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ObjectiveTo investigate the protective effect of total lignans of Arctii Fructus on the retinal tissue in the rat model of type 2 diabetes mellitus. MethodWistar rats were randomized into normal， model， solvent， Shuangdan Mingmu Capsules （618 mg·kg-1）， and low-， medium-， and high-dose （100， 200， 400 mg·kg-1， respectively） total lignans of Arctii Fructus groups， with 16 rats in each group. The rat model was established by streptozotocin （STZ） combined with a high-fat diet and administrated with corresponding drugs by gavage once a day for 14 weeks. At the 14th week， blood was sampled for the collection of serum from the abdominal aorta after anesthesia， and bilateral eyeballs were collected and frozen. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes of the retinal tissue in rats. The pathological changes of retinal vascular network in rats were observed by retinal vascular tissue digestion and mounting The levels of vascular endothelial growth factor （VEGF）， tumor necrosis factor-α （TNF-α）， and intercellular adhesion molecule-1 （ICAM-1） in the serum were determined by the ELISA kit. ResultCompared with the normal group， the solvent group showed pathological changes in the retinal tissue， reduced retinal ganglion cells （P<0.01）， and retinal thinning （P<0.01）， decreased E/P value in retinal blood vessels （P<0.01）， and elevated serum levels of VEGF， TNF-α， and ICAM-1 （P<0.01）. Compared with the model group， the total lignans of Arctii Fructus increased the retinal ganglion cells （P<0.01）， thickened the retina （P<0.01）， and lowered the serum levels of VEGF， TNF-α， and ICAM-1 （P<0.05， P<0.01）. ConclusionTotal lignans of Arctii Fructus may lower the VEGF， TNF-α， and ICAM-1 levels to protect the retina.
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ObjectiveTo explore the clinical efficacy and safety of the combination of Erchentang and Bixie Fenqingyin in the treatment of patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome to provide a new method and evidence for the treatment of acute cerebral infarction with hyperuricemia. MethodA total of 132 eligible patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome admitted to the Putuo Hospital of Shanghai University of Traditional Chinese Medicine（TCM） from May 2021 to May 2022 were randomly divided into a Chinese medicine group， a western medicine group， and a control group， with 44 cases in each group. All three groups received routine western medical treatment for acute cerebral infarction. Additionally， the Chinese medicine group received Erchentang combined with Bixie Fenqingyin， the western medicine group received Benzbromarone tablets， and the control group did not receive any uric acid-lowering treatment. The treatment duration was four weeks. The modified Rankin Scale （mRS） score after three months of onset， as well as the National Institutes of Health Stroke Scale （NIHSS） scores， TCM syndrome scores， serum uric acid （SUA） levels， serum C-reactive protein （CRP） and interleukin-6 （IL-6） levels， serum superoxide dismutase （SOD） and malondialdehyde （MDA） levels， and other safety indicators were observed before and after treatment. ResultA total of 129 cases completed the trial observation， with 43 cases in the Chinese medicine group， 42 cases in the western medicine group， and 44 cases in the control group. The rate of good prognosis in the Chinese medicine group （83.7%，36/43） was higher than that in the western medicine group （64.3%，27/42） and the control group （40.9%，18/44） （χ2=4.184，16.930，P<0.05）， and the western medicine group was superior to the control group （χ2=4.707，P<0.05）. After treatment， the NIHSS scores， TCM syndrome scores， SUA， CRP， IL-6， and MDA levels of the patients in all three groups decreased， while the SOD levels increased compared with those before treatment （P<0.05）. Among them， the improvement in NIHSS score was better in the Chinese medicine group and the western medicine group than in the control group （P<0.05）. The Chinese medicine group showed the greatest improvement in TCM syndrome （P<0.05）， while the western medicine group showed the greatest reduction in uric acid levels （P<0.05）. No significant abnormalities in safety indicators were observed before and after treatment in the three groups， and no serious adverse reactions were reported. ConclusionThe combination of Erchentang and Bixie Fenqingyin can significantly improve the prognosis， early neurological deficits， and TCM syndromes of patients acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome. It can also lower uric acid levels and inhibit inflammatory and oxidative stress reactions.
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ObjectiveTo explore the clinical efficacy and safety of Qifu Yixin prescription in treating chronic heart failure in the patients with the syndrome of heart Qi deficiency， so as to provide clinical evidence for the treatment of chronic heart failure with this prescription and promote the clinical application and transformation of this prescription. MethodA total of 106 chronic heart failure patients with the syndrome of heart Qi deficiency who met the criteria in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine （TCM） from September 2022 to May 2023 were selected and randomized into an observation group （53 cases） and a control group （53 cases）. Both groups received routine Western medicine treatment. In addition， the observation group received Qifu Yixin prescription， while the control group received placebo. The treatment course for both groups was 12 weeks. The New York heart association （NYHA） cardiac function grading， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， soluble growth-stimulating expression gene 2 （sST2）， left ventricular ejection fraction （LVEF）， the ratio of early diastolic maximum mitral flow velocity （E） to early diastolic mitral annular motion velocity （e'） （E/e'）， left ventricular end diastolic diameter （LVEDD）， TCM syndrome scores， 6-minute walking test （6MWT）， Minnesota Living with Heart Failure Questionnaire （MLHFQ）， and Kansas City Cardiomyopathy Questionnaire （KCCQ） were determined before and after treatment. ResultFinally， 102 patients were included for analysis， including 51 patients in the observation group and 51 patients in the control group. After treatment， 42 patients in the observation group showed improved cardiac function grading， with a total response rate of 82.35%， and 32 patients in the control group showed improved cardiac function grading， with a total response rate of 62.75%. The total response rate regarding the cardiac function in the observation group was higher than that in the control group （χ2=4.923， P<0.05）. The observation group outperformed the control group in lowering the NT-proBNP level， elevating LVEF， decreasing the E/e' ratio （P<0.05）， reducing LVEDD and sST2 levels， and recovering TCM syndrome score， 6MWT score， MLHFQ score， and KCCQ score （P<0.05）. None of the safety indexes in the two groups showed abnormal values before and after treatment， and no serious adverse reaction was observed. ConclusionQifu Yixin prescription can improve the heart function， exercise tolerance， and quality of life and alleviate the TCM syndrome of the chronic heart failure patients with the syndrome of heart Qi deficiency by inhibiting myocardial fibrosis.
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The glasses-free three dimensional(3D) endoscopic display system provides the surgeon with the depth information of the minimally invasive surgery scene obtained from the binocular perspective, which can effectively relieve the surgeon's posture fatigue and visual fatigue during the long-term surgery, and assist in the operation of surgical instruments more accurately to reduce the damage to the surrounding tissues of the operation area. However, the glasses-free 3D display device currently has the problem of a narrow optimal viewing zone and easy crosstalk, especially in the surgical teaching application scenario, which performs poorly. In order to overcome the limitation of the narrower field of view, we introduce deep learning algorithms to detect and locate multiple faces, fine-tune the 3D display grating of the endoscope, rearrange pixels, and change the best view area, so that more people can get the best view. The experimental results show that the face detection accuracy of the method is 97.88%, and the detection time is 135 frames/ms, which achieves high accuracy while maintaining real-time performance.
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Humans , Endoscopes , Endoscopy , Imaging, Three-Dimensional , Minimally Invasive Surgical Procedures , Surgical InstrumentsABSTRACT
Objective:To investigate the relationship between hyperuricemia and outcome in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to Department of Neurology, Putuo Hospital, Shanghai University of Tranditional Chinese Medicine between January 2020 and September 2020 were enrolled retrospectively. The modified Rankin Scale (mRS) score was used to evaluate the clinical outcome 3 months after the onset. ≤2 was considered as good outcome, and >2 was considered as poor outcome. The demography and baseline characteristics were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome. Results:A total of 210 patients were included, their age was 69.87±62.62 years. There were 125 males (59.52%) and 85 females (40.48%). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 4. The serum uric acid level in 169 patients (80.48%) was normal and 41 (19.52%) had hyperuricemia; 120 patients (57.14%) had a good outcome, and 90 (42.86%) had a poor outcome. Blood glucose level, serum uric acid level, baseline NIHSS score and the proportions of diabetes mellitus, history of stroke or transient ischemic attack, hyperuricemia in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [ OR] 2.735, 95% confidence interval [ CI] 1.461-5.121; P=0.002), hyperuricemia ( OR 2.400, 95% CI 1.102-5.228; P=0.027), and higher baseline NIHSS score ( OR 1.233, 95% CI 1.118-1.360; P<0.001) were the independent risk factors for poor outcome in patient with acute ischemic stroke. Conclusion:Hyperuricemia is an independent risk factor for poor outcome in patients with acute ischemic stroke.
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OBJECTIVE： To establish a method for the determination of harmine derivative DH-330 in rat plasma and to use it for pharmacokinetic behavior evaluation of DH-330 in rats after intragastric administration. METHODS： Using tinidazole as internal standard， after pre-treatment of acetonitrile precipitated protein， UPLC-MS method was adopted to determine the plasma concentration of DH-330. UPLC analysis was performed on Waters ACQUITY BEH C18 column （50 mm×2.1 mm，1.7 μm） with mobile phase consisted of acetonitrile-methanol-0.5％ formic acid aqueous solution（15 ∶ 55 ∶ 30， V/V/V） at flow rate of 0.4 mL/min， while the column temperature was 30 ℃， and sample size was 5 μL. MS analysis was conducted by electrospray ionization source， positive ion scanning， ion source temperature at 124 ℃， DH-330 detection of mass to charge ratio （m/z） of 335.8→334.8， and internal standard m/z of 247.0→81.0. Six Wistar rats were given DH-330 suspension（50 mg/kg） intragastrically. Blood samples were collected from fundus venous plexus capillary before administration （0 h） and 0.25，0.5，1，2，4，6，8，12，24 h after administration. Plasma concentration of DH-330 was determined and plasma concentration-time curves were drawn. Pharmacokinetic parameters were calculated by using Kinetica 5.0 software. RESULTS： The linear ranges of DH-330 were 25.05-2 004 ng/mL（r＝0.999 8），and the limits of quantitation was 25.05 ng/mL. RSDs of intra-day and inter-day were all less than 10％. The accuracy RE was －9.76％ to 4.55％. The extraction recovery was higher than 85％（RSD＜5％）. Stability RE was －2.53％ to 2.29％. They were not affected by matrix effect or residual effect of injection. The pharmacokinetic parameters of DH-330 in rats after intragastric administration included that cmax was （1 162.43±241.72）ng/mL，AUC0-∞ was （3 242.93±652.31）ng·h/mL，t1/2 was （1.93±0.61）h， MRT was （3.23±0.30）h，CL was （16.80±5.30）L/h·kg， Vss was （54.78±19.64）L/kg. CONCLUSIONS： The established method is simple， specific， sensitive， precise and recovery， which can be used for the plasma concentration determination of DH-330 in rats. DH-330 has short half-life， rapid absorption and large apparent distribution volume after intragastric administration in rats， which indicates that it has high lipophilicity and may be mainly distributed in tissues.
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Objective: To assess the value of residual liver volume ratio measured with CT for preoperative evaluation in pediatric hepatoblastoma. Methods Totally 40 hepatoblastoma patients confirmed by pathology with the average age of (1.8±0.8)years were enrolled. All patients underwent pre-operation enhanced CT scan. The total liver volume, the predicted resected liver volume were measured, and the standard liver volume, the residual liver volume were calculated, respectively. The residual liver volume ratio was calculated with the formula of residual liver volume ratio=residual liver volume/standard liver volume×100%. The volume of the actual resected liver was measured by water immersion method and then compared with the volume of the pre-resected liver measured with CT. ROC curve was used to evaluate the efficacy of residual liver volume ratio for prediction of moderate and severe liver dysfunction. Results: The predicted resected liver volume and actual resected liver volume was (393.62±216.54)cm3 and (388.38±207.56)cm3, respectively, with no significant difference (t=1.679, P=0.101). The residual liver volume was (234.55±70.42)cm3, and the residual liver volume ratio was (63.64±13.70)%. AUC of ROC curve for prediction of moderate and severe liver dysfunction was 0.837 (P=0.016), the critical value was 56.32%, and the sensitivity and the specificity was 86.7% and 70.0%, respectively. Conclusion: The preoperative calculation of residual liver volume ratio with CT in children with hepatoblastoma is a great value in the selection of surgical option and evaluation of postoperative liver function.
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<p><b>OBJECTIVE</b>To analyze the efficacy of percutaneous endoscopic gastrostomy (PEG) in pediatric patients.</p><p><b>METHOD</b>From October 2011 to October 2014, children in the gastrointestinal ward of Guangzhou Women and Children's Medical Center received PEG or jejunal tube PEG(JET-PEG). The success rate, operation time were recorded. The changes of their weight, enteral nutrition calories and the incidence of pneumonia before and after the first 6 months of operation were compared. Follow-up was conducted until October 2014, the recent and long term complications, the length of indwelling time, the replacement or removal of the tube were recorded, the patients swallowing function or the primary disease's outcomes were observed.</p><p><b>RESULT</b>Of the 13 cases, 10 were male, 3 were female, their average age was 2 years (range 1.8 months-9 years). We performed PEG for 12 of the patients who had congenital craniofacial problems that led to feeding difficulties or recurrent cough and pneumonia (6/12), or neurological disorders (6/12) with inability to swallow, and in one case JET-PEG was performed, this child suffered from chronic intestinal pseudo-obstruction with vomiting and abdominal distension. The gastrostomy was successful in all the patients through one operation, the average operation time of PEG was (25 ± 3) minutes, JET-PEG was 60 minutes. One local skin infection was noted, no long-term complication occurred. In the first 6 months after operation, all the patients gained weight((5.5-30.5) kg postoperation vs. (3.0-30.0) kg preoperation), and 12 cases' enteral nutrition calories increased (from (209-502) to(272-543) kJ/(kg·d)), the incidence of pneumonia decreased in the children who had recurrent pneumonia before the operation (from (0-1.5) to (0-0.16) per month). Until October 2014, their average length of gastric tube indwelling time was 17.8 months (range 4-36 months). In 4 cases PEG tube was removed when they could eat completely independently, the other 9 needed enteral vein nutrition via PEG tube or jejunal tube, in 3 of them balloon type gastric fistula tube was applied. Two of the 13 cases who had cleft palate received stomatological operations when their weight grew to meet the standard.</p><p><b>CONCLUSION</b>PEG and JET-PEG are safe and effective method for enteric nutrition feeding in pediatrics, the technique causes minimal trauma and has rapid postoperative recovery, few complications, good aesthetic appearances and simple nursing, it can significantly improve their nutritional status and quality of life.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Enteral Nutrition , Methods , Gastrostomy , Incidence , Nervous System Diseases , Therapeutics , Pneumonia , TherapeuticsABSTRACT
Objective To investigate the clinical value of endoscopy for chronic diarrhea in infants and safety of gastroscopy replacing colonoscopy.Methods According to the Nelson chronic diarrhea definition,data of 52 hospitalized infants under 1 year from March 2006 to April 2014,who underwent colonoscopy because of diarrhea lasting for more than 2 weeks and achieving no improvement after series of treatments,or diarrhea suspected with severe milk protein allergy were collected.Endoscopy and mucosal biopsy were performed under intravenous anesthesia.Results A total of 49 cases (94.2%)were found abnormal under endoscopy.Lymphocytes,plasma cells and a little eosinophils were found in lamina propria in 26 cases,20-100 eosinophils/HPF were found in lamina propria in 21 patients,who were diagnosed as eosinophilic colitis.The 21 patients came back for open food challenge test 4 weeks later,16 cases were positive,who were diagnosed as milk protein allergy.Two infants with Crohn disease and ulcerative colitis respectively were treated with mesalazine and prednisone,but symptoms repeated.No complication was observed during endoscopy.Conclusion The etiology of infant chronic diarrhea is complex,except for peptic infections and lactose intolerance ,eosinophilic colitis may be the major cause.Ulcerative colitis and Crohn disease are rare in infants,but cannot be ignored .Endoscopy and mucosal biopsy are important in di-agnosis and treatment.Gastroscopy instead of colonoscopy is safe and effective.
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To discuss clinical diagnosis and treatment of cow’s milk protein allergy and cow’s milk protein-induced FPIES (food protein induced enterocolitis syndrome). Methods We retrospectively analyzed clinical data of one infant with milk protein allergy-induced FPIES. Results A 67 days old female on mixed breast and formula feeding developed recurrent diarrhea, abdominal distension, vomiting, mucousy and bloody stools, feeding dififculty, anemia, and failure to thrive since 2 weeks after birth. Laboratory studies showed anemia, increased CRP level and elevation of peripheral white blood count and eosinophil proportion. Milk-speciifc IgE was negative. She was previously hospitalized 4 times, all with admitting diagnosis of“necrotizing enterocolitis”. We treated her with milk protein elimination for 4 weeks and all symptoms were resolved. Milk protein re-challenge test was positive, consistent with clinical features of cow’s milk protein allergy-induced infant FPIES. Conclusions Cow’s milk protein allergy and cow’s milk protein-induced FPIES can present with non-speciifc and variable clinical symptoms and signs, and should be considered in the differential diagnosis.
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Objective:To study the content of total flavones in different parts of Mosla dianthera harvested in different seasons to pro-vide reference for the determination of optimal medicinal part and harvesting time of the plant. Methods:The total flavones content of M. dianthera was determined by TLC-UV. Results:The content of total flavones extracted from the plant in September was highest, and that in the leaves was much higher than that in the stems or the roots. Conclusion:It is advisable to harvest the aerial parts of M. dianthera in September.
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Objective: To observe the efficacy of electroacupuncture plus TDP for treating functional dyspepsia Methods: Sixty cases of functional dyspepsia were treated with electroacupuncture plus TDP, and another 60 cases were treated with Domperidone as a control. Results: After 10 treatments, the curative rate in treatment group was 33.3%, with a total effective rate of 91.7%. While in control group, the curative rate was 13.3%, with a total effective rate of 66.7%. There were significant differences between the two groups (P＜0.01,P＜0.001). Conclusion: Electroacupuncture plus TDP had the better therapeutic effect in treating functional dyspepsia.
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In the automatic analysis system of the kidney-tissue image, boundary enhancement for glomerulus area is a vital step. Complex characteristics of kidney-tissue image leads to the difficulty in boundary features description. This paper suggests a kind of feature template under the special boundary definition. A nonlinear threshold surface is constructed by neural network, then the proper surface can be selected to enhance boundary with the influence of error permissibility being taken into account. Experimental results indicate that this learning method with error permissibility can enhance the boundary of glomerulus and suppress noises at the same time, so it can obtain good processed effects and have a fine performance highly adaptive to various sample images.
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Humans , Image Processing, Computer-Assisted , Kidney Glomerulus , Pathology , Neural Networks, ComputerABSTRACT
Object To study the DNA fingerprinting of Arctium lappa L obtained from different localities Methods DNA fingerprinting of samples of crude and processed A lappa collected from four large commercial centers were examined by RAPD Results All crude A lappa showed similar fingerprinting characteristics, while the processed products gave considerable different results Conclusion DNA fingerprinting study is a reliant method to differentiate crude A lappa from its processed product