.Methods:CVST inpatients with headache as the first symptom admitted to the First Affiliated Hospital of Nanjing Medical University from January 2012 to December 2019 were enrolled retrospectively as case group. In the same period, patients with similar headache symptoms and healthy subjects were included consecutively as control group. The differences of demographic data, biochemical indexes, blood routine indexes and plasma D-dimer were compared among the three groups. Multivariate logistic regression analysis was used to identify the independent correlation between NLR and plasma D-dimer and CVST with headache as the first symptom. According to the median NLR, patients with CVST were divided into low NLR group and high NLR group, and the differences in clinical manifestations, imaging manifestations and plasma D-dimer were compared between the two groups. Multiple linear regression analysis was used to determine the independent correlation between the reciprocal of NLR and plasma D-dimer and clinical features. Results:A total of 51 CVST inpatients with headache as the first symptom, 54 headache controls and 53 healthy controls were included in the study. There were significant differences in triglyceride ( P=0.002), fasting blood glucose ( P=0.044), serum albumin ( P=0.013), uric acid ( P=0.010), plasma D-dimer ( P<0.001), proportion of D-dimer negative patients ( P<0.001), mean corpuscular volume ( P=0.015), white blood cell count ( P<0.001), neutrophil count ( P<0.001), lymphocyte count ( P=0.005), monocyte count ( P=0.004), mean platelet volume ( P=0.010), platelet distribution width ( P=0.029), NLR ( P<0.001) and lymphocyte to monocyte ratio ( P<0.001) among the three groups. Post-hoc analysis showed that plasma D-dimer and NLR in the case group were significantly higher than those in the two control groups (all P<0.001). Multivariate logistic regression analysis with the headache control group and the healthy control group as references showed that NLR and plasma D-dimer were significantly and independently correlated with CVST with headache as the first symptom (all P<0.05). According to the median NLR (4.817 6), the case group was divided into low NLR group and high NLR group. The comparison showed that the onset time ( P=0.041), the proportion of patients with headache as the only symptom ( P=0.016) and the proportion of plasma D-dimer negative patients ( P=0.002) in the low NLR group were significantly higher than those of the high NLR group, and the proportion of patients with headache complicated with disturbance of consciousness ( P=0.032), plasma D-dimer ( P<0.001) and fasting blood glucose ( P<0.001) were significantly lower than those in the high NLR group. With the reciprocal of NLR as the dependent variable, multiple linear regression analysis showed that the reciprocal of NLR was independently negatively correlated with plasma D-dimer ( R=-0.521, P<0.001), and independently positively correlated with headache as the only symptom ( R=0.280, P=0.049). Conclusions:NLR was significantly increased in CVST patients with headache as the first symptom. It might help early diagnosis and clinical feature prediction of CVST patients.
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Objective:To investigate the correlation between serum uric acid level and heart rate variability (HRV) in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to the Department of Neurology, the First Affiliated Hospital of Nanjing Medical University from July 2017 to July 2019 were enrolled retrospectively. They were divided into 4 groups (Q1, Q2, Q3, and Q4) according to the sex-specific serum uric acid quartiles. The demographic data, baseline clinical data, laboratory indicators and HRV recorded by 24-h dynamic electrocardiogram in each group were compared. The independent correlation between HRV time domain parameters RR (normal-to-normal, NN) interval standard deviation (standard deviation of the NN intervals, SDNN), RR interval mean standard deviation (standard deviation of the average NN intervals, SDANN) and serum uric acid level was analyzed through multiple linear regression model.Results:A total of 141 patients were enrolled in the study, including 100 males (70.92%), aged 61.55±12.92 years. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 2 (interquartile range: 1-4), and the serum uric acid level was 302.87±73.48 μmol/L. There were significant differences in the NIHSS score ( P<0.034), the proportion of patients with hypertension ( P=0.015), the estimated glomerular filtration rate ( P<0.001), and the HRV time domain parameters (all P<0.001) between each quartile group. The proportion of patients with low HRV (SDNN <100 ms) in the lowest serum uric acid level quartile group was significantly higher than that in other quartile groups ( P<0.05). Multiple linear regression analysis showed that serum uric acid levels were significantly and positively correlated with SDNN (standardized β=0.321, P<0.001) and SDANN (standardized β=0.266, P=0.001). Conclusions:The low level of serum uric acid in patients with acute ischemic stroke indicates that HRV is low, which may suggest that the mechanism of oxidative stress is involved in the decrease of HRV in patients with acute ischemic stroke.
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Objective: To investigate the effect of miR-125b on the ventricular remodeling after myocardial infarction in the rats via phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, and to elucidate its mechanism. Methods: A total of 75 rats were divided into sham operation group, myocardial infarction group and miR-125b inhibitor group, with 25 rats in each group. The acute myocardial infarction models were established in the rats in myocardial infarction group and miR-125b inhibitor group. The rats in miR-125b inhibitor group was injected with miR-125b inhibitor via the tail vein. The rats were sacrificed 4 weeks later, the body weig hts were recorded; the hearts were obtained, and the big vessel and left and right auricular appendix were cut out; the heart weights were weighed. The heart weight/body weight (HW/BW), (left ventricle + ventricular septum) weight/body weight (LV+S)/BW, (left ventricular + ventricular septum) weight/heart weight (LV+S)/HW were calculated. HE staining was used to observe the morphological changes of myocardium tissue. Masson staining was used to observe the myocardial fibrosis, and the collagen volume integral of myocardium was calculated. Immunofluorescence staining was used to observe the expression levels of type I collagen and type III collagen proteins in the myocardium tissue of the rats. Western blotting method was used to detect the expression levels of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), PI3K, Akt and phosphorylated Akt (p-Akt) in the peripheral region of myocardial infarction of the rats. Results: The HE staining results showed that the myocardial cells in sham operation group were arranged neatly; the myocardial cells in myocardial infaction group had hypertrophy and disordered arrangement; the myocardial cells in miR-125b inhibitor group were arranged neatly. Compared with sham operation group, the HW/BW, (LV + S)/BW and (LV + S)/HW of the rats in myocardial infarction group were elevated (P<0.05), the collagen volume integral was increased (P<0.05), the protein expression levels of type I collagen and type III collagen were increased (P<0.05), the expression levels ANP and BNP proteins were increased (P<0.05), and the expression levels of PI3K and p-Akt proteins were decreased (P<0.05). Compared with myocardial infarction group, the HW/BW, (LV+S)/BW and (LV+S)/HW of the rats in miR-125 b inhibitor group were decreased (P<0.05), the collagen volume integral was decreased (P<0.05), the expression levels of type I collagen and type III collagen proteins were decreased (P<0.05), the expression levels of ANP and BNP proteins were decreased (P<0.05), and the expression levels of PI3K and p-Akt proteins were increased (P<0.05). Conclusion: Inhibition of miR-125b can inhibit ventricular remodeling after myocardial infarction in the rats by inhibiting the PI3K/Akt signaling pathway, and plays an important role in reversing ventricular remodeling after myocardial infarction.
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<p><b>PURPOSE</b>To investigate the effects of estrogen G protein-coupled receptor 30 (GPR30) agonist G1 on hippocampal neuronal apoptosis and microglial polarization in rat traumatic brain injury (TBI).</p><p><b>METHODS</b>Male SD rats were randomly divided into sham group, TBI + vehicle group, TBI + G1 group. Experimental moderate TBI was induced using Feeney's weigh-drop method. G1 (100μg/kg) or vehicle was intravenously injected from femoral vein at 30 min post-injury. Rats were sacrificed at 24 h after injury for detection of neuronal apoptosis and microglia polarization. Neuronal apoptosis was assayed by immunofluorescent staining of active caspase-3. M1 type microglia markers (iNOS and IL-1β) and M2 type markers (Arg1 and IL-4) were examined by immunoblotting or ELISA. Total protein level of Akt and phosphorylated Akt were assayed by immunoblotting.</p><p><b>RESULTS</b>G1 significantly reduced active caspase-3 positive neurons in hippocampus. Meanwhile G1 increased the ratio of Arg1/iNOS. IL-1β production was decreased but IL-4 was increased after G1 treatment. G1 treatment also increased the active form of Akt.</p><p><b>CONCLUSIONS</b>GPR30 agonist G1 inhibited neuronal apoptosis and favored microglia polarization to M2 type.</p>
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Animals , Male , Rats , Apoptosis , Brain Injuries, Traumatic , Drug Therapy , Pathology , Cell Polarity , Hippocampus , Interleukin-1beta , Microglia , Neurons , Proto-Oncogene Proteins c-akt , Metabolism , Rats, Sprague-Dawley , Receptors, G-Protein-CoupledABSTRACT
Objective To investigate the value of ADC histogram of tumor volume measurement in the diagnosis of prostate cancer,and to screen out the best diagnostic parameter value.Methods 31 cases of prostate cancer and 35 cases of benign prostatic hyperplasia confirmed by biopsy or surgical pathology were analyzed retrospectively.DWI examination was performed on all patients before treatment,and b value of 0 and 1500 s/mm2 was selected.The total tumor ADC histogram parameters were measured respectively,including the average value of ADC (ADCmean ),the median ADC (ADCmedian ),the tenth percentile ADC (ADC10th),the twenty-fifth percentile ADC (ADC25th), the fiftieth percentile ADC (ADC50th),the seventy-fifth percentile ADC (ADC75th),the ninetieth percentile ADC (ADC90th), skewness and kurtosis.The histogram parameters of the two groups of patinents and their diagnostic efficacy were analyzed and compared.Results ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th in the prostate cancer group were statistically lower than those of benign prostatic hyperplasia group (P <0.01),and there was no significant difference in the skewness and kurtosis between the two groups of diseases (P > 0.05 ).ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th diagnosing prostate cancer in the area under ROC curves (AUC)were more than 0.78.ADC10th had the best diagnostic efficacy and its AUC was 0.82, with the optimal cut-off value for 0.27 × 10 -3 mm2/s,with sensitivity and specificity for 78.4％ and 83.3％.Conclusion The ADC histogram of the total tumor volume measurement is of great value in the diagnosis of prostate cancer,among which ADC10th is the most effective parameter.It can accurately distinguish between prostate cancer and prostatic hyperplasia nodules.
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Objective To explore the significance of day surgery mode on cataract patients for achieving win-win among patient, hospital and medical insurance.Methods 120 cataract patients (selected from December 2015 to June 2016, in the Ophthalmic Center of Leshan People′s hospital) were included in this retrospective study and day surgery group (n=60) was observation group and hospitalization surgery group was control one (n=60).All cases underwent cataract phacoemulsification and intraocular lens implantation.Treatment process, average day on the waiting list, average preoperative stay, average length of stay, medical cost and patient satisfaction were compared between the two groups.Results Days on the waiting list in day surgery group (1.2 d) reduced 8 days than in hospitalization surgery group (9.2 d).Preoperative stay in day surgery group reduced 1.5 days than in hospitalization surgery group.Length of stay ware reduced by 3 days as compared to the control group.The average medical cost in day surgery group was much less than the control group and the patient satisfaction was much higher.Conclusion The high efficiency of day surgery mode can shorten the length of hospital stay, lessen the cost of medical expense, realize the security management of medical service, so as to provide more convenience, more safety, better quality and cheaper medical service for patients.It achieves social and economic benefits and finally achieves win-win among patient, hospital and medical insurance.
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Objective To investigate CT and MRI features of dermatofibrosarcoma protuberans (DFSP).Methods Totally 16 patients with DFSP confirmed by pathology were enrolled.Tumor morphology,CT and MRI imaging appearance (11 cases underwent plain and enhanced CT,5 cases underwent plain and enhanced MRI) were analyzed retrospectively.Results DFSP usually occurred in the skin of truck,head and neck,protruding from the skin surface in different extent.Some lesions even suspended out of the skin.The lesions were divided into nodular type (n=12) and diffuse type (n=4) according to their morphological appearance.The tumors usually demonstrated as iso-density or slightly low density solid mass compared to muscle on CT.On MRI,it usually demonstrated as low signal on T1WI and high signal on T2WI.Tumor blood supply was rich,and it usually showed progressively moderate to strong enhancement.The signs within DFSP include hanging sign (n=2),skin tail sign (n＝6),fascia tail sign (n=l),fat tail sign (n=4).Conclusion DFSP can be characterized by nodular or diffuse lesions,the manifestations of different form are slightly different,but still have a certain characteristic.
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Objective To investigate the value of ADC histogram of tumor volume measurement in the diagnosis of prostate cancer,and to screen out the best diagnostic parameter value.Methods 31 cases of prostate cancer and 35 cases of benign prostatic hyperplasia confirmed by biopsy or surgical pathology were analyzed retrospectively.DWI examination was performed on all patients before treatment,and b value of 0 and 1500 s/mm2 was selected.The total tumor ADC histogram parameters were measured respectively,including the average value of ADC (ADCmean ),the median ADC (ADCmedian ),the tenth percentile ADC (ADC10th),the twenty-fifth percentile ADC (ADC25th), the fiftieth percentile ADC (ADC50th),the seventy-fifth percentile ADC (ADC75th),the ninetieth percentile ADC (ADC90th), skewness and kurtosis.The histogram parameters of the two groups of patinents and their diagnostic efficacy were analyzed and compared.Results ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th in the prostate cancer group were statistically lower than those of benign prostatic hyperplasia group (P <0.01),and there was no significant difference in the skewness and kurtosis between the two groups of diseases (P > 0.05 ).ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th diagnosing prostate cancer in the area under ROC curves (AUC)were more than 0.78.ADC10th had the best diagnostic efficacy and its AUC was 0.82, with the optimal cut-off value for 0.27 × 10 -3 mm2/s,with sensitivity and specificity for 78.4％ and 83.3％.Conclusion The ADC histogram of the total tumor volume measurement is of great value in the diagnosis of prostate cancer,among which ADC10th is the most effective parameter.It can accurately distinguish between prostate cancer and prostatic hyperplasia nodules.
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Purpose To evaluate the application value of using a-cyanoacrylate rapid medical glue in preoperative localization of ground-glass nodules under CT guidance.Materials and Methods 48 cases were retrospectively analyzed,in which the pulmonary ground-glass nodules took preoperative localization under CT guidance.The rapid medical glue was injected in pulmonary ground-glass nodules,which was used for preoperative localization.Results After preoperative localization of rapid medical glue in 48 cases,pulmonary ground-glass nodules of all patients were resected successfully by video-assisted thoracoscope surgery (VATS).The complications of pneumothorax did not occur in all cases,with little pulmonary hemorrhagein in 10 cases.Conclusion When the fast medical glue has been used in the CT-guided preoperative localization of ground-glass nodules,there are advantages of high accuracy of localization and surgery.Moreover,this method is simple,safe and effective.
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Objective To systemically evaluate the clinical therapeutic effect and safety of traditional Chinese medicine on Kawasaki disease. Methods Through retrieval of the reports in PubMed, the Cochrane Library, China National Knowledge Internet (CNKI), VIP database, Wanfang database by computer, the correlative articles of clinically randomized controlled trials (RCTs) published in China during the period from 1990 to 2013 were collected, and their quality evaluation was made. All the articles were screened according to inclusion and exclusion criteria, in which interventions were traditional Chinese medicine therapy and conventional western treatment. The articles selected were assessed with the software of RevMan 5.2. Results There were 212 articles searched out, but only 13 articles, 656 children with Kawasaki disease were conformed to the inclusion criteria. The Meta analysis indicated that the total effective rate in the traditional Chinese medicine group was superior to the group treated with western medicine. The difference in the curative effects between the two groups had notable significance [odds ratio (OR) = 3.58, 95%confidence interval (95%CI) was 2.16-5.93, test for overall effect Z=4.94, P<0.000 01]. No difference was seen in the curative effect of improving coronary artery changes between the traditional Chinese medicine group and western medicine control group (OR=2.03, 95%CI was 0.74-5.62, test for overall effect Z=1.37, P=0.17). Conclusion The clinical therapeutic effect of traditional Chinese medicine on Kawasaki disease is superior to that treated by western medicine.
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Keratoconus is a progressive, non - inflammatory corneal thinning disorder that produces a unique spectrum of change in the surface curvature of the cornea. The suspected factors associated with the cause of keratoconus include genetic mechanisms, familial associations, allergy, atopy and so on, but environmental factors, such as abnormal rubbing, contact lens wearing and ultraviolet radiation may be easily ignored. Although it is commonly thought that keratoconus is a result of various pathological progress mediated by multiple factors, those chronic trauma could play important roles in the pathological progress. The classic definition of keratoconus is still referred as a non - inflammation disorder with malnutrition of keratectasia, more and more clinical evidences and experimental results that may refute this concept. It may be due to the long-term persistent chronic trauma resulted from eye rubbing, contact lens or ultraviolet radiation. Under this conditions, the increased release of inflammatory mediators and matrix metalloproteinases may accelerate keratocyte apoposis and enzyme metabolism disorders, with the result of matrix cell lost, tensile strength decreased and keratectasia. Here, for some papers known about the relationship between chronic cornea trauma and keratoconus were reviewed and discussed its possible causal relationship.
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Objective To investigate the correlation between eigenvalues(λ∥ andλ⊥)of sciatic nerve and limb function in a rabbit model of acute nerve traction inj ury for finding the role ofλ∥ andλ⊥ on diagnosis of nerve inj uries.Methods The right sciatic nerves of 32 Newland rabbits were selected to be performed as traction injury,and then left sciatic nerves were treated as control for the sham operation side.MRI DTI scan was performed before and after the operation on 1 day ,3 day,and 1 week,2,3,4,6 and 8 weeks respectively.Theλ∥ andλ⊥ of inj ured sciatic nerves and sham operated nerves were measured,meanwhile functional exami-nations were evaluated,and then analyzing the correlation betweenλ⊥ of inj ured sciatic nerves and the score of inj ured limb function in the periods of 3 days to 8 weeks;finally different portions of sciatic nerve were removed for histological examinations.Results Theλ⊥ of inj ured sciatic nerves in the proximal portion was slightly increased at 3 days and recovered to the normal at 2 weeks.Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were slightly raised at 1 day,reached to its maximum value at 3 days,and then decreased gradually after 1 week and dropped to the pre-operation level after 4 weeks.Theλ⊥ of inj ured sciatic nerves in the proximal portions was significantly higher than that of the sham-operated nerves from 1 day to 1 week(F=7.275,P=0.000). Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were significantly higher than that of the sham-operated nerves from 1 day to 3 weeks(F=5.851,F=3.794,P=0.001,P=0.000).However,there was no significantly difference between theλ∥ of inj ured nerves in each portion and sham-operated nerves .The negative correlation between theλ⊥ of inj ured sciatic nerves in the distal portion and the score of the nerve function in the injured limb was found (r=-0.938,r=-0.897,P<0.01).Conclu-sion Theλ⊥ of inj ured nerves in the traction portion and distal portion could monitor the process of degeneration and regeneration of sciatic nerve in traction inj ury,while theλ∥ plays no obvious role in diagnosis of nerve inj uries.
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Objective To make sciatic nerve traction injury models of rabbit , in order to prospectively evaluate possibility and accuracy of diffusion tensor tracking (DTT) in sciatic nerve injures. Methods The right sciatic nerves of 32 New Zealand white rabbits were selected for traction injury , and the left sciatic nerves were the sham operation side. DTI scan was performed before and after the operation on 1st day , 3rd day, and 1 week, 2, 3, 4, 6 and 8th week respectively, and DTT was reconstructed. Then the length of reconstructed fiber tracts and fiber density index were calculated. After the MRI scan , the sciatic nerve was removed to perform pathologic examination at different time points. Results The difference of the length of reconstructed fiber tracts between nerve traction injury and sham operation side was significant at 1 day~2weeks after operation (P<0.05), while the difference was not significant at 3~8 weeks.The fiber density index of nerve traction injury and sham operation side was significantly different at 1 day~8 weeks(P<0.05). 1day after operation, myelin sheath of traction portion was obviously twisting. 3 days after operation , a large amount of myelin sheath broke down. 2 weeks after operation , axon, myelin sheath degeneration and regeneration coexisted at the same time. 8 weeks after operation , nerve fibers regenerated and restored to normal structure. Conclusion The length time curve and density index-time curve of nerve traction injury are consistent with the changes of pathology , which can be used as a supplementary method to evaluate the degeneration and regeneration in nerve injury.
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Objective To investigate the clinical and electroencephalogram (EEG) features of patients with idiopathic generalized epilepsy in adults with phantom absences.Methods Six patients were referred to the clinic of epilepsy from April,2007 to December,2011.They all had clinical assessment,EEG,or video EEG confirming absences seizure.Results Six patients showed the following similar clinical-EEG features:(1) mild ictal impairment of consciousness associated with generalized 3.0-3.5 Hz spike and slow wave discharges; (2) late-onset generalized tonic-clonic seizures; (3) absence status epilepticus with or without secondary generalized tonic-clonic seizures; (4) generalized discharges were mostly seen in three types in the awaking stage:fragmented discharge (＜4 s),brief discharge (4-10s) and long-time discharge (＞ 10 s).None of the patients had myoclonic jerks or photosensitivity.One patient' s mother had a history of generalized tonic clonic seizures.One patient had a history of children absence epilepsy and one patient had a history of febrile convulsion in the age of 1-3.Conclusion Idiopathic generalized epilepsy with phantom absences has distinct clinical and EEG features and may become a new idiopathic generalized epilepsy syndrome in adults.
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Objective To study factors used to predict 30-day mortality and favorable outcomes to intracerebral hemorrhage (ICH) in young adult subjects and to estimate the reliability of these predictors.Methods Data of 175 acute ICH patients selected from 201 patients admitted to our hospital from 2008 to 2011 were reviewed retrospectively.Patients were assessed with Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) and routine laboratory examinations after admission.Independent predictors of 30-day mortality or good outcome (modified Rankin score,0-2) were identified by stepwise logistic regression.Results There were 90 male and 85 female,and 142 survivals and 33 deaths.The modified Rankin score (mRS) of survival group was ＜6 and mRS =6 in death group,and mRS ＜3 in good outcome group and mRS ＞ or =3 in poor outcome group.Independent factors for 30-day mortality were hypertension (P =0.023) or hyperglycemia (P =0.007),infra-tentorial ICH (P =0.000),large ICH volume (P =0.008),low Glasgow Coma Scale (GCS) scores (P =0.000),high white blood cell count (P =0.000),higher blood glucose level (P =0.039) and prothrombin time (PT) (P =0.001) after admission.Independent factors for 30-day good outcome were younger age (P =0.001),normal blood pressure (P=0.010) or absence of hyperglycemia (P=0.028),lower NIHSS scores (P=0.000),small ICH volume (P =0.000),low white blood cell (WBC) count (P =0.000),lower blood glucose level (P =0.012) or lower systolic blood pressure (SBP) level (P =0.000) at admission.The NIHSS score and GCS score were excellent predictors,while the SBP level,WBC count and ICH volume were fine predictors.Conclusions Overall prognostic factors should be integrated to get high reliabilities for predicting the outcomes of ICH in young people.
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BACKGROUND:Magnetic resonance diffusion tensor imaging can display the dispersion changes of peripheral nerve injury and be used to conduct quantitative research, so it has good application prospects in displaying the nerve injury and regeneration. OBJECTIVE:To investigate the possibility of magnetic resonance diffusion tensor imaging of rabbit acute sciatic nerve traction injury, and to figure out the value of diffusion tensor parameters in the diagnosis of peripheral nerve injuries and to reveal the pathologic basis. METHODS:The right hind limb sciatic nerves of 32 New Zealand white rabbits were selected to make the regeneration and repair models, the left hind limb nerves as the sham-operation side. Diffusion tensor imaging examination of sciatic nerves were performed at 1 and 3 days, 1, 2, 3, 4, 6 and 8 weeks after operation with 1.5 T MRI. Fractional anisotropy and apparent diffusion coefficient were measured through diffusion tensor tracing reconstruction, and then the pathological examination was performed. RESULTS AND CONCLUSION:Diffusion tensor imaging revealed only the proximal nerve, injured nerve as wel as the middle of the distal nerve at 1 day after traction injury. At 1 week, the nerve of distal portion appeared thinner and shorter fiber bundle. At 2-6 weeks after operation, the fiber bundle was increased and thickened. At 8 weeks after operation, the distal nerve fibers had nearly restored to the level before injury. There was significant difference in the fractional anisotropy value of traction portion and distal portions between traction injury and sham-operation group at 1 day-8 weeks after operation (P<0.05). While there was significant difference in the fractional anisotropy value of proximal traction portion between traction injury and sham-operation group 1 day-1 week after operation (P<0.05). There were no significant differences in the apparent diffusion coefficient values between traction injury and sham-operation group at 1 day-8 weeks after operation. Fal of fractional anisotropy value in the early stage of nerve traction injury was the result of myelin sheath broke down and axonal disintegrated;recovery of fractional anisotropy value resulted from myelin sheath proliferated and myelin sheath grew slowly to mature. Diffusion tensor tracing can show the abnormal change of the sciatic nerve with traction injury in rabbit clearly and early, and the measurement of fractional anisotropy value can be used as the sensitive method to monitor the degeneration and regeneration after nerve traction injury.