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BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.
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Mixed reality (MR), characterized by the ability to integrate digital data into human real feeling, is a new technique in medical imaging and surgical navigation. MR has tremendous value in surgery, but its application in oromaxillofacial head and neck oncology surgery is not yet reported. This paper reports the application of MR in oromaxillofacial head and neck oncology surgery. The merits, demerits, and present research situations and prospects of MR are further discussed.
Subject(s)
Humans , Augmented Reality , Surgery, Computer-AssistedABSTRACT
Five secondary metabolites, including a new isopimarane derivative xylaroisopimaranin A (1), were isolated from the endophytic fungus Xylaralyce sp. (HM-1), and their structures were elucidated by 1D, 2D NMR, MS and CD spectra. Their bioactivities were performed to antibacterial, Hep G2 cells cytotoxicity and brine shrimp inhibition. The biological evaluation results showed that the xylaroisopimaranin A (1), xylabisboein B (2), griseofulvin (3) , 5-methylmellein (4) and mellein-5-carboxlic acid (5) displayed no significant Hep G2 cells cytotoxicity and antibacterial acitivity, but they inhibited the brine shrimp with IC₅₀ from 0.5 to 25 µmol/mL.
Subject(s)
Artemia , Fungi , Griseofulvin , Hep G2 CellsABSTRACT
[Abstract] China has a vast territory and often needs workers in a special environment. Working and training in a special environment (such as high temperature, plateau anoxia, cold, long voyage, and so on) will put forward higher requirements for the body, and the body will also have adaptive changes. However, once the compensation range of the body is exceeded, there will be a series of discomfort and even pathological changes. A small number of literatures have described the major changes of the whole body under various special conditions, but there is still a lack of related summary of the metabolic changes, compensatory changes and pathological changes of kidney under various extreme environments. Therefore, the compensatory modification of the kidney and the possible causes of injury in various special environments have been summarized and analyzed in present paper, and combined with the related pathophysiological mechanism, the related protective measures of kidney have also been introduced.
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Background@#Automated peritoneal dialysis (APD) can cater to individual needs, provide treatment while asleep, take into account the adequacy of dialysis, and improve the quality of life. Currently, independent research and development of APD machines made in China are more conducive to patients. A randomized, multicenter, crossover study was conducted by comparing an APD machine made in China with an imported machine. The safety, effectiveness, and manipulability of the two machines were compared.@*Methods@#Two hundred and sixty patients who underwent peritoneal dialysis (PD) on a regular basis in 18 centers between August 2015 and February 2016 were included. The inclusion criteria include age ≥18 years and PD ≥30 days. The exclusion criteria were as follows: hemodialysis; exit site or tunnel infection; and peritonitis ≤30 days. The patients were randomly divided into Group A, who were first treated with a FM machine made in China, then changed to an imported machine; and Group B, who were treated using the reverse sequence. APD treatment was performed with 10 L/10 h and 5 cycles of exchange. After 72 h, the daily peritoneal Kt/V, the accuracy of the injection rate, accuracy of the injection temperature, safety, and manipulability of the machine were assessed. Noninferiority test was conducted between the two groups.@*Results@#The daily peritoneal Kt/V in the APD machine made in China and the imported APD machine were 0.17 (0.14, 0.25) and 0.16 (0.13, 0.23), respectively. There was no significant difference between the groups (Z = 0.15, P = 0.703). The lower limit of the daily Kt/V difference between the two groups was 0.0069, which was greater than the noninferiority value of -0.07 in this study. The accuracy of the injection rate and injection temperature was 89.7% and 91.5%, respectively, in the domestic APD machine, which were both slightly better than the accuracy rates of 84.0% and 86.8% in the imported APD machine (89.7% vs. 84.0%, P = 0.2466; 91.5% vs. 86.8%, P = 0.0954). Therefore, the APD machine made in China was not inferior to the imported APD machine. The fuselage of the imported APD machine was space-saving, while the APD machine made in China was superior with respect to body mobility, man-machine dialog operation, alarm control, and patient information recognition.@*Conclusions@#The FM machine made in China was not inferior to the imported APD machine. In addition, the FM machine made in China had better operability.@*Trial Registration@#Clinicaltrials.gov, NCT02525497; https://clinicaltrials.gov/ct2/results?cond=&term=NCT02525497&cntry=& state=&city=&dist=.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , China , Cross-Over Studies , Multicenter Studies as Topic , Peritoneal Dialysis , Methods , Quality of Life , TemperatureABSTRACT
Two new polyketides, chinoketides A and B (1 – 2) with a known compound xylarphthalide A (3), were isolated from the solid medium of the endophytes from the leaves of the relic plant Distylium chinense with the “black-box” co-culture method, and the structures of two new compounds were elucidated by NMR, MS and CD spectra. And the absolute configurations of chinoketides A (1) and B (2) were determined as 2R,3R,8S and 5R,6S by calculating their ECD spectra to compare with the experimental CD spectra. Finally, the antimicrobial activities were evaluated to Erwinia carotovora sub sp. Carotovora (Jones) Bersey et al, and the results showed that compounds 1 – 3 displayed the antimicrobial activities with MIC value at 20.5, 30.4 and 10.2 µg/mL.
Subject(s)
Coculture Techniques , Endophytes , Methods , Pectobacterium carotovorum , Plants , PolyketidesABSTRACT
Phosphatase and tension homolog pseudogene 1 (PTENP1) is a pseudogene of phosphatase and tension homology deletion (PTEN), a well-known carcinoma suppressor gene.It belongs to processed pseudogenes which is unable to encode functional proteins. Its transcription product is a member of long noncoding RNA(lncRNA) family. PTENP1 primarily modulates the expression of PTEN at the levels of epigenetics and post-transcription, and then it plays a significant role in inhibiting oncogenesis via the signaling pathways of PI3/AKT, MAPK etc. The present paper is intended to summarized the existing researches of PTENP1 in human tumors and provide some help for future studies.
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Donation after brain death followed by circulatory death (DBCD) is a unique practice in China. The aim of this study was to define the pathologic characteristics of DBCD liver allografts in a porcine model. Fifteen male pigs (25-30 kg) were allocated randomly into donation after brain death (DBD), donation after circulatory death (DCD) and DBCD groups. Brain death was induced by augmenting intracranial pressure. Circulatory death was induced by withdrawal of life support in DBCD group and by venous injection of 40 mL 10% potassium chloride in DCD group. The donor livers were perfused in situ and kept in cold storage for 4 h. Liver tissue and common bile duct samples were collected for hematoxylin and eosin staining, TUNEL testing and electron microscopic examination. Spot necrosis was found in hepatic parenchyma of DBD and DBCD groups, while a large area of necrosis was shown in DCD group. The apoptosis rate of hepatocytes in DBD [(0.56±0.30)%] and DBCD [(0.50 ± 0.11)%] groups was much lower than that in DCD group [(3.78±0.33)%] (P<0.05). And there was no significant difference between DBD group and DBCD group (P>0.05)). The structures of bile duct were intact in both DBD and DBCD groups, while the biliary epithelium was totally damaged in DCD group. Under electron microscope, the DBD hepatocytes were characterized by intact cell membrane, well-organized endoplasmic reticulum, mild mitochondria edema and abundant glycogens. Broken cell membrane, mild inflammatory cell infiltration and sinusoidal epithelium edema, as well as reduced glycogen volume, were found in the DBCD hepatocytes. The DCD hepatocytes had more profound cell organelle injury and much less glycogen storage. In conclusion, the preservation injury of DBCD liver allografts is much less severe than that of un-controlled DCD, but more severe than that of DBD liver allografts under electron microscope, which might reflect post-transplant liver function to some extent.
Subject(s)
Animals , Humans , Allografts , Apoptosis , Brain Death , China , Death , Heart Arrest , Hepatocytes , Pathology , In Situ Nick-End Labeling , Liver , Pathology , Liver Transplantation , Methods , Microscopy, Electron , Organ Preservation , Methods , Swine , Tissue Donors , Tissue and Organ Procurement , MethodsABSTRACT
Donation after brain death followed by circulatory death (DBCD) is a unique practice in China. The aim of this study was to define the pathologic characteristics of DBCD liver allografts in a porcine model. Fifteen male pigs (25-30 kg) were allocated randomly into donation after brain death (DBD), donation after circulatory death (DCD) and DBCD groups. Brain death was induced by augmenting intracranial pressure. Circulatory death was induced by withdrawal of life support in DBCD group and by venous injection of 40 mL 10% potassium chloride in DCD group. The donor livers were perfused in situ and kept in cold storage for 4 h. Liver tissue and common bile duct samples were collected for hematoxylin and eosin staining, TUNEL testing and electron microscopic examination. Spot necrosis was found in hepatic parenchyma of DBD and DBCD groups, while a large area of necrosis was shown in DCD group. The apoptosis rate of hepatocytes in DBD [(0.56±0.30)%] and DBCD [(0.50 ± 0.11)%] groups was much lower than that in DCD group [(3.78±0.33)%] (P0.05)). The structures of bile duct were intact in both DBD and DBCD groups, while the biliary epithelium was totally damaged in DCD group. Under electron microscope, the DBD hepatocytes were characterized by intact cell membrane, well-organized endoplasmic reticulum, mild mitochondria edema and abundant glycogens. Broken cell membrane, mild inflammatory cell infiltration and sinusoidal epithelium edema, as well as reduced glycogen volume, were found in the DBCD hepatocytes. The DCD hepatocytes had more profound cell organelle injury and much less glycogen storage. In conclusion, the preservation injury of DBCD liver allografts is much less severe than that of un-controlled DCD, but more severe than that of DBD liver allografts under electron microscope, which might reflect post-transplant liver function to some extent.
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<p><b>OBJECTIVE</b>To evaluate the outcomes of liver transplant recipients who received liver allografts from hepatitis B surface antigen (HBsAg)-positive donors.</p><p><b>METHODS</b>The medical records of 23 male patients (median age, 42.5 years; range: 29-61) who received HBsAg-(+) liver allografts in our organ transplant center were retrospectively analyzed. All patients had confirmed diagnosis of end-stage liver disease (ESLD) secondary to hepatitis B virus (HBV) infection, including 13 HBsAg(+)/HBeAg(-)/HBcAb(+) cases and 10 HBsAg(+)/HBeAb(+)/HBcAb(+) cases. After transplantation, all patients were administered oral entecavir and intravenous anti-hepatitis B immunoglobulin (HBIG) (2000 IU/d during the first week), along with a steroid-free immune suppression regimen. HBV-related antigen and antibody and HBV DNA were detected on post-transplantation days 1, 7, 14, 21, and 30. The liver allografts were monitored by ultrasound imaging. After discharge, monthly follow-up recorded liver function, renal function, acute rejection, infections, vascular complications, biliary complications, HBV recurrence, cancer recurrence, and patient survival.</p><p><b>RESULTS</b>Two of the recipients died from severe perioperative pneumonia. The remaining 21 recipients were followed-up for 10 to 38 months, and all 21 patients remained HBsAg(+). One recipient developed biliary ischemia and required a second liver transplantation at five months after the primary transplantation. Three recipients (all primary) died from tumor recurrence at 9, 14, and 18 months post-transplantation, respectively. All other recipients survived and had acceptably low HBV DNA copy levels. Color Doppler imaging showed good graft function and normal texture. The patient and graft survival rates were 78.3% (18/23) and 73.9% (17/23), respectively. The recurrence rate of HBV infection was 100% (23/23). In surviving patients, no liver function abnormality, graft loss, or death was found to be related to the recurrence of HBV infection.</p><p><b>CONCLUSION</b>Liver transplantation using HBsAg(+) liver grafts was safe for patients with ESLD secondary to HBV infection.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , End Stage Liver Disease , General Surgery , Virology , Hepatitis B Surface Antigens , Allergy and Immunology , Liver Transplantation , Allergy and Immunology , Methods , Recurrence , Retrospective Studies , Tissue DonorsABSTRACT
<p><b>OBJECTIVE</b>To discuss the diagnosis and treatment of the crush syndrome in the earthquake.</p><p><b>METHODS</b>Thirty-five patients with crush syndrome caused by earthquake were involved the retrospective study. The role of nutritional support, active wound treatment and hemodialysis on the patients' recovery was observed.</p><p><b>RESULTS</b>The function of the heart and kidneys were gradually improved by the planned removal of the necrotic tissue, which laid a foundation for the further repair of the wound.</p><p><b>CONCLUSION</b>The removal of necrotic tissue, which can decrease the toxic absorption, will improve the success rate for treatment of the crush syndrome patients when being assisted with the hemodialysis.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , China , Crush Syndrome , General Surgery , Therapeutics , Disasters , Earthquakes , Renal Dialysis , Retrospective StudiesABSTRACT
<p><b>BACKGROUND</b>Recently, much attention has been paid to hepatic artery reconstruction in rat liver transplantation, which can prevent bile duct ischemia and preserve better liver structure. In this study, three methods of graft arterialization, including sleeve, cuff, and stent anastomosis, were conducted and the results were compared.</p><p><b>METHODS</b>Orthotopic liver transplantation (OLT) with rearterialization was conducted in 90 rats, which were divided into sleeve, cuff, and stent groups (n = 30 in each). Ninety-six rats received OLTs with standardized two-cuff technique without rearterialization as a control. The sleeve technique included an end-to-end anastomosis between the donor common hepatic artery and recipient proper hepatic artery, or between the donor celiac artery and recipient common hepatic artery. Cuff technique involved an anastomosis between the donor common hepatic artery and recipient common hepatic artery. In the stent technique, the recipient hepatic artery and donor hepatic artery were connected using an intraluminal polyethylene stent. The arterial anastomosis time and arterial patency rate in each group were recorded. The liver graft survival and bile duct complication rates were measured.</p><p><b>RESULTS</b>The total surgical time of OLT with rearterialization was (118.3 +/- 12.9) minutes in the sleeve group, (106.2 +/- 11.6) minutes in the cuff, (93.8 +/- 10.2) minutes in the stent, and (88.2 +/- 9.6) minutes in the control. The corresponding anhepatic phase was (19.6 +/- 2.8), (19.2 +/- 2.2), (18.6 +/- 1.8), and (20.0 +/- 2.5) minutes respectively in the sleeve, cuff, stent, and control groups. One-week survival rate was 86.5% in the control, and 86.7% in the groups with rearterialization. No significant difference was detected in the survival rate between them (P > 0.05). The incidence of biliary complications in non-rearterialized group (17.7%) was significantly higher than that in the rearterialized group (6.7%, P < 0.05). No significant difference was found in the incidence of biliary complications among the three rearterialized groups (P > 0.05).</p><p><b>CONCLUSIONS</b>The OLT with rearterialization is more physiological than that without rearterialization, and leads to a lower rate of bile duct complications. Among the three methods of rearterialization, sleeve anastomosis is associated with a higher survival rate, allowing less dissection and less injury to the surrounding tissues.</p>
Subject(s)
Animals , Male , Rats , Hepatic Artery , General Surgery , Liver , Pathology , General Surgery , Liver Transplantation , Methods , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To study the accumulation of fluoride in rat hippocampus and its effect on cholinesterase activity.</p><p><b>METHODS</b>Rats were subchronically exposed to NaF, and fluoride concentration and cholinesterase activity in rat hippocampus were determined.</p><p><b>RESULTS</b>Fluoride concentration in rat hippocampus was significantly correlated with the dosage of fluoride, and there were significant differences among high dosage group [(13.03 +/- 1.79) micro g/g], low dosage group [(9.83 +/- 0.92) micro g/g] and control [(8.27 +/- 1.11) micro g/g], P < 0.01. Acetylcholinesterase activities among three groups [(0.111 +/- 0.031) micro mol/mg, (0.143 +/- 0.025) micro mol/mg, (0.183 +/- 0.027) micro mol/mg] were also significantly different (P < 0.01), which was negatively correlated with fluoride concentration in rat hippocampus (r = -0.700, P < 0.01). The activity of butylcholinesterase in high dosage group [(0.041 +/- 0.010) micro mol/mg] was different from that of control [(0.067 +/- 0.025) micro mol/mg, P < 0.05], but the activity was not significantly related with fluoride concentration in rat hippocampus (r = -0.317, P = 0.094).</p><p><b>CONCLUSION</b>Fluoride may go through the blood-brain barrier and accumulate in rat hippocampus, and inhibit the activity of cholinesterase.</p>