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1.
Article in English | WPRIM | ID: wpr-922357

ABSTRACT

PURPOSE@#COVID-19 is also referred to as a typical viral septic pulmonary infection by 2019-nCoV. However, little is known regarding its characteristics in terms of systemic inflammation and organ injury, especially compared with classical bacterial sepsis. This article aims to investigate the clinical characteristics and prognosis between COVID-19-associated sepsis and classic bacterial-induced sepsis.@*METHODS@#In this retrospective cohort study, septic patients with COVID-19 in the intensive care unit (ICU) of a government-designed therapy center in Shenzhen, China between January 14, 2020 and March 10, 2020, and septic patients induced by carbapenem-resistant klebsiella pneumonia (CrKP) admitted to the ICU of the Second People's Hospital of Shenzhen, China between January 1, 2014 and October 30, 2019 were enrolled. Demographic and clinical parameters including comorbidities, critical illness scores, treatment, and laboratory data, as well as prognosis were compared between the two groups. Risk factors for mortality and survival rate were analyzed using multivariable logistic regression and survival curve, respectively.@*RESULTS@#A total of 107 patients with COVID-19 and 63 patients with CrKP were enrolled. A direct comparison between the two groups demonstrated more serious degrees of primary lung injury following 2019-nCoV infection (indicated by lower PaO@*CONCLUSION@#Critical COVID-19 shares clinical characteristics with classical bacterial sepsis, but the degree of systemic inflammatory response, secondary organ damage and mortality rate are less severe. However, following 2019-nCoV infection, the level of immunosuppression may be increased and thus induce in more death at the later stage of patients' hospitalstay.


Subject(s)
COVID-19 , Carbapenems , Hospital Mortality , Humans , Intensive Care Units , Klebsiella , Prognosis , Retrospective Studies , SARS-CoV-2 , Sepsis
2.
Article in English | WPRIM | ID: wpr-916993

ABSTRACT

Background@#Xylazole (Xyl) is a veterinary anesthetic that is structurally and functionally similar to xylazine. However, the effects of Xyl in vitro remain unknown. @*Objectives@#This study aimed to investigate the anesthetic mechanism of Xyl using fetal rat nerve cells treated with Xyl. @*Methods@#Fetal rat nerve cells cultured for seven days were treated with 10, 20, 30, and 40 μg/ mL Xyl for 0, 5, 10, 15, 20, 25, 30, 45, 60, 90, and 120 min. Variations of amino acid neurotransmitters (AANTs), Nitric oxide-Cyclic GMP (NO-cGMP) signaling pathway, and ATPase were evaluated. @*Results@#Xyl decreased the levels of cGMP and NO in nerve cells. Furthermore, Xyl affected the AANT content and Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activity in nerve cells. These findings suggested that Xyl inhibited the NO-cGMP signaling pathway in nerve cells in vitro. @*Conclusions@#This study provided new evidence that the anesthetic and analgesic effects of Xyl are related to the inhibition of the NO-cGMP signaling pathway.

3.
Article in English | WPRIM | ID: wpr-928601

ABSTRACT

OBJECTIVES@#To study the efficacy and safety of domestic generic levetiracetam in replacement of brand-name levetiracetam in the treatment of children with epilepsy.@*METHODS@#A retrospective analysis was performed on the medical data of 154 children with epilepsy who received domestic generic levetiracetam in the inpatient or outpatient service of Guangdong Provincial People's Hospital from May 2019 to December 2020. Domestic generic levetiracetam and brand-name levetiracetam were compared in terms of efficacy and safety.@*RESULTS@#For these 154 children, the epilepsy control rate was 77.3% (119/154) at baseline. At 6 months after switching to domestic generic levetiracetam, the epilepsy control rate reached 83.8% (129/154), which showed a significant increase (P<0.05). There was no significant change in the frequency of seizures from baseline to 6 months after switching (P>0.05). The incidence of refractory epilepsy in children with no response after switching treatment was significantly higher than that in children with response (P<0.05). Before switching, only 1 child (0.6%) experienced somnolence, while after switching, 3 children (1.9%) experienced mild adverse drug reactions, including dizziness, somnolence, irritability, and bad temper.@*CONCLUSIONS@#Switching from brand-name to generic levetiracetam is safe and effective and holds promise for clinical application, but more prospective randomized controlled trials are required in future.


Subject(s)
Child , Epilepsy/drug therapy , Humans , Levetiracetam , Prospective Studies , Retrospective Studies , Seizures
4.
Article in Chinese | WPRIM | ID: wpr-928132

ABSTRACT

Dendrobium officinale can serve as Chinese medicinal material effective in nourishing yin, clearing heat, and producing fluid, and is used to treat throat diseases, but its active substances and mechanism are not clear. To clarify the active fraction and underlying mechanism of D. officinale against chronic pharyngitis(CP), the present study induced a CP model in rats by pepper water combined with low-concentration ammonia, and crude polysaccharides of D. officinale(DOP), non-polysaccharides of D. officinale(DON), and total extract of D. officinale(DOT)(0.33 g·kg~(-1), calculated according to the crude drug) were administered by gavage for six weeks. The changes in oral secretions and pharyngeal conditions of rats with CP were observed and rated. The hematological indicators were determined by an automatic hematology analyzer. The serum levels of pro-inflammatory factors, such as tumor necrosis factor-alpha(TNF-α), interleukin 1β(IL-1β), and interleukin 6(IL-6), and T-lymphocyte cytokines, including interferon γ(IFN-γ), interleukin 4(IL-4), interleukin 17(IL-17), and transforming growth factor β1(TGF-β1) were detected by the enzyme-linked immunosorbent assay(ELISA). The proportions of CD3~+, CD4~+, and CD8~+cells in peripheral blood T lymphocyte subsets were determined by the flow cytometry. The histomorphological changes of the pharynx were observed by hematoxylin-eosin(HE) staining. The protein expression of nuclear factor-κB P65(NF-κB P65), cyclooxygenase-2(COX-2), F4/80, and monocyte chemoattractant protein-1(MCP-1) in the pharynx were detected by immunohistochemistry and Western blot. The results showed that DOP and DON could significantly relieve pharyngeal lesions, reduce white blood cells(WBC) and lymphocytes(LYMP), decrease the levels of pro-inflammatory factors TNF-α, IL-6, and IL-1β, and inhibit the protein expression of NF-κB P65, COX-2, F4/80, and MCP-1 in the pharynx. DOP was superior in reducing oral secretions and serum IL-17 level and inferior in increasing CD4~+/CD8~+ratio to DON. It is suggested that both polysaccharides and non-polysaccharides of D. officinale have anti-PC effects and the anti-inflammatory mechanism may be related to the regulation of T lymphocyte distribution and inhibition of the inflammatory signaling pathways mediated by NF-κB P65. The anti-inflammatory effect of DOP may be related to the regulation of Th17/Treg balance, while that of DON may be related to the regulation of the Th/Tc ratio.


Subject(s)
Ammonia/therapeutic use , Animals , Anti-Inflammatory Agents/therapeutic use , Cyclooxygenase 2 , Dendrobium/chemistry , Interleukin-17/therapeutic use , Interleukin-6 , NF-kappa B/metabolism , Pharyngitis/drug therapy , Plant Extracts/chemistry , Polysaccharides/pharmacology , Rats , Tumor Necrosis Factor-alpha , Water
5.
Article in English | WPRIM | ID: wpr-927627

ABSTRACT

OBJECTIVE@#The association between neutrophil-to-lymphocyte ratio (NLR) with subclinical macrovascular and microvascular diseases has been less investigated. We sought to examine the association between NLR and new-onset subclinical macrovascular and microvascular abnormalities in the Chinese population.@*METHODS@#From a community cohort, we included 6,430 adults aged ≥ 40 years without subclinical macrovascular and microvascular diseases at baseline. We measured subclinical macrovascular and microvascular abnormalities separately using the ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and albuminuria.@*RESULTS@#During a mean follow-up of 4.3 years, 110 participants developed incident abnormal ABI, 746 participants developed incident elevated baPWV, and 503 participants developed incident albuminuria. Poisson regression analysis indicated that NLR was significantly associated with an increased risk of new-onset abnormal ABI, elevated baPWV, and albuminuria. Compared to overweight/obese participants, we found a much stronger association between NLR and subclinical vascular abnormalities in participants with normal weight. Furthermore, we found an interaction between the NLR and body mass index (BMI) on the risk of new-onset abnormal ABI ( P for interaction: 0.01).@*CONCLUSION@#NLR was associated with subclinical macrovascular and microvascular diseases in the Chinese population. Furthermore, in participants with normal weight, the association between NLR and subclinical vascular abnormalities was much stronger.


Subject(s)
Adult , Aged , Ankle Brachial Index , Body Mass Index , China/epidemiology , Cohort Studies , Female , Humans , Incidence , Lymphocytes/cytology , Male , Middle Aged , Neutrophils/cytology , Poisson Distribution , Prospective Studies , Vascular Diseases/etiology
6.
Article in Chinese | WPRIM | ID: wpr-923970

ABSTRACT

Objective To study the composition and concentration of atmospheric particulate pollutants in four seasons in the industrial and clean living areas, and to provide a scientific basis for the strategy of controlling industrial pollution and atmospheric environment. Methods An industrial area dominated by the automobile industry in Shanghai and a relatively clean living area were selected. Samples were collected simultaneously in both areas and continuously for 7 days in the middle of each season. The composition and concentration of PM2.5 were determined, and the ecological risk of heavy metals in PM2.5 was evaluated by the potential ecological risk index method. Results We found PM2.5 concentration was associated with seasonal changes. The PM2.5 concentration in living areas was the highest in winter, followed by spring, and the lowest in summer. The PM2.5 concentration in industrial areas was the highest in spring, followed by winter, and the lowest in summer. The heavy metals in PM2.5 were the same, including Al, Cr, Mn, Ni, As, Cd, Hg and Pb. The content of Cr, Cd and Pb in PM2.5 in the industrial area is significantly higher than that in the living area. The potential ecological hazard coefficient of PM2.5 heavy metal Cd in the industrial zone was the highest, up to 189.47, and it was the main component of the total potential ecological hazard index of heavy metals. According to the total potential risk grade of heavy metals, the heavy metal Cd in the industrial area had different degrees of ecological harm with seasonal changes. The ecological harm degree of heavy metal Cd was the highest in winter, high in spring and autumn, and low in summer. Conclusion Although the concentration of PM2.5 in the industrial area is not higher than that in the living area, the content of Cr, Cd and Pb in the PM2.5 in the industrial area is significantly higher than that in the living area. The concentration of PM2.5 in the industrial area is mainly related to seasons, industrial production and human factors. The potential ecological harm coefficient of heavy metal Cd in PM2.5 is the highest in comparison with other heavy metals such as Cr, Hg and Pb, and it is the main component of the total potential ecological harm index ofheavy metals.

7.
Article in Chinese | WPRIM | ID: wpr-923948

ABSTRACT

Objective To study the composition and concentration of atmospheric particulate pollutants in four seasons in the industrial and clean living areas, and to provide a scientific basis for the strategy of controlling industrial pollution and atmospheric environment. Methods An industrial area dominated by the automobile industry in Shanghai and a relatively clean living area were selected. Samples were collected simultaneously in both areas and continuously for 7 days in the middle of each season. The composition and concentration of PM2.5 were determined, and the ecological risk of heavy metals in PM2.5 was evaluated by the potential ecological risk index method. Results We found PM2.5 concentration was associated with seasonal changes. The PM2.5 concentration in living areas was the highest in winter, followed by spring, and the lowest in summer. The PM2.5 concentration in industrial areas was the highest in spring, followed by winter, and the lowest in summer. The heavy metals in PM2.5 were the same, including Al, Cr, Mn, Ni, As, Cd, Hg and Pb. The content of Cr, Cd and Pb in PM2.5 in the industrial area is significantly higher than that in the living area. The potential ecological hazard coefficient of PM2.5 heavy metal Cd in the industrial zone was the highest, up to 189.47, and it was the main component of the total potential ecological hazard index of heavy metals. According to the total potential risk grade of heavy metals, the heavy metal Cd in the industrial area had different degrees of ecological harm with seasonal changes. The ecological harm degree of heavy metal Cd was the highest in winter, high in spring and autumn, and low in summer. Conclusion Although the concentration of PM2.5 in the industrial area is not higher than that in the living area, the content of Cr, Cd and Pb in the PM2.5 in the industrial area is significantly higher than that in the living area. The concentration of PM2.5 in the industrial area is mainly related to seasons, industrial production and human factors. The potential ecological harm coefficient of heavy metal Cd in PM2.5 is the highest in comparison with other heavy metals such as Cr, Hg and Pb, and it is the main component of the total potential ecological harm index ofheavy metals.

8.
Acta Pharmaceutica Sinica ; (12): 707-715, 2022.
Article in Chinese | WPRIM | ID: wpr-922888

ABSTRACT

We analyzed the anticancer effect and mechanism of the novel indoleamine 2,‍3-dioxygenase 1 (IDO1) inhibitor NLG-919 combined with temozolomide (TMZ) on human glioma cell lines. The anti-tumor activity of NLG-919 and temozolomide after single and combined treatments was detected by MTT assay. Colony formation assay, invasion assay and migration assays were used to detect the effects of NLG-919 and temozolomide alone or in combination on proliferation, invasion and migration of human glioma cells. A flow cytometry assay was used to detect cell apoptosis, cell cycle arrest, reactive oxygen species (ROS) production and mitochondrial membrane potential damage (JC-1). An immunofluorescence assay was used to detect the expression level of IDO1 and HPLC was used to detect the expression level of L-kynurenine (Kyn) to explore the anti-tumor mechanism of NLG-919 and temozolomide. The results show that NLG-919 had a weak in vitro inhibitory effect compared to that of temozolomide. The IC50 of NLG-919 on U251 cells and U87 after 72 h was 26.9 and 30.7 μmol·L-1, respectively. However, when NLG-919 was used in combination with temozolomide, its anti-glioma activity was significantly increased. Compared with the single treatment, the combination treatment had a potent ability to inhibit proliferation, invasion and migration of glioma cells. Combination treatment improved the capacity of temozolomide to induce cell cycle arrest and inhibit the growth of glioma cells. NLG-919 significantly down-regulated the expression and activity of IDO1 in glioma cells, and the inhibitory effect was improved after combination with temozolomide, and effectively blocked the production of Kyn through the metabolism of L-tryptophan (Trp). In conclusion, the IDO1 inhibitor NLG-919 and temozolomide showed synergistic effects in the anticancer therapy of human glioma cell lines.

9.
Article in Chinese | WPRIM | ID: wpr-873552

ABSTRACT

@#Objective    To explore the difference of myocardial injury between off-pump coronary artery bypass grafting (OPCAB) and modified perfusion on-pump coronary artery bypass grafting (ONCAB). Methods    A total of 558 patients who underwent coronary artery bypass grafting in Beijing Anzhen Hospital from 2017 to 2019 were included. According to whether or not they received modified perfusion cardiopulmonary bypass, all the 558 patients were divided into two groups including an OPCAB group (OP group) and an ONCAB group (ON group). There were 465 patients in the OP group including 282 males and 183 females with an average age of 63.58±7.87 years. In the ON group, there were 93 patients including 64 males and 29 females with an average age of 63.91±7.51 years. Creatine kinase MB (CK-MB) and cardiac specific troponin I (cTnI) were measured 24 hours before operation, 30 minutes after operation, 12 hours after operation, 36 hours after operation and 48 hours after operation. Results    No perioperative death occurred in all patients. CK-MB (5.00 ng/mL vs. 8.60 ng/mL, Z=–2.189, P=0.029) and cTnI (3.00 ng/mL vs. 7.80 ng/mL, Z=–5.307, P=0.000) in postoperative 12 hours in the ON group were less than those in the OP group. CK-MB (5.00 ng/mL vs. 5.60 ng/mL, Z=–2.280, P=0.023) and cTnI (0.10 ng/mL vs. 1.02 ng/mL, Z=–6.418, P=0.000) in postoperative 36 hours in the ON group were less than those in the OP group. cTnI (0.07 ng/mL vs. 0.81 ng/mL, Z=–1.946, P=0.032) in postoperative 48 hours in the ON group was less than that in the OP group. Conclusion    Compared with OPCAB, modified perfusion ONCAB has less myocardial damage. 

10.
Acta Pharmaceutica Sinica ; (12): 289-295, 2021.
Article in Chinese | WPRIM | ID: wpr-872625

ABSTRACT

Ten triterpenoid saponins were isolated and purified from the water extract of Glycyrrhiza glabra by polyamide resin combined with macroporous resin column chromatography, ODS medium pressure column chromatography and semi-preparative RP-HPLC. Their structures were elucidated by physicochemical properties, NMR and MS spectra, and determined as 3β-O-[β-D-glucuronpyranosyl-(1→2)-β-D-glucuronpyranosyl]-30β-O-β-D-glucuronpyranosyl-oleanane-11-oxo-12(13)-ene (1), 3β-O-[β-D-glucuronpyranosyl-(1→2)-β-D-glucuronpyranosyl]-30β-O-α-L-rhamnopyranosyl-oleanane-11-oxo-12(13)-en-22β,30-diol (2), uralsaponin C (3), licorice-saponin A3 (4), licorice-saponin P2 (5), 22β-acetoxyl-glycyrrhizin (6), macedonoside A (7), 29-hydroxyl-glycyrrhizin (8), licorice-saponin G2 (9), glycyrrhizin (10). Compounds 1 and 2 are two new compounds and named as licorice-saponin R3 and licorice-saponin S3.

11.
Chinese Journal of Radiology ; (12): 1324-1328, 2021.
Article in Chinese | WPRIM | ID: wpr-910300

ABSTRACT

Objective:To investigate the values of CT angiography (CTA) and color Doppler ultrasound in the diagnosis and etiological screening of varicocele (VC).Methods:Ninety-seven patients with VC diagnosed by the Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital from May 2016 to December 2017 were retrospectively included. The CTA and color Doppler ultrasonographic data of 194 spermatic veins (including 116 varicocele veins) were analyzed. Paired t test was used to compare the mean diameter of spermatic veins at the root of scrotum measured by CTA and color Doppler ultrasound. McNemar test was used to compare the sensitivity and specificity of CTA and color Doppler examination for VC, and χ 2 or Fisher exact probability was used to compare the detection rate of CTA and color Doppler examination in screening the etiology of VC. Results:The average diameters of scrotal root of spermatic veins by CTA and color Doppler ultrasonography were (2.9±0.6) and (3.0±0.6) mm for VC cases, with no significant difference found( t=0.885, P=0.381). According to the diagnostic VC standard of color Doppler ultrasound (diameter>2 mm), no significant difference was found between CTA and color Doppler ultrasound in the sensitivity [95.69%(111/116) vs. 100%(116/116)] and specificity [100%(78/78) vs. 100%(78/78)] in the diagnosis of VC. The etiological detection rate of CTA in 97 patients with VC was significantly higher than that of color Doppler ultrasound ( P<0.05). Conclusions:Both CTA and color Doppler ultrasound have high sensitivity and specificity in the diagnosis of VC. CTA has a higher etiological detection rate in etiological screening of VC than color Doppler ultrasound.

12.
Chinese Journal of Trauma ; (12): 805-810, 2021.
Article in Chinese | WPRIM | ID: wpr-909942

ABSTRACT

Objective:To investigate the clinical effect of free superficial circumflex iliac artery flap combined with anterolateral thigh flap in repairing large skin defect of the hand.Methods:A retrospective case series study was conducted to analyze the clinical data of 9 patients with large skin defect of the hand admitted to Ningbo No.6 Hospital from January 2016 to December 2019,including 7 males and 2 females,aged 31-63 years[(45.3±5.6)years]. The area of skin defect reanged from 20 cm×15 cm to 25 cm×20 cm. One side of the superficial circumflex iliac artery flap and the contralateral anterolateral thigh flap were used for repair. Both recipient and donor sites were sutured at the first stage. The ilioinguinal region and thigh donor region were sutured directly. The area of superficial circumflex iliac artery flap was from 19 cm×6 cm to 23 cm ×10 cm and that of anterolateral thigh flap was 19 cm×9 cm to 23 cm×8 cm. The flap survival,healing of donor and recipient area and complications were observed. At 1,6 and 12 months after operation,the function of the flap was evaluated by the late functional evaluation criteria of the flap,hand function by the upper limb functional evaluation criteria of the Chinese Medical Association,and scar condition of the donor site by Vancouver Scar Scale(VVS). At the last follow-up,the color,elasticity,appearance and scar of the donor site were observed.Results:All patients were followed up for 6-18 months[(12.5±2.3)months]. All flaps survived successfully. All patients achieved donor-site healing at the first stage,except that one patient experienced incision dehiscence in the thigh donor site after operation and healed after the second stage suture. The texture and appearance of the flaps were good. The flap in 5 patients was obviously bloated. Therefore,the secondary skin flap repair was selected,and the appearance was significantly improved after operation. Scores for function of the flap and the hand were improved over time( P<0.05). At 12 months after operation,the function of the flap was excellent in 3 patients,good in 4 and fair in 2,with the excellent and good rate of 78%;the result of hand function was excellent in 3 patients,good in 3 and fair in 3,with the excellent and good rate of 67%. The VVS score of the donor site decreased from(9.7±1.3)points at postoperative 1 month to(5.7±0.9)points at postoperative 6 months and(3.4±0.8)points at postoperative 12 months( P<0.05). At the latest follow-up,the color and elasticity of the flap was similar to that of the surrounding skin tissue,only with slight bloating;the scar of the donor site was small. Conclusions:The free superficial circumflex iliac artery flap combined with anterolateral thigh flap can cover large skin defect of the hand at one time,with good appearance and texture of the flap. The appearance and function of the wounded hand are good after operation,leaving only linear scar in the donor site.

13.
Chinese Journal of Trauma ; (12): 780-785, 2021.
Article in Chinese | WPRIM | ID: wpr-909938

ABSTRACT

Objective:To investigate the clinical effect of the anterolateral femoral perforator flap(ALTP)pedicled with the oblique branch of lateral circumflex femoral artery(LCFA)assisted by CT angiography(CTA)examination for repairing soft tissue defects of limbs.Methods:A retrospective case series study was made on 51 patients with soft tissue defects of limbs treated in Ningbo No.6 Hospital from March 2015 to March 2020,including 31 males and 20 females at age of 26-63 years[(42.0±8.9)years]. The defects were located at the forearm in 15 patients,at the hand in 13,at the lower leg in 15 and at the ankle in 8. The size of defects ranged from 9 cm×6 cm to 18 cm×10 cm,with the size of flaps from 10 cm×6 cm to 20 cm×12 cm. A total of 33 patients were examined with CTA scanning and Doppler ultrasound(CTA group)and 18 patients with Doppler ultrasound(Doppler group). All patients underwent debridement and negative pressure closed drainage(VSD)at stage I and were repaired by ALTP pedicled with the oblique branch of LCFA at stage II. The diameter and length of the vessel pedicle was recorded in CTA group before operationand in both groups during operation. The time of flap harvesting in both groups was recorded during operation. The survival of the flap in both groups was observed one week after operation. Zhang Hao's scoring standard was applied to evaluate the outcome at the last follow-up.Results:All patients were followed up for 6-12 months[(9.1±1.5)months]. In CTA group,the diameter of LCFA vessel pedicle measured before operation had no significant difference from that during operation( P>0.05),while the length of LCFA vessel pedicle before operation[(12.3±2.1)cm]was longer than(10.9±2.2)cm during operation( P<0.05). The two group showed no significant differences in the diameter and length of LCFA vessel pedicle during operation( P>0.05). The time of flap harvesting in CTA group was(38.5±6.2)minutes,significantly shorter than(51.4±8.4)minutes in Doppler group( P<0.05). One week after operation,all flaps survived. Two patients developed flap arterial congestion in CTA group,among whom one survived after surgical revision and one with partially necrosis was healed after dressing change. One patient was found with flap arterial congestion with partial necrosis in Doppler group,who was healed after dressing change. There was no significant difference in postoperative flap arterial congestion between the two groups( P>0.05). The patients' satisfaction score in CTA group was(8.5±1.5)points at the last follow-up,higher than(7.4±2.0)points in Doppler group( P<0.05). Conclusion:For repairing soft tissue defects of limbs,free ALTP pedicled with the oblique branch of LCFA assisted by three- dimensional CT angiography can accurately get the information of perforator,shorten the flap harvesting time,and obtain satisfactory clinical results as compared to Doppler ultrasound.

14.
Chinese Journal of Trauma ; (12): 675-678, 2021.
Article in Chinese | WPRIM | ID: wpr-909920

ABSTRACT

Severe open injury of upper limb is often accompanied by destructive injury of bone and soft tissue,which is a thorny problem in the repair and reconstruction of injured upper limbs for inadequate repair can cause severe limb dysfunction. At present,some problems that affect the limb functional recovery are noted during the treatment of severe open injury of upper limb,such as inconsistent evaluation of soft tissue injury,undefined standard for reconstruction methods and outdated repair concept. Therefore,the author introduces and analyzes the issues concerning early bone and soft tissue repair after severe open injury of upper limb based on the actual clinical situation and self experiences,so as to provide references for improving the therapeutic effect.

15.
Journal of Clinical Hepatology ; (12): 1006-1010., 2021.
Article in Chinese | WPRIM | ID: wpr-876641

ABSTRACT

Hepatitis B virus (HBV) infection is a major global public health issue. Clinical cure (also known as functional cure) of chronic hepatitis B (CHB) is the ideal therapeutic goal recommended by the latest guidelines for the prevention and treatment of CHB in China and globally. Optimized treatment regimens with direct-acting antiviral agents [e.g., nucleos(t)ide analogues] or immunomodulators (e.g., pegylated interferon-α) sequentially or in combination tend to have low cure rates. Rapid development has been achieved in the research and development of drugs for the treatment of CHB. This article reviews the clinical study of new antiviral drugs for CHB, including the selection of subjects, study design, dosage, dose escalation, adverse events, and efficacy evaluation. It is necessary to introduce the knowledge of quantitative pharmacology to analyze the association of drug exposure in body with efficacy and adverse reactions, and exploratory indicators should be incorporated for comprehensive analysis. This review provides related experience and new ideas for the clinical research and development of new anti-HBV drugs.

16.
Article in Chinese | WPRIM | ID: wpr-876076

ABSTRACT

@#Objective    To investigate the influence of different discontinuation time of clopidogrel and aspirin before off-pump coronary artery bypass grafting on postoperative volume of drainage and blood products imported. Methods    A total of 454 patients who underwent coronary artery bypass grafting in Beijing Anzhen Hospital from January 2017 through December 2019 were included. According to the preoperative discontinuation of clopidogrel and aspirin, all the 454 patients were divided into three groups including a guide group, a non-stop group and a stop group. There were 86 patients in the guide group including 59 males and 27 females with an average age of 64.12±6.15 years. They continued to take aspirin 100 mg/d before operation, but stopped clopidogrel for more than 5 days. In the non-stop group, there were 234 patients including 141 males and 93 females with an average age of 63.71±7.01 years. They continued to take aspirin 100 mg/d before operation, and stopped clopidogrel <5 days. In the stop group, there were 134 patients including 76 males and 58 females with an average age of 62.90±7.78 years. They stopped aspirin and clopidogrel for more than 5 days before operation. The clinical effectiveness was compared among the three groups. Results    No perioperative death occurred in all patients. There was no statistical difference in platelet count, coagulation function, liver function, renal function, or myocardial markers among the groups (P>0.05). The hemoglobin [97 (15) g/ L vs. 98 (21) g/L vs. 100 (20) g/L, F=4.894, P=0.008] in the non-stop group was lower than that in the guide group and the non-stop group at 30 minutes postoperatively. The flow volume (399.87±127.19 mL vs. 367.05±125.89 mL vs. 349.63±130.68 mL, F=7.770, P=0.000) in the non-stop group at 3 hours postoperatively, the flow volume [600 (300) mL vs. 580 (245) mL vs. 550 (350) mL, Z=8.218, P=0.016] in the non-stop group at 6 hours postoperatively, the flow volume [750 (370) mL vs. 730 (350) mL vs. 730 (350) mL, Z=8.329, P=0.016] in the non-stop group at 12 hours postoperatively, the flow volume [890 (365) mL vs. 850 (340) mL vs. 850 (350) mL vs. Z=6.585, P=0.037] in the non-stop group at 24 hours postoperatively and the flow volume [950 (375) mL vs. 940 (360) mL vs. 940 (380) mL, Z=8.680, P=0.013] in the non-stop group at 48 hours postoperatively were more than those of the guide group and the stop group. The retention time of drainage tube was longer in the non-stop group [3 (1) d vs. 3 (1) d vs. 3 (1) d, Z=6.579, P=0.037] than in the guide group and the non-stop group. The amount of suspended erythrocytes input [0 (2) U vs. 0 (2) U vs. 0 (0) U, Z=6.150, P=0.046], and the amount of plasma input [200 (200) mL vs. 0 (200) mL vs. 0 (200) mL, F=4.144, P=0.016], the number of cases of plasma input (119 patients vs. 34 patients vs. 47 patients, Z=10.116, P=0.006) were more than those of the guide group and the stop group. Conclusion    Aspirin maintenance is recommended for patients before off-pump coronary artery bypass grafting. If not necessary, clopidogrel is discontinued for at least 5 days.

17.
Article in English | WPRIM | ID: wpr-880716

ABSTRACT

Midpalatal corticotomy-assisted rapid maxillary expansion (MCRME) is a minimally invasive treatment of maxillary transverse deficiency (MTD) in young adults. However, the effect of MCRME on respiratory function still needs to be determined. In this study, we evaluated the changes in maxillary morphology and the upper airway following MCRME using computational fluid dynamics (CFD). Twenty patients with MTD (8 males, 12 females; mean age 20.55 years) had cone-beam computed tomography (CBCT) images taken before and after MCRME. The CBCT data were used to construct a three-dimensional (3D) upper airway model. The upper airway flow characteristics were simulated using CFD, and measurements were made based on the CBCT images and CFD. The results showed that the widths of the palatal bone and nasal cavity, and the intermolar width were increased significantly after MCRME. The volume of the nasal cavity and nasopharynx increased significantly, while there were no obvious changes in the volumes of the oropharynx and hypopharynx. CFD simulation of the upper airway showed that the pressure drop and maximum velocity of the upper airway decreased significantly after treatment. Our results suggest that in these young adults with MTD, increasing the maxillary width, upper airway volume, and quantity of airflow by MCRME substantially improved upper airway ventilation.

18.
Article in Chinese | WPRIM | ID: wpr-880423

ABSTRACT

Polymer hydrophilic lubricating coatings for medical catheters refer to highly hydrophilic coating films fixed on the surface of catheters with binding force, which can reduce the surface friction with human tissues during the use of interventional catheters, improve the patient comfort of and effectively reduce the incidence of infection. Based on the development process of medical catheter coating, this review summarizes recent advances in the field of polymer hydrophilic lubricating coatings for medical catheters from types of hydrophilic coating polymer, development of coating technology and establishment of coating performance evaluation method. Main problems in this field are analyzed and development trends in the future are prospected.


Subject(s)
Catheters , Humans , Hydrophobic and Hydrophilic Interactions , Polymers
19.
Article in English | WPRIM | ID: wpr-922472

ABSTRACT

Streptococcus mutans (S. mutans) is generally regarded as a major contributor to dental caries because of its ability to synthesize extracellular polysaccharides (EPS) that aid in the formation of plaque biofilm. The VicRKX system of S. mutans plays an important role in biofilm formation. The aim of this study was to investigate the effects of vicK gene on specific characteristics of EPS in S. mutans biofilm. We constructed single-species biofilms formed by different mutants of vicK gene. Production and distribution of EPS were detected through atomic force microscopy, scanning electron microscopy and confocal laser scanning microscopy. Microcosmic structures of EPS were analyzed by gel permeation chromatography and gas chromatography-mass spectrometry. Cariogenicity of the vicK mutant was assessed in a specific pathogen-free rat model. Transcriptional levels of cariogenicity-associated genes were confirmed by quantitative real-time polymerase chain reaction. The results showed that deletion of vicK gene suppressed biofilm formation as well as EPS production, and EPS were synthesized mostly around the cells. Molecular weight and monosaccharide components underwent evident alterations. Biofilms formed in vivo were sparse and contributed a decreased degree of caries. Moreover, expressional levels of genes related to EPS synthesis were down-regulated, except for gtfB. Our report demonstrates that vicK gene enhances biofilm formation and subsequent caries development. And this may due to its regulations on EPS metabolism, like synthesis or microcosmic features of EPS. This study suggests that vicK gene and EPS can be considered as promising targets to modulate dental caries.


Subject(s)
Animals , Biofilms , Dental Caries , Dental Plaque , Rats , Streptococcus mutans/genetics
20.
Journal of Experimental Hematology ; (6): 1510-1516, 2021.
Article in Chinese | WPRIM | ID: wpr-922287

ABSTRACT

OBJECTIVE@#To explore the role of follicular helper T cell (Tfh)/ follicular regulatory T cell (Tfr) imbalance in B-cell lymphoma (BCL).@*METHODS@#Sixteen BCL patients who were admitted to the Department of Hematology of The First People's Hospital of Yichang and 20 healthy people from December 2019 to November 2020 were enrolled and respectively divided into observation group and control group. The levels of Tfh and Tfr in peripheral blood were detected by flow cytometry. The changes of Tfh, Tfr, and Tfh/Tfr ratio were compared and the relationship between Tfh/Tfr ratio and efficacy, prognosis was analyzed.@*RESULTS@#Compared with the healthy controls, Tfh and Tfh/Tfr ratio in peripheral blood of the BCL patients increased (P<0.05, P<0.01), while levels of Tfr was decreased (P<0.01). After chemotherapy, Tfh and Tfh/Tfr ratio in peripheral blood of the BCL patients decreased significantly than before chemotherapy (P<0.01), but Tfr was no significant difference. Multivariate analysis showed that Tfh and Tfh/Tfr ratio were positively correlated with international prognostic index (IPI) score and Ann Arbor stage (r=0.626, 0.564, 0.573, 0.608, respectively), while Tfr negatively (r=-0.504, -0.542, respectively). According to the average value of Tfh/Tfr ratio at initial diagnosis, BCL patients were divided into Tfh/Tfr high ratio group and low ratio group. It was found that the complete remission (CR) rate, overall response rate (ORR), and survival time in the high ratio group were significantly lower than the low ratio group (P<0.01).@*CONCLUSION@#There is an imbalance of Tfh/Tfr ratio in peripheral blood of the BCL patients, and those with a high Tfh/Tfr ratio have lower CR, ORR and shorter survival time.


Subject(s)
Flow Cytometry , Humans , Lymphoma, B-Cell , T Follicular Helper Cells , T-Lymphocytes, Helper-Inducer , T-Lymphocytes, Regulatory
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