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1.
Article in Chinese | WPRIM | ID: wpr-920817

ABSTRACT

@#Objective    To systematically review risk factors for esophagogastric anastomotic leakage (EGAL) after  esophageal cancer surgery for adults to provide theoretical basis for clinical prevention and treatment. Methods    PubMed, Web of Science, The Cochrane Library, WanFang Data, VIP, CNKI and CBM were searched from inception to January 2020 to collect case control studies and cohort studies about risk factors for EGAL after esophageal cancer surgery. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using RevMan 5.3 software. Results    A total of 33 studies were included, including 19 case-control studies and 14 cohort studies, all of which had a Newcastle-Ottawa Scale (NOS)≥6. There were 26 636 patients, including 20 283 males and 6 353 females, and there were 9 587 patients in China and 17 049 patients abroad. The results of meta-analysis showed that the following factors could increase the risk for EGAL (P≤0.05), including patient factors (18): age, sex, body mass index (BMI), smoking history, smoking index (≥400), alcohol history, digestive tract ulcer, respiratory disease, lower ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), chronic obstructive pulmonary disease (COPD), coronary atherosclerosis, peripheral vascular disease, arrhythmia, diabetes, hypertension, cerebrovascular disease, celiac trunk calcification and descending aortic calcification; preoperative factors (6): abnormal liver function, renal insufficiency, American Society of Anesthesiologists (ASA) grading, neoadjuvant radiotherapy and preoperative albumin<35 g/L, preoperative lower albumin; intraoperative factors (7): retrosternal route, cervical anastomosis, thoracoscopic surgery, operation time≥4.5 h, tubular stomach, upper segment tumor, splenectomy; postoperative factors (5): respiratory failure, postoperative arrhythmia, use of fiberoptic bronchoscopy, pulmonary infection, deep venous thrombosis. Neoadjuvant chemotherapy could reduce the risk for postoperative EGAL (P<0.05). However, age≥60 years, upper gastrointestinal inflammation, diffusing capacity for carbon monoxide (DLCO%), thoracic surgery history, abdominal surgery history, glucocorticoid drugs history, neoadjuvant chemoradiotherapy, anastomotic embedding, end-to-end anastomosis, hand anastomosis, intraoperative blood loss and other factors were not significantly correlated with EGAL. Conclusion    Current evidence suggests that the risk factors for postoperative EGAL include age, sex, BMI, smoking index, alcohol history, peptic ulcer, FEV1/FVC, COPD, diabetes, ASA grading, neoadjuvant radiotherapy, preoperative albumin<35 g/L, cervical anastomosis, thoracoscopic surgery, operation time≥4.5 h, tubular stomach, upper segment tumor, intraoperative splenectomy, postoperative respiratory failure, postoperative arrhythmia and other risk factors. Neoadjuvant chemotherapy may be the protection factor for EGAL. Due to limited study quality, more high quality studies are needed to verify the conclusion.

2.
Ultrasonography ; : 140-149, 2022.
Article in English | WPRIM | ID: wpr-919565

ABSTRACT

Purpose@#This study explored the performance of prenatal ultrasonography in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC). @*Methods@#Fetuses diagnosed with hepatic hilar cyst in the second trimester were included in this study. A series of prenatal ultrasound examinations were performed in the second and third trimesters. The diameter of the gallbladder (GB) and hepatic cyst were measured, as well as the wall thickness of the GB. The GB-cyst connection, visibility of the right hepatic artery (RHA), and other concomitant abnormalities were carefully evaluated. A neonatal transabdominal ultrasound examination was performed within 1 week after birth, and clinical data were followed up to 6 months after birth. @*Results@#Between January 1, 2016 and January 31, 2020, 53 fetuses diagnosed with hepatic hilar cyst were recruited. Eight were excluded because they were lost to follow-up. Among the 45 cases included in this study, 10 were diagnosed with CBA and 35 with CC after birth. Statistically significant differences were found in GB width, wall thickness, change in GB width, change in cyst length, GB-cyst connection, and RHA visibility between the CBA and CC groups. GB width showed the best diagnostic performance with an area under the curve (AUC) of 0.899. The combination of GB width, GB wall thickness, and GB-cyst connection yielded a comparable AUC of 0.971. @*Conclusion@#The GB should be carefully evaluated in fetuses with hepatic hilar cyst. Prenatal ultrasound findings could provide suggestive parameters for the differential diagnosis of CBA from CC.

3.
Chinese Journal of Traumatology ; (6): 118-121, 2022.
Article in English | WPRIM | ID: wpr-928482

ABSTRACT

Intertrochanteric fractures have become a severe public health problem in elderly patients. Proximal femoral nail anti-rotation (PFNA) is a commonly used intramedullary fixation device for unstable intertrochanteric fractures. Pelvic perforation by cephalic screw is a rare complication. We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture. The patient underwent surgery with PFNA as the intramedullary fixation device. Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation. We performed a cemented total hip arthroplasty as the savage procedure. At the latest follow-up of 12 months after total hip arthroplasty, the patient had no pain or loosening of the prosthesis in the left hip. Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device, especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation. The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.


Subject(s)
Aged , Aged, 80 and over , Bone Nails/adverse effects , Female , Femur , Fracture Fixation, Intramedullary/adverse effects , Hip Fractures/surgery , Humans , Retrospective Studies , Treatment Outcome
4.
Article in Chinese | WPRIM | ID: wpr-927853

ABSTRACT

Objective To screen the potential key genes of osteosarcoma by bioinformatics methods and analyze their immune infiltration patterns. Methods The gene expression profiles GSE16088 and GSE12865 associated with osteosarcoma were obtained from the Gene Expression Omnibus(GEO),and the differentially expressed genes(DEGs)related to osteosarcoma were screened by bioinformatics tools.Gene Ontology(GO)annotation,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment,and analysis of immune cell infiltration were then carried out for the DEGs.The potential Hub genes of osteosarcoma were identified by protein-protein interaction network,and the expression of Hub genes in osteosarcoma and normal tissue samples was verified via the Cancer Genome Atlas(TCGA). Results A total of 108 DEGs were screened out.GO annotation and KEGG pathway enrichment revealed that the DEGs were mainly involved in integrin binding,extracellular matrix (ECM) structural components,ECM receptor interactions,and phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)signaling pathway.Macrophages were the predominant infiltrating immune cells in osteosarcoma.Secreted phosphoprotein 1(SPP1),matrix metallopeptidase 2(MMP2),lysyl oxidase(LOX),collagen type V alpha(II)chain(COL5A2),and melanoma cell adhesion molecule(MCAM)presented differential expression between osteosarcoma and normal tissue samples(all P<0.05). Conclusions SPP1,MMP2,LOX,COL5A2,and MCAM are all up-regulated in osteosarcoma,which may serve as potential biomarkers of osteosarcoma.Macrophages are the key infiltrating immune cells in osteosarcoma,which may provide new perspectives for the treatment of osteosarcoma.


Subject(s)
Bone Neoplasms/immunology , Computational Biology/methods , Gene Expression Profiling/methods , Humans , Osteosarcoma/immunology , Phosphatidylinositol 3-Kinases/genetics , Tumor-Associated Macrophages/immunology
5.
Article in English | WPRIM | ID: wpr-927682

ABSTRACT

Objective@#miR-663a has been reported to be downregulated by X-ray irradiation and participates in radiation-induced bystander effect via TGF-β1. The goal of this study was to explore the role of miR-663a during radiation-induced Epithelium-to-mesenchymal transition (EMT).@*Methods@#TGF-β1 or IR was used to induce EMT. After miR-663a transfection, cell migration and cell morphological changes were detected and the expression levels of miR-663a, TGF-β1, and EMT-related factors were quantified.@*Results@#Enhancement of cell migration and promotion of mesenchymal changes induced by either TGF-β1 or radiation were suppressed by miR-663a. Furthermore, both X-ray and carbon ion irradiation resulted in the upregulation of TGF-β1 and downregulation of miR-663a, while the silencing of TGF-β1 by miR-663a reversed the EMT process after radiation.@*Conclusion@#Our findings demonstrate an EMT-suppressing effect by miR-663a via TGF-β1 in radiation-induced EMT.


Subject(s)
Down-Regulation , Epithelial-Mesenchymal Transition , Epithelium/metabolism , MicroRNAs/metabolism , Transforming Growth Factor beta1/pharmacology
6.
Journal of Preventive Medicine ; (12): 385-388, 2022.
Article in Chinese | WPRIM | ID: wpr-923720

ABSTRACT

Objective@#To investigate vitamin D levels among primary and middle school students in Xicheng District, Beijing Municipality, and to examine the association of vitamin D levels with hemoglobin (Hb) and serum ferritin (SF) levels, so as to provide insights into the prevention of anemia among primary and middle school students. @*Methods@#The first, third and fifth grade primary school students and the first grade junior high school students were sampled from Xicheng District in 2019, using the multistage stratified cluster sampling method, and students' gender, age, height, weight and Hb levels were collected. The 25-hydroxyvitamin D [25-( OH )D] was measured using electrochemiluminescence assay, and SF was detected using immunoturbidimetry. The vitamin D deficiency was determined according to the American College of Endocrinology guidelines. The associations of 25-( OH) D levels with Hb and SF levels were examined using Pearson correlation analysis and Spearman rank correlation analysis. @*Results@#Totally 403 primary and junior high school students were investigated, including 196 boys ( 48.64% ) and 207 girls ( 51.36% ). There were 179, 114 and 110 students at ages of 6 to 8 years ( 44.41% ), 9 to 11 years ( 28.29% ) and 12 to 13 years ( 27.30% ), respectively. The mean 25-( OH )D level was ( 14.80±5.96 ) ng/mL among the study students, and there were 90 students ( 22.33% ) with severe vitamin D deficiency, 243 students ( 60.30% ) with vitamin D deficiency, 63 students ( 15.63% ) with vitamin D inadequacy and 7 students ( 1.74% ) with vitamin D sufficiency. The mean Hb level was ( 136.28±8.33 ) g/L and the median SF level (interquartile range) was 56.80 (14.36) ng/mL among the study students, respectively. The 25-( OH )D level positively correlated with Hb ( r=0.364, P<0.001 ) and SF levels ( rs=0.374, P<0.001 ), and after adjustment for age and body mass index, the 25-( OH )D still correlated positively with Hb ( r=0.157, P=0.048 ) and SF levels ( rs=0.174, P=0.022 ) .@*Conclusions@#Vitamin D deficiency is prevalent among primary and middle school students in Xicheng District, and the 25-(OH)-D levels correlate positively with Hb and SF levels. 25-( OH )-D deficiency may contribute to the development of anemia.


Subject(s)
Vitamin D , Hemoglobins
7.
Chinese Journal of Radiology ; (12): 1167-1171, 2021.
Article in Chinese | WPRIM | ID: wpr-910280

ABSTRACT

Objective:To evaluate the application value of double-layer spectral detector CT (DLSDCT) in differentiating central lung cancer from atelectasis.Methods:Fifty-one patients with central lung cancer accompanied by atelectasis confirmed by pathology in Shandong Cancer Hospital from January to December 2020 were enrolled. The differentiating rates of tumor from atelectasis of the conventional CT, 40 keV virtual monoenergetic imaging (MonoE), iodine density map (ID), and 40 keV MonoE-ID fusion images of unenhanced scan, arterial and venous phase were retrospectively analyzed. Cochran′s Q test was used to compare the differentiating rate (Bonferroni correction afterwards), and Friedman test was used to compare the maximum diameter of the tumor of each imaging method.Results:Of the 51 patients, none of the conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the unenhanced scan could distinguish lung tumors from atelectasis; the number of cases in which the conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the arterial phase could distinguish lung tumors from atelectasis regions was 4, 5, 5 and 6, respectively; the number of cases in which the conventional CT, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the venous phase could distinguish lung tumors from atelectasis regions was 17, 35, 39 and 38, respectively, and the difference was statistically significant (χ 2=52.40, P<0.001). The differentiating rates of the 40 keV MonoE, ID, and 40 keV MonoE-ID fusion image were significantly higher than that of conventional CT image (χ2=-0.35, -0.43, -0.41, P<0.001, Bonferroni correction afterwards); There was no significant difference in the differentiating rate among 40 keV MonoE, ID and MonoE-ID fusion image ( P=1.00). Seventeen tumors could be differentiated in conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images of venous phase, and the maximum diameters of lung tumors were (50±21) mm, (50±23) mm, (50±23) mm, and (50±23) mm, respectively, and the difference was not statistically significant (χ2=3.61, P=0.31). Conclusions:The venous phase spectral images of DLSDCT can differentiate most central lung cancer from atelectasis. Therefore, it has great clinical application value in tumor staging, efficacy evaluation, and radiotherapy.

8.
Article in Chinese | WPRIM | ID: wpr-909989

ABSTRACT

Objective:To discuss the pathological characteristics and strategy for diagnosis and treatment of the transolecranon fracture-dislocation of the elbow in children.Methods:Retrospectively reviewed were the 15 patients who had been treated at Hospital of Pediatric Orthopedics, Xi'an Honghui Hospital from October 2016 to March 2019 for transolecranon fracture-dislocation of the elbow. They were 11 boys and 4 girls, with an average age of 8.3 years (from 5 to 14 years) and 10 left and 5 right arms injured. Type Ⅰ (simple fracture) was found in 11 cases and type Ⅱ (comminuted fracture) in 4 cases in 3 of which the coronoid process was affected. Of them, 14 were treated successfully with closed reduction and plaster fixation under local anesthesia in emergency but one was unsuccessfully. Of the 11 simple fractures, 10 received tension band fixation with Kirschner wire and a short oblique one underwent bone plate fixation; the 4 comminuted fractures were treated by fixation with a combination of Kirschner wire and bone plate.Results:The 15 patients obtained follow-up for 8 to 15 months (average, 11 months). The final follow-up observed fine anatomical relationship of the elbow in all patients, and no such complications as relapse of radial head dislocation, avascular necrosis of the trochlea or early closure of the epiphyseal plate. The transolecranon fracture-dislocation of the elbow obtained bony union in all patients after 5 to 7 weeks (average, 5.6 weeks). The therapeutic efficacy was evaluated at the final follow-up by the Mayo elbow performance score as excellent in 11 cases, as good in 3 and as fair in one.Conclusions:As a type of complicated fracture-dislocation of the elbow, the transolecranon fracture-dislocation of the elbow is rare in children, mainly manifested as simple ones. Treatment options depend on the type of fracture-dislocation. Only anatomical reduction of the olecranon fracture and restoration of a normal trochlear notch can lead to a stable humeroradial joint and thus fine clinical efficacy.

9.
Article in Chinese | WPRIM | ID: wpr-908897

ABSTRACT

Objective:To enhance the comprehensive learning and clinical practice capabilities of intravenous therapy specialized nurses based on the "Internet+" and standardized patient (SP) multidisciplinary linkage teaching.Methods:In this study, 54 nurses who took training of the intravenous therapy specialists in Chaoyang Hospital affiliated to Capital Medical University from July 2019 to December 2019 were selected as research subjects and randomly divided into a control group and a study group, with 27 ones in each group. The control group used traditional training of intravenous therapy specialized nurse, and the research group used the multidisciplinary linkage model of "Internet+" and SP. After the training, the nurses were assessed for theoretical and practical operation and satisfaction surveys, and the incidence of venous catheterization complications during the training of the two groups of nurses was counted. SPSS 22.0 was used for t test and chi-square test. Results:There was no statistically significant difference between the two groups of nurses in the theoretical assessment of basic knowledge and professional knowledge ( P>0.05). The total score of case analysis and theoretical assessment of the study group was higher than that of the control group, and the difference was statistically significant ( P<0.001). The nurses of the study group scored higher than the control group did in such 8 aspects, namely, central venous catheter (CVC) maintenance, peripherally inserted central catheter (PICC) placement, PICC maintenance, infusion port maintenance, peripheral venous catheters, aseptic technique, prevention and treatment of catheterization complications, and health education, with statistically significant differences ( P<0.05). There were statistically significant differences in the average score of nurse satisfaction between the two groups [(85.4±3.7) vs. (95.7±2.6)], and in the incidence of complications between the two groups ( χ2=4.618, P=0.032). Conclusion:"Internet+" and SP multidisciplinary linkage teaching helps to enhance the comprehensive learning and clinical practice ability of intravenous therapy specialized nurses, reduce the incidence of complications, enable patients to receive high-quality intravenous infusion therapy and care, and ensure the safety of patients.

10.
Acta Physiologica Sinica ; (6): 795-804, 2021.
Article in English | WPRIM | ID: wpr-921282

ABSTRACT

Farnesoid X receptor (FXR) has been identified as an inhibitor of platelet function and an inducer of fibrinogen protein complex. However, the regulatory mechanism of FXR in hemostatic system remains incompletely understood. In this study, we aimed to investigate the functions of FXR in regulating antithrombin III (AT III). C57BL/6 mice and FXR knockout (FXR KO) mice were treated with or without GW4064 (30 mg/kg per day). FXR activation significantly prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT), lowered activity of activated factor X (FXa) and concentrations of thrombin-antithrombin complex (TAT) and activated factor II (FIIa), and increased level of AT III, whereas all of these effects were markedly reversed in FXR KO mice. In vivo, hepatic AT III mRNA and protein expression levels were up-regulated in wild-type mice after FXR activation, but down-regulated in FXR KO mice. In vitro study showed that FXR activation induced, while FXR knockdown inhibited, AT III expression in mouse primary hepatocytes. The luciferase assay and ChIP assay revealed that FXR can bind to the promoter region of AT III gene where FXR activation increased AT III transcription. These results suggest FXR activation inhibits coagulation process via inducing hepatic AT III expression in mice. The present study reveals a new role of FXR in hemostatic homeostasis and indicates that FXR might act as a potential therapeutic target for diseases related to hypercoagulation.


Subject(s)
Animals , Antithrombin III , Blood Coagulation , Hepatocytes , Liver , Mice , Mice, Inbred C57BL , Mice, Knockout , Receptors, Cytoplasmic and Nuclear/genetics
11.
Article in Chinese | WPRIM | ID: wpr-912402

ABSTRACT

Objective:To observe the clinical efficacy of oral glucocorticoids in the treatment of acute non-arteritic anterior ischemic optic neuropathy (NAION).Methods:A prospective clinical study. From December 2017 to June 2020, 40 eyes of 40 patients with acute NAION who were diagnosed in Department of Ophthalmology of Tengzhou Central People's Hospital were included in the study. All the affected eyes underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examination of optic disc; 35 eyes (BCVA≥0.1) underwent visual field examination at the same time. The BCVA examination was carried out using the international standard decimal visual acuity chart, which was converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. The static visual field inspection was performed with Humphrey automatic perimeter to obtain the average mean deviation (MD) value. The thickness of peripapillary retinal nerve fire layer (pRNFL) around the optic disc of the affected eye was measured with an OCT instrument. According to the wishes of patients, they were divided into hormone treatment group and control group. All were given vitamin B1 and methylcobalamin orally; the hormone treatment group was given oral prednisone acetate treatment, 60 mg/d (regardless of body weight); after 2 weeks, the dose was reduced by 5 mg every 5 days, and the dose was reduced to 40 mg and maintained until optic disc edema subsides; thereafter, the dose was quickly reduced until the drug was stopped. Three and 6 months after treatment, the same equipment and methods were used for related examinations before treatment to observe the thickness changes of BCVA, MD, and pRNFL. The thickness of BCVA, MD, and pRNFL between the two groups was compared by Mann-Whitney U test. The thickness of BCVA, MD, and pRNFL before and after treatment within the group was compared by rank analysis of variance. Results:Among 40 eyes of 40 cases, 21 eyes were in the hormone treatment group, and 19 eyes were in the control group. There were differences in age, sex composition, course of disease, associated systemic risk factors, BCVA, MD, and pRNFL thickness between the two groups. There was no statistical significance ( P>0.05). At 3 and 6 months after treatment, the average logMAR BCVA of the eyes of the hormone treatment group and the control group were 0.26±0.32, 0.26±0.34, 0.28±0.30, 0.25±0.32, respectively. The visual field MD were -15.52±6.87, -15.55±6.04 dB and -14.82±7.48, -15.18±6.40 dB; pRNFL thickness was 70.38±10.22, 73.79±11.82 μm and 65.67±10.07, 69.26±10.85 μm. LogMAR BCVA ( Z=-0.014, -0.315; P=1.000, 0.768), visual field MD ( Z=-0.041, -0.068; P=0.979, 0.957), pRNFL thickness ( Z= -0.965, -1.112; P=0.347, 0.270), the difference was not statistically significant. Conclusion:Compared with the control group, oral glucocorticoid treatment of acute NAION fail to improve the visual function and morphological prognosis during the 6-month follow-up period.

12.
Chinese Journal of School Health ; (12): 627-630, 2021.
Article in Chinese | WPRIM | ID: wpr-876418

ABSTRACT

Objective@#To analyze the role of school based symptom monitoring system in public health emergencies in Hangzhou, to provide the basis for prevention and control strategies for public health emergencies in schools.@*Methods@#Data regarding school public health emergencies in Hangzhou in 2019 were collected from the Public Health Emergencies Report Management Information System, and data regarding public health early warning in schools were collected from the Hangzhou School Symptom Monitoring System. The usage of school symptom monitoring system was analyzed by SAS 9.0 software, and the positive warning events and public health emergencies were compared and analyzed, the rate and composition ratio were compared with the χ 2 test, the number of cases was compared with the non parameter rank and the Mann Whitney test, and the trend test was conducted using Cochran Armitage test.@*Results@#In 2019, the average use rate of the city s school symptom monitoring system was 54.65%, the average response rate of automatic early warning was 70.68%, and the use rate (χ 2=860.79, p<0.01) and automatic early warning response rate (χ 2=1 615.91,P<0.01) of school systems varied greatly by region. In 2019, 161 positive early warning incidents were detected through the school symptom monitoring system, 197 public health emergencies were reported through the emergency network, and fewer public health emergencies were reported in areas where more positive warning events were detected(Z=10.65,P<0.01). The proportion of disease category in positive warning events was different from that in public health emergencies in(χ 2=28.33, P<0.01). The number of cases of positive early warning events of the same disease was much lower than the number of cases of public health emergencies without warning, and the time of positive warning signals was on average 4 days ahead of the time of receiving the report of public health emergencies.@*Conclusion@#Smartphone based school symptom monitoring system in Hangzhou plays a sentinel role in public health emergencies prevention and control in schools.

13.
Article in English | WPRIM | ID: wpr-874629

ABSTRACT

Background and Objectives@#The immunomodulatory potential of mesenchymal stem cells (MSCs) can be regulated by a variety of molecules, especially cytokines. The inflammatory cytokine, TNF-like ligand 1A (TL1A), has been reported as an inflammation stimulator in-multiple autoimmune diseases. Here, we studied the effects of TL1A/TNF-receptor 2 (TNFR2) pathway on the therapeutic potency of bone marrow-derived MSCs (BMSCs). @*Methods@#and Results: BMSCs, fibroblast-like synoviocytes (FLSs), and H9 and jurkat human T lymphocytes were used in this study. BMSCs paracrine activities, differentiation, proliferation, and migration were investigated after stimulation with TL1A, and intervened with anti-TNFR2. Additionally, the effects of TL1A on BMSCs therapeutic potency were evaluated by treating RA-FLSs, and H9 and jurkat T cells with TL1A-stimulated BMSCs conditioned medium (CM). Indian hedgehog (IHH) involvement was determined by gene silencing and treatment by recombinant IHH (rIHH). TL1A induced BMSCs stemness-related genes, COX-2, IL-6, IDO, TGF-β and HGF through TNFR2. Also, TL1A corrected biased differentiation and increased proliferation, and migration through TNFR2. Meanwhile, CM of TL1A-stimulated BMSCs decreased the inflammatory markers of RA-FLSs and T cells. Moreover, TL1A-stimulated BMSCs experienced IHH up-regulation coupled with NF-κB and STAT3 signaling up-regulation, while p53 and oxidative stress were down-regulated. Furthermore, treatment of BMSCs by rIHH increased their anti-inflammatory effects.More importantly, knockdown of IHH decreased the ability of TL1A-stimulated BMSCs to alleviating the inflammation in RA-FLSs and T cells. @*Conclusions@#This study reports the effects of TL1A/TNFR2 pathway on the biological behaviors and therapeutic potency of BMSCs through IHH. These findings could introduce novel procedures to increase the stemness of MSCs in cellular therapy.

14.
Article in Chinese | WPRIM | ID: wpr-908688

ABSTRACT

Objective:To observe the changes of skeletal muscle indexes in elderly patients with type 2 diabetes complicated with sarcopenia treated with sitagliptin and acarbose.Methods:A total of 60 patients over 60 years old with type 2 diabetes complicated with sarcopenia in Dalian Municipal Central Hospital from January 2019 to January 2020 were selected and divided into two groups by random number table method.One group received sitagliptin and metformin,and the other group received acarbose and metformin. The changes of skeletal muscle indexes, glucagon-like peptides-1 (GLP-1), insulin resistance index (HOMA-IR) and inflammatory indexes were compared between the two groups at baseline and 36 weeks after treatment.Results:After treatment, the skeletal muscle index (SMI) of sitagliptin group was increased (5.94 ± 1.52 vs. 5.99 ± 1.52), and the difference was statistically significant ( P<0.05). Muscle strength and SMI decreased in acarbosse group (18.75 ± 4.64 vs. 17.72 ± 4.44, 6.09 ± 1.74 vs. 6.00 ± 1.71), with statistical significance ( P<0.05). GLP-1 increased in sitagliptin group, 0 min: (10.65 ± 1.68) pmol/L vs. (12.41 ± 1.88) pmol/L; 60 min: (22.79 ± 2.85) pmol/L vs. (25.51 ± 2.79) pmol/L; 120 min: (24.26 ± 2.94) pmol/L vs. (29.49 ± 2.91) pmol/L; 180 min: (11.68 ± 1.84) pmol/L vs. (12.88 ± 1.83) pmol/L. There were significant differences ( P<0.05). HOMA-IR and CRP decreased: 4.73 ± 3.04 vs. 3.16 ± 2.41, (2.39 ± 0.50) mg/L vs. (2.33 ± 0.43) mg/L, and the differences were statistically significant ( P<0.05). HOMA-IR in acarbose group decreased after treatment (5.80 ± 3.94 vs. 4.00 ± 1.63), and the difference was statistically significant ( P<0.05). Comparison between the two groups after treatment, the decreased value of muscle strength in sitagliptin group was less than that in acarbose group, and the difference was statistically significant ( P<0.05). GLP-1 and overall GLP-1 area under the curve in sitagliptin group were higher than those in acarbose group (67.64 ± 6.81 vs. 58.98 ± 6.72), with statistical significance ( P<0.05). HOMA-IR and CRP in sitagliptin group were lower than those in acarborose group: 3.16 ± 2.42 vs. 4.00 ± 1.63, (2.33 ± 0.43) mg/L vs. (2.41 ± 0.70) mg/L, with statistical significances ( P<0.05). Conclusions:Sitagliptin therapy improves muscle mass and protects muscle strength in elderly patients with type 2 diabetes mellitus and sarcopenia.

15.
Article in Chinese | WPRIM | ID: wpr-908132

ABSTRACT

Objective:To explore the impact of multidisciplinary transitional nursing on AIDS patients' nursing participation, nursing continuation and virus suppression.Methods:A total of 322 patients with AIDS who were hospitalized in the Infection Department of Dalian Sixth People's Hospital from March 2014 to March 2018 were selected and randomly divided into general nursing group and multidisciplinary transitional nursing group with 161 cases in each group. The demographic and clinical data of each patient were recorded and compared, and the barriers of patients to participate in nursing and medical consultation were recorded. Consulted The patients were consulted about the nursing participation before hospitalization and the times of nursing continuation. After one year of follow-up, the number of cases of nursing participation, nursing continuity and virus suppression were recorded. The differences between the two groups were compared. The patients in the multidisciplinary transitional care group were divided into three subgroups after discharge, and the comparison between the subgroups was made. Multivariate Logistic regression analysis was performed.Results:In the multidisciplinary nursing group, 119 cases (81.51%, 119 / 146) and 105 cases (71.92%, 105 / 146) were involved in nursing and 105 cases (71.92%, 105/146) in the multidisciplinary nursing group, and 100 cases (62.11%, 100/161) and 90 cases (55.90%, 90/161) in the general nursing group 1 year after discharge, respectively. The difference between the two groups was statistically significant ( χ2 value was 14.09, 8.48, P<0.05). There was a significant difference in the number of cases in the multidisciplinary transitional care group without consulting the subgroup, only the medical and nursing consulting subgroup and medical, and the nursing and social support consulting subgroup in nursing participation, nursing continuation and increased viral suppression ( χ2 value was 22.90, 37.21, 23.07, P<0.05). The results of the regression model suggested that patients with medical and nursing consultation only, patients with medical, nursing, and social consultation had OR value of 1.67 and 1.89 compared with patients without consultation. The OR value was 1.35 and 1.76, which were significantly different. Conclusions:Through multidisciplinary transitional nursing, it can significantly improve nursing participation and nursing continuity and can improve virus suppression.

16.
Article in Chinese | WPRIM | ID: wpr-907803

ABSTRACT

Objective:To investigate the epidemiological and clinicopathological characteristics of thyroid cancer.Methods:Data of 13 673 thyroid cancer patients admitted to the First Medical Center of PLA General Hospital from Jan. 2014 to Dec. 2019 were retrospectively analyzed. According to the admission criteria, 9 662 patients were screened out, including 2 768 males and 6 894 females, with an average age of 43.98±11.28 years. According to the year of diagnosis and treatment, the incidence of thyroid cancer, the changing trend of age of new cases, the average length of hospitalization, the pathological classification of the tumor, the size of the primary tumor, multifocal tumor, and the rate of lymph node metastasis were statistically analyzed. The surgical methods were summarized and discussed.Results:① Characteristics of population economics: the ratio of males to females were 1.00:2.49, the number of cases increased year by year, and the rate of increase of female was higher than that of male. The average age of onset of the patients was (43.98±11.28) years old, and the incidence rate of the young population increased by 6.0%, showing a younger trend. The mean length of hospital stay was (7.21±2.85) d, and the length of hospital stay decreased. ② Clinicopathological features: There were 9 513 cases of papillary thyroid carcinoma (PTC) (98.46%) , 45 cases of follicular thyroid carcinoma (FTC) (0.47%) , 58 cases of medullary carcinoma (MTC) (0.60%) and 18 cases of poorly differentiated thyroid carcinoma (PDTC) (0.19%) . There were 2 cases (0.02%) of undifferentiated thyroid carcinoma (ATC) and 26 cases (0.26%) of a particular type. The tumor size was (1.10±0.85) cm, among which the microcarcinoma (D ≤1 cm) accounted for 64.5% and showed an increasing trend year by year, with the fastest growth rate. There were 3 809 cases of multifocal carcinoma (39.4%) , and the proportion of multifocal carcinoma increased year by year in recent 3 years. The central region and lateral region lymph node metastasis rates were 33.0% and 13.0%, respectively. Correlation analysis showed that the differences were statistically significant except for pathological types ( P<0.05) . ③ Surgical methods: in the first 3 years, 2 224 patients (84.2%) underwent normative primary resection, which increased to 94.9% in the last 3 years. In the first 3 years, 2 033 patients (77.0%) underwent central lymph node dissection, which increased to 91.8% in the last 3 years. In the first 3 years, 188 cases (50.5%) underwent normative lateral cervical dissection, which increased to 71.6% in the last 3 years. Conclusions:The incidence of thyroid cancer is increasing year by year, showing a younger trend; Papillary carcinoma accounts for 98.5% of thyroid cancer. The proportion of microcarcinoma and multifocal carcinoma is increasing. The rate of lymph node metastasis in the central region and lateral region is increasing; surgery is gradually standardized, and it is necessary to standardize the diagnosis and treatment of thyroid cancer and postoperative follow-up.

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Acta Pharmaceutica Sinica ; (12): 3473-3483, 2021.
Article in Chinese | WPRIM | ID: wpr-906815

ABSTRACT

We explored the mechanism of patchouli oil in the treatment of inflammatory bowel disease (IBD) based on network pharmacology and differentially expressed genes in macrophages. The chemical composition of patchouli oil was detected by GC-MS, targets for active components were collected through TCMSP and Swiss Target Prediction platform, and targets for treatment of IBD were retrieved from DrugBank, GeneCards, OMIM, PharmGkb, and TTD databases. The intersection targets were merged, Cytoscape software was used to construct the "component-to-intersection target" network, and protein-protein interaction (PPI) network was drawn with String platform. The intersection targets were enriched for GO and KEGG enrichment analysis on Metascape platform, and the molecular docking of AutoDock Vina was used to verify the analysis results. The macrophage chip data was downloaded, and the differential genes were obtained by using R software. KEGG signaling pathway analysis of differentially expressed genes were performed by DAVID platform. Real-time fluorescence quantitative PCR was used to verify the screened components in the cell model in vitro. The 14 main components of patchouli oil corresponded to 112 targets, and the intersection obtained 97 common targets of patchouli oil for IBD treatment. GO enrichment analysis yielded 53 items. Eighteen items were obtained by KEGG enrichment analysis, involving cAMP signaling pathway, Notch signaling pathway, adhesion connection, Th17 cell differentiation and other signaling pathways. Molecular docking showed that the selected active components of patchouli oil had good binding activity with the targets. Differentially expressed genes were enriched in inflammatory pathways such as Toll-like receptors, JAK-STAT and NF-κB signaling pathways. q-PCR showed that patchouli oil, patchouli alcohol, pogostone can reduce the mRNA levels of cytokines (TNF-α, IL-1β, IL-6, and IL-23) and up-regulate the mRNA levels of tight junction proteins (occludin and claudin-1) in the inflammatory model of NCM460 normal colon epithelial cells. Patchouli alcohol can significantly reduce the levels of TNF-α, IL-6, and IL-1β inflammatory factors in RAW264.7 macrophages induced by LPS. This study revealed the multi-component, multi-target and multi-pathway of patchouli oil, and confirms the anti-inflammatory effect of patchouli oil and its main components in the inflammatory cell model in vitro and the protection of intestinal epithelial barrier integrity function, which provides a theoretical basis for further elucidating the mechanism of patchouli oil in the treatment of IBD.

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China Pharmacy ; (12): 3008-3013, 2021.
Article in Chinese | WPRIM | ID: wpr-906782

ABSTRACT

OBJECTIVE:To establish the fingerprint of wine-processed Schisandra chinensis ,and to conduct cluster analysis and principal component analysis. METHODS :HPLC method was adopted. The determination was performed on Diamonsil C 18(2) column with mobile phased consisted of methanol-water (gradient elution )at the flow rate of 1 mL/min. The detection wavelength was set at 250 nm,and the column temperature was 30 ℃;the injection volume was 10 μL. With schisandrol A as the reference peak,HPLC fingerprints of 15 batches of samples were drawn and their similarity were evaluated with Similarity Evaluation System of TCM Chromatographic Fingerprint (2012 edition). The common peaks were determined. Cluster analysis and principal component analysis were performed by using SPSS 22.0 statistical software. RESULTS :There were 20 common peaks in 15 batches of samples ,and the similarities were 0.983-0.999;a total of 8 common peaks were identified ,namely 5-hydroxymethyl furfural,schisandrol A ,schisandrol B ,schisantherin A ,schisantherin B ,deoxyschizandrin,γ-schizandrin,pseudo-γ-schizandrin. The results of cluster analysis showed that 15 batches of wine-processed S. chinensis could be clustered into 4 categories. Among them,S1-S4 and S 14 were clustered into one category ,S9-S11 were clustered into one category ,S5,S7-S8,S12-S13 were clustered into one category ,and S 6 and S 15 were clustered into one category. The results of principal component analysis showed that the cumulative variance contribution rate of first four principal component s was 85.381%;the classification results were basically consistent with the results of cluster analysis. Compared with S. chinensis ,5-hydroxymethyl furfural was newly found in S. chinensis after wine-processing ,with high content ;but there was no significant difference in the other chromatographic peaks. CONCLUSIONS:The established HPLC fingerprint is simple and easy to operate ,combined with cluster analysis and principal component analysis ,can be used for quality control of wine-processed S. chinensis decoction pieces.

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Article in Chinese | WPRIM | ID: wpr-906610

ABSTRACT

Objective To analyze the epidemiological characteristic of stroke incidence and mortality in Chongqing, and to provide suggestions for targeted prevention and control of stroke. Methods Data of reported cases of ischemic stroke (I63), hemorrhagic stroke (I61-I62), subarachnoid hemorrhage (I60), and unclassified stroke (I64) in Chongqing in 2018 was collected. SPSS 25.0 was used to calculate the incidence, age-standardized incidence rate (ASIR), mortality, age-standardized mortality rate (ASMR) and proportion of stroke. The incidence and mortality of stroke were compared by Chi-square test between males and females, and between central urban areas and suburban counties. Results In 2018, the incidence and ASIR of stroke were 294.61/105 and 222.43/105 in Chongqing, respectively. The mortality and ASMR of stroke were 116.34/105 and 85.81/105. The incidence, ASIR and proportion of ischemic stroke were 186.63/105, 139.17/105 and 63.35%, respectively. The incidence of ischemic stroke in male was higher than that in female (χ2=18.52, P2=29.50, P2=6.67, P=0.010). The mortality of ischemic stroke in suburban counties was higher than that in central urban areas (χ2=17.55, P2=27.64, P2=18.60, P2=23.46, P2= 43.57, P<0.001). Conclusion The incidence and mortality of stroke in Chongqing were lower than the national average levels. The incidence of ischemic stroke was higher than that of hemorrhage stroke. The mortality of hemorrhage stroke was higher than that of ischemic stroke. Men and suburban counties were the focus of stroke prevention and control in Chongqing.

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Article in Chinese | WPRIM | ID: wpr-904729

ABSTRACT

@#How to effectively repair esophageal fistulas, caused by esophageal perforation, rupture and anastomotic leakage after esophagectomy has always been a key problem for the digestive surgeon. Although there are many clinical treatment methods, the therapeutic effect is still completely unsatisfactory, especially when severe mediastinal purulent cavity infection is associated with the esophageal fistula. In recent years, foreign centers have promoted a new minimally invasive endoscopic treatment technology to repair the esophageal fistula, endoscopic vacuum-assisted closure therapy, with significantly curative effect. In this article, we will review the specific operation, advantages and disadvantages, as well as the clinical efficacy of endoscopic vacuum-assisted closure therapy in treating the esophageal fistulas, to provide a new therapeutic technique for esophageal fistulas and expand the new field of minimally invasive endoscopic therapy.

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