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Objective:To analyze the molecular mechanism of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS by network pharmacology method and molecular docking technology.Methods:The active components and targets of Zhenqi Fuzheng Capsules were obtained through TCMSP, and the AIDS-related targets were obtained through GeneCards, OMIM and DrugBank databases. The intersection target PPI network was constructed through STRING 11.5 database, and Cytoscape 3.9.1 software was used for network topology analysis; Metascape database was used for GO function and KEGG pathway enrichment analysis of core targets; Cytoscape 3.9.1 was used to construct Zhenqi Fuzheng Capsules component-target-pathway network; Autodock Tools software was used to carry out molecular docking of core targets and active components.Results:Totally 31 active components and 180 targets of Zhenqi Fuzheng Capsules were screened out. TNF, IL6, AKT1, IL1B, TP53, VEGFA, RELA, EGFR and CASP3 were identified as the core targets. GO functional enrichment analysis obtained 1 436 biological processes, 53 cellular components, and 117 molecular functions. KEGG pathway enrichment analysis obtained 167 pathways, which were related to pathways in cancer, AGE-RAGE signaling pathway in diabetic complications, and IL-17 signaling pathway was closely related. Molecular docking results showed that core targets such as AKT1 and TNF had good binding activity to quercetin, kaempferol, and luteolin.Conclusion:The main active components of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS are quercetin, kaempferol and luteolin, which may treat AIDS through the IL-17 signaling pathway.
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Objective:To analyze the disease characteristics and hospitalization burden of elderly inpatients with cerebrovascular disease, so as to provide basis for disease prevention, diagnosis, treatment and rehabilitation of elderly patients with multiple chronic conditions.Methods:The data of the first page of medical records of elderly inpatients with cerebrovascular disease from 2015 to 2020 in a comprehensive tertiary hospital in Jiangsu Province were retrospectively collected.Descriptive analysis, variance analysis and multiple linear regression analysis were carried out for the research objects using SPSS statistics and Python complex network methods.Results:A total of 14 657 elderly inpatients with cerebrovascular disease were included.From 2015 to 2020, the number of hospitalizations increased from 1 268 to 4 733, the average number of hospitalizations increased from 2.0 to 2.9, the average length of stay decreased from 11.9 days to 9.1 days, and the average number of illnesses increased from 1.9 to 4.9.The five most common comorbidities associated with cerebrovascular diseases were hypertension, diabetes, ischemic heart disease, other types of heart disease and other respiratory diseases.From 2015 to 2020, the average hospitalization costs of elderly cerebrovascular inpatients decreased from 20588.1 Chinese yuan(CYN)to 15580.9 Chinese yuan(CYN). The hospitalization cost was mainly composed of drug cost(46.6%), diagnosis cost(28.2%)and treatment cost(20.2%). There were significant differences in the average hospitalization expenses among patients with different gender, age, number of admissions, length of stay and number of diseases( P<0.05 for all). Gender, age, number of hospitalizations and length of stay had an impact on hospitalization expenses. Conclusions:The number of inpatients, comorbidities, and hospitalized times of elderly patients with cerebrovascular disease showed an increasing trend, while the number of hospitalization days and the average hospitalization cost showed a downward trend.Comorbidities associated with cerebrovascular diseases should be one of the concerns of chronic disease management in the elderly.
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Objective:To investigate the efficacy and feasibility of radiofrequency resection of supraglottic laryngeal carcinoma under a multifunctional opener.Methods:The clinical data of four cases of supraglottic laryngeal carcinoma (type T1N1M0 in two cases, T2N1M0 in one case, and T1N0M0 in one case) who received treatment in the Affiliated Hospital of Jining Medical University during January-June 2019 were retrospectively analyzed. Radiofrequency resection of supraglottic laryngeal carcinoma under a multi-functional opener combined with bilateral neck II-IV region lymph node dissection was performed. Swallowing, breathing and phonation were observed and analyzed based on references.Results:Among the four cases, two cases had a normal diet at 3 days after surgery, one case had a normal diet at 7 days after surgery, and one case had a normal diet at 16 days after surgery. Tracheotomy was not performed in any case. After surgery, breathing and speech communication were not affected.Conclusion:Radiofrequency surgery under a multifunctional opener can be used for treatment of early supraglottic laryngeal cancer. It is an effective treatment with minimal trauma, mild postoperative pain and promotes the early recovery of normal swallowing function.
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Syndromes of coronary heart disease with angina pectoris were analyzed to provide guidance for clinical practice and to improve accuracy of traditional Chinese medicine (TCM) diagnoses and efficacy of TCM treatment. A total of 860 cases with coronary heart disease with angina pectoris were selected from TCM Clinical Research Information Sharing System for TCM clinics and research. Syndromes were automatically extracted with the cluster method and were analyzed to provide objective evidence for clinical studies. Final syndrome classifications were recognized and confirmed by clinical experts. Popular syndromes included Qi and blood deficiency, blood stasis and obstruction collaterals, liver depression and spleen deficiency, and Qi stagnation and blood stasis. Syndromes Qi and blood deficiency and blood stasis and obstruction collaterals accounted for 28.61% of total syndromes, whereas liver depression and spleen deficiency and Qi stagnation and blood stasis accounted for 26.44%. The main syndrome elements comprised Qi deficiency, blood deficiency, blood stasis, and Qi stagnation.
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Aged , Female , Humans , Male , Middle Aged , Angina Pectoris , Diagnosis , Therapeutics , Cluster Analysis , Coronary Disease , Diagnosis , Therapeutics , Diagnosis, Differential , Hemostasis , Medicine, Chinese Traditional , SyndromeABSTRACT
Acupuncture-moxibustion has been used in more than 180 countries,but high quality evidences for its efficacy and safety are still insufficient,which is a key issue limiting the development of acupuncture-moxibustion.Combined with characteristics of acupuncture-moxibustion discipline,this study was aimed to use international patient registry to collect real world clinical data and design meaningful clinical outcome in order to exploit the efficacy and safety of acupuncture-moxibustion and to provide important basis and supplement for confirmatory research.This paper summarized key technologies of international patient registry study for acupuncture-moxibustion based on real world to guide the design,implementation and evaluation.
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<p><b>OBJECTIVE</b>To observe and evaluate the clinical efficacy of transcutaneous vagus nerve stimulation (taVNS) at auricular concha for primary insomnia (PI) and affective disorder.</p><p><b>METHODS</b>A total of 35 patients who met the diagnosis standard of PI in(5th edition) were included. The self-developed auricular vagus nerve stimulator (TENS-200A) was applied at auricular concha, 30 min per treatment, twice a day, 5 days a week for consecutive 4 weeks. The follow-up visit was conducted at the end of 6th week. The Pittsburg sleep quality index scale (PSQI), 17-items Hamilton depression scale (17HAMD) and Hamilton anxiety scale (HAMA) were applied for evaluation. The PSQI, HAMA and 17HAMD were observed before and after treatment; the safety was also observed.</p><p><b>RESULTS</b>Compared before treatment, the PSQI was significantly decreased to (13.20±3.61) at the end of 2nd week (<0.05); compared before treatment, the 17HAMD and HAMA were significantly decreased at the end of 4th week and 6th week (all<0.05). No adverse reaction was observed.</p><p><b>CONCLUSIONS</b>The taVNS could not only relieve PI symptoms, but also improve the depressive and anxiety symptoms, in addition, it may have positive long-term efficacy and safety.</p>
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This study was aimed to observe the effects of acupuncture combination with medicated thread moxibustion ofZhuang nationality medicine on neurotransmitters in rats with sleep deprivation. A total of 80 SPF grade healthy Wistar rats were randomly divided into the control group, model group, treatment group and diazepam group with 20 rats in each group. The establishment of insomnia model was through sleep deprivation in the model group, treatment group and diazepam group. Based on the treatment of the model group, the treatment group was treated by acupuncture combination with medicated thread moxibustion ofZhuang nationality medicine, once a day for continuous 14 days. Intragastric administration of diazepam according to 3 mg·kg-1 body weight was given in the diazepam group. While intragastric administration of the same volume normal saline was given to the control group once a day for continuous 14 days. And then, the levels of orexin, NE, 5-HT, CRH and ACTH were detected. The expressions of orexin mRNA and c-Fos were observed. The results showed that compared with the control group, the levels of orexin, ACTH, 5-HT, NE and CRH increased or obviously increased in the model group with significant difference (P < 0.05, orP< 0.01). The expressions of orexin mRNA and c-Fos in the model group were increased or obviously increased with significant difference (P < 0.05, orP< 0.01). Compared with the model group, the levels of orexin, ACTH, 5-HT, NE and CRH reduced or obviously reduced with significant difference in the treatment group (P < 0.05, orP < 0.01). The expressions of orexin mRNA and c-Fos were reduced or obviously reduced with significant difference in the treatment group (P <0.05, orP < 0.01). It was concluded that acupuncture combination with medicated thread moxibustion ofZhuang nationality medicine took an effect on the treatment of insomnia by mediating neurotransmitters associated with hypothalamic-pituitary-adrenal axis (HPA axis) through orexin, which was probably related with its therapeutic mechanism.
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This study was aimed to observe effects ofDendrobium ofifcinaleKimura et Migo on cardiac function and changes of blood vessel in rabbits with coronary heart disease (CHD).Thirty clean grade healthy rabbits were randomly divided into 5 groups, which were the control group, model group,Dendrobium low-dose (DLD), middle-dose (DMD), and high-dose (DHD) group, with 6 rabbits in each group. Constrictor ring was implanted in the left coronary artery to establish CHD model in the model group, DLD, DMD and DHD groups. Intragastric administration of Dendrobium decoction at the dose of 10, 20, and 40 g·kg-1 was given to rabbits in the DLD, DMD and DHD groups once a day for 21 consecutive days, respectively. The same volume of normal saline was given to the control group and the model group. Detections were made on levels of IL-8, TNF-α, VCAM-1, ICAM-1, the expression of actin, changes of LVSP, LVEDP,±dp/dtmax, BPs, BPd and morphologic changes of blood vessel. The results showed that compared with the control group, levels of IL-8, TNF-α, VCAM-1, ICAM-1 and the expression of actin increased or significantly increased in the model group with statistical significance (P< 0.05, orP< 0.01); LVEDP increased significantly (P< 0.01). However, LVSP,±dp/dtmax and BPs reduced (P< 0.05, orP< 0.01). The blood vessel wall became thicker. Compared with the model group, IL-8, TNF-α, VCAM-1, ICAM-1 and the expression of actin in the DMD and DHD group reduced or significantly reduced with statistical significance (P< 0.05, orP< 0.01); LVEDP reduced significantly in the DMD and DHD group with statistical significance (P< 0.01). While, LVSP,±dp/dtmax and BPs increased or significantly increased with statistical significance (P< 0.05, orP< 0.01). The thickening of blood vessel wall was inhibited. It was concluded thatDendrobium ofifcinale Kimura et Migo can improve cardiac function, which may take effect by improving and inhibiting pathologic changes of blood vessel and alleviating vessel injury.
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BACKGROUND:Both osteopontin and leptin are closely linked to bone metabolism, therefore, which may be related to the attack of femoral head necrosis. OBJECTIVE:To study the correlation of serum osteopontin and leptin in the development of femoral head necrosis. METHODS:Thirty-one patients with femoral head necrosis (case group, including 11 cases of ARCO II, 10 of ARCO III, 10 of ARCO IV) and 10 healthy adults (control group) were selected as the research objects. Enzyme-linked immunosorbent assay was used to determine the levels of osteopontin and leptin in serum folowed by statistical analysis. RESULTS AND CONCLUSION:In the case group, the serum levels of osteopontin and leptin were significantly higher than those in the control group (P < 0.05). But the serum levels of osteopontin and leptin showed no correlation between the two groups. These findings indicate that the serum levels of osteopontin and leptin are both elevated in patients with femoral head necrosis, which maybe play a role in the pathogenesis of femoral head necrosis, but there is no obvious correlation.
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Aim To investigate the expression of Notch pathway and Nephrin in angiotensin Ⅱ ( AngⅡ)-stimulated mice podocyte. Methods Mice podo-cyte was stimulated by AngⅡ, and then was treated with valsartan. The levels of Notch1, Notch intracellu-lar domain 1 ( NICD1 ) , Hes1 and Nephrin were deter-mined by immunofluorescence, Western blot and Real-time PCR. Results AngⅡincreased Notch1, NICD1 and Hes1 expression, and decreased Nephrin expres-sion in a time-dependent manner ( P<0. 01 ) . Valsar-tan inhibited AngⅡ-induced activation of Notch path-way and enhanced Nephrin level ( P <0. 01 ) . Con-clusion AngⅡdecreases Nephrin expression in podo-cyte by activating Notch pathway.
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Objective To observe the role of Osterix in controlling bone volume in vertebral body and to investigate the possible mechanism .Methods X-ray radiology ,micro CT and HE staining were used to evaluate the change of bone volume in both Osterix knockout and transgenic mice .TRAP staining was used to assess the activity of osteoclasts and immunohistochemistry was used to examine the expression level of RANKL .Results No obvious changes were found in Osterix transgenic mice ,while X-ray examina-tion ,micro CT and HE staining showed that the bone density and bone volume in the lumbar vertebral body increased significantly in OSX null mice 12 weeks after birth .TRAP staining showed that the number of osteoclasts decreased in OSX null mice .IHC re-vealed that the expression level of RANKL was down-regualted in OSX null mice .Conclusion Osterix play an important role in controlling bone volume of vertebral body in mice .
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Purpose To investigate effect of valsartan on expression of Notch pathway and production of extracellular matrix. Methods Urine protein and production of extracellular matrix were measured after diabetic mice were treated with valsartan. The levels of Jag-ged1, Notch1, Notch intracellular domain 1 (NICD1), transforming growth factor-β1 (TGF-β1), TypeⅣcollagen and Laminin were determinated by immunohistochemistry, Western blot and real-time PCR. Results Valsartan suppressed urine protein and production of extracellular matrix in diabetic mice (P<0. 05). Valsartan also inhibits overexpression of Jagged1, Notch1, NICD1, TGF-β1, Type Ⅳ collagen and Laminin in glomerular tissues of diabetic mice (P<0. 05 or P<0. 01). Conclusion Valsartan inhibits activa-tion of Notch pathway in glomerular tissues of diabetic mice, inhibits production of extracellular matrix in glomerulus and delays glomer-ulosclerosis.
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Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).
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BACKGROUND: Vascular endothelial growth factor (VEGF) and its receptor fms-like tyrosine kinase-1 (Flt-1) have a very important position in the field of male reproduction. However, it is still unclear about their expression meaning and regulatory mechanism in the reproductive system. OBJECTIVE: To study the expression and location of VEGF and Flt-1 in the epididymal sperm of adolescent male rats. METHODS: The expression of VEGF and Flt-1 was detected in 10 adolescent SD rats. The concentration of the sperm was (30-40)×109/L. Immunofluorescent staining was used for VEGF and Flt-1 expression and location in the sperm. RESULTS AND CONCLUSION: Immunofluorescent staining showed that VEGF and Flt-1 were both localized in the acrosome of sperm head, as well as in the neck, middle and principal segment of sperm tail. Specific expression patterns of VEGF and Flt-1 in the sperm of rats display that they may participate in spermiotelcosis, relevant to movement, capacitation and acrosome reaction of the sperm.
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Purpose To investigate the clinical, imaging and pathologic characteristics of dedifferentiated chondrosarcoma.Methods The clinical and pathological data were reviewed in 11 cases of dedifferentiated chondrosarcoma.Results Most of these patients were male (7/11). The mean age was 57.1 years.Most tumors were located in the long bone and pelvis. Imaging showed that bones were extensively destroyed.There was calcification or ossification on focus of infection. The gross specimen showed that cartilage component was located within bone and dedifferentiated sarcoma was found out of the bone.Microscopically, well differentiated chondrosarcoma and poorly differentiated sarcoma components were observed. Six patients died and the average survival time was 14 months.Conclusions Dedifferentiated chondrosarcoma is an unusual subtype of chondrosarcoma with pleomorphic alterations. Further understanding the pathologic features of the tumor is important to increase the accurancy of diagnosis.
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Objective To explore the risk factors of lower limb deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT. Methods A total of 1 068 patients with traumatic fractures were involved in the study to analyze the incidence of DVT under 43 risk factors including general state, injury type, fracture condition and operation and screen significant factors for multiple factor analysis. Results The total incidence rate of DVT in 1 068 patients was 12.0%. The univariate analysis showed that male patients at age ＞60 years, with BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension, coronary artery disease and cerebrovascular disease had higher incidence rate of DVT. In different injury types, the fall injury caused the highest incidence rate of DVT (45.6%). There were different DVT rates for different fracture position,with the highest incidence rate of DVT for femur shaft fracture (20.5%). The incidence rate of DVT was 51.7% for fractures of more than three parts, 14.2% for fractures of two parts and only 3.7% for sole part. The incidence rate of DVT for comminuted fractures was higher than the overall rate. The operation duration, massive transfusion during operation and epidural anesthesia were related with the increase of incidence of DVT. Multivariate analysis found nine independent risk factors and showed that the more risk factors were, the higher incidence of DVT was. Conclusions The risk factors of DVT for traumatic fractures include age ＞60 years, BMI≥25 kg/m2, history of smoking, fall injury, more than three parts of fractures, comminuted fractures, operation duration ＞ 2 hours, massive transfusion during operation and epidural anesthesia.
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Objective To set up a three-dimensional finite element model (FEM) to investigate biomechanics of point contact locking plate (PC-LP) fixating femoral shaft fractures. Methods One intact fresh adult cadaveric femur was scanned by CT at 1 mm interval. Then, the data of CT were utilized to establish three-dimensional FEM by using software Mimics and PRO/E and simulate the different clini-cal loading conditions. The changes of theoretical stress of femur and PC-LP were analyzed under flexion, axial compression and torsion loads. Results (1) Under four-point bending load, the distribution of femur stress was in uniformity, with the largest stress of the PC-LP focused on the edge. (2) Under axial compression load of 250 N, the largest stress of the femur was focused on the screw holes on beth distal ends, with the largest stress of the PC-LP focused on the middle screw holes. (3) Under the torsion load cused on the middlepart and the middle screw holes. Conclusions Under the four-point bending, ax-ial compression and torsion loads, the distribution of femur stress is in uniformity, when the largest stress of the PC-LP focuses on edge or the middle screw holes, while that of the PC-LP on two screw holes of proximal or distal ends.
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Objective To validate a new standardized training program for urological surgeons to improve their laparoscopic surgical skills. Methods The laparoscopic surgical training program was carried out by using the traditional mechanical simulators and animal models. Thirty-three trainees participated the urological laparoscopic surgical training program. Initially, the novices were assigned to practise basic laparoscopic skills step by step on the simulator with fixed trocar positions. After a period of basic training, they were allowed to practise on animal models for some particular proce-dures. Results All trainees (33/33, 100.0%) participated were able to perform all basic techniques skillfully and completed laparoscopic anastomosis accurately after the training. The time required for performing the partial nephrectomy, dismembered pyeloplasty and ureteral reimplantation on animal models declined from 64.0±18.4, 127.54±17.5 and 75.84±11.6 min at the beginning to 30.94±3.8, 65.2±7. 5 and 37.7±7.2 min after practicing these procedures 8 times (P<0.01). They could un-derstand the crucial procedures of the laparoseopic surgeries after 6 to 8 special trainings on animal models. Fifteen trainees (15/33, 45.5%) had started to carry out laparoscopic surgeries after-finish- ing the training program. Conclusions Our program enables the participants to improve their techniques in complicated laparoscopic surgeries. The challenging parts of reconstructive laparoscopic surgeries such as laparoscopic dismembered pyeloplasty can be taught by using animal models. This program could be incorpo-rated easily by all urological departments developing a laparoscopie surgical training program.
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Objective To explore operative indications,methods and effect of one stage total hip arthroplasty(THA)in treatment of acetabular fractures.Methods One stage total hip arthroplasty (THA)was carried out in 11 patients with acetabular fractures including 10 males and one female(at mean age of 42.4 years)8-37 days(mean24 days)after injury.There were anterior column fractures in three patients,posterior wall fracture in one,posterior column fracture in two,posterior column fracture combined with posterior wall fracture in two,transverse fracture in one,transverse fracture combined with posterior wall fracture in one and two-column fracture in one.Fresh acetabular fractures were first fixed with reconstruction plate or screws to restore shape of acestbular wall;then,granule or bulk of resected femoral head were implanted into acetabulum posterior to placement of acetabular cup prosthesis.While for old acetabular fractures,the resected femoral head was first implanted on acetabular superior wall and posterior wall and then acetabular cup prosthesis was placed.Results Follow-up for 6-45 months (mean 28 months)showed obdous improvement of hip joint function,with average Harris score of 78 points and average active degree of 95°.X-ray film presented loosening of acetabulum and osteolysis in one patient.All patients began weight bearing three months after operation,with no dislocation of joint prosthesis.Conclusions Under strict control of indications,one stage THA can be done for patients who miss operative reduction due to obvious acetabular fracture dislocation and severe articular cartilage injury.Stable aeetabular cup may beget satisfactory short-term clinical results.
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BACKGROUND: Vascular injuries of the extremitiesy are frequently concomitant with vascular defects and are usually repaired by autologous vessel grafting. However, the source of autologous vessels is limited and the preparation of them is traumatic.OBJECTIVE: To retrospectively evaluate the extremity-preserving efficacy of vascular prosthesis grafting in repairing major vascular injuries of the extremities in 29 cases.DESIGN: A retrospective study.SETTING: Department of Orthopedics and Traumatic Surgery, Center for Battle Wound and Trauma of Chinese PLA, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: We selected 29 patients with major vascular injuries of the extremities repaired by vascular prosthesis grafting who received the treatment at the Department of Orthopedics and Traumatic Surgery of the Center for Battle Wound and Trauma of the Chinese PLA of the Research Institute of Surgery of, Daping Hospital of the Third Military Medical University of Chinese PLA between January 1989 and December 2000. There were 23 males and 6 females. Injury sites: 9 cases were at subclavian artery, 6 at axillary artery, 2 at brachial artery, 10 at femoral artery, 1 at femoral vein and 1 at popliteal artery. 11 of these 29 cases (37.9%) were complicated with shock, 8 with fractures and dislocations, 5 with peripheral nerve injuries and 3 with infections.METHODS: The vascular prosthesis was anastomosed end to end with the trimmed culprit vessels. As for the 3 cases with infective arterial injuries,the vessels were placed away from the infected region and were bridged together in a non-inf1ammatory region and then muscles or musculo-cutaneous flaps were used to cover the infected regions.The functions of the extremities of the patients were evaluated according to MAS at week 2 and 1 year after the operation.MAIN OUTCOME MEASURES: The vascular patency rate and the extremity-preserving outcomes..RESULTS: All 29 patients entered the stage of result analysis. Extremitypreserving efficacy: All the patients who underwent vascular prosthesis grafting had their extremities preserved. Only 1 patient had the late sequelae of ulcers in the foot sole due to extended extremity ischemia and nerve damage. The rate of 2-week patency rate of the grafted vessels was 100% and the 1-year rate of patency was 96.5%, as revealed by Doppler blood stream scanning. The excellent and good rate of the function of extremity was 89%.CONCLUSION: Vascular prosthesis grafting is the one of the methods for repairing the major vascular injuries so as to preserve the extremities and their functions.