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1.
Acta Pharmaceutica Sinica ; (12): 433-440, 2022.
Article in Chinese | WPRIM | ID: wpr-922936

ABSTRACT

Three tricyclic [6,5,7] and six tetracyclic [6,5,5,5] novel indole alkaloids were synthesized and evaluated on triglyceride inhibitory activities for the first time. Among them, compound 4c showed the most potent activity with IC50 value of 6.35 μmol·L-1. Meanwhile, compound 4c also exhibited a good safety profile at the cellular level. Preliminary mechanism study indicated that 4c might increase intracellular lipid metabolism by activating AMPK. These results provide a novel family of lead compounds for the discovery of anti-NAFLD candidates.

2.
China Pharmacy ; (12): 542-547, 2022.
Article in Chinese | WPRIM | ID: wpr-920722

ABSTRACT

OBJECTIVE To explore the effects of acteoside on hypoxia/reoxygena tion(H/R)-induced cardiomyocyte damage by regulating Rho family GTPase 3(Rnd3)/nuclear factor κB(NF-κB)pathway. METHODS The H 9c2 cardiomyocyte were divided into control group (no administration ,no modeling ),H/R group (only modeling ),H/R+AS-L group ,H/R+AS-M group , H/R+AS-H group (10,30,90 μmol/L acteoside for above 3 groups firstly ,and then modeling ),H/R+pcDNA group [transfecting pcDNA (empty vector ) firstly,and then modeling] ,H/R + pcDNA-Rnd 3 group [overexpression of Rnd 3 by transfecting pcDNA-Rnd3(Rnd3 overexpression vector )firstly,and then modeling] ,H/R+AS-H+si-NC group [transfecting si-NC (negative control)firstly,and then giving 90 μmol/L acteoside and modeling],H/R+AS-H+si-Rnd3 group [inhibiting overexpression of Rnd 3 by transfecting si-Rnd 3 (Rnd3 small interfering RNA ) firstly,and then giving 90 μ mol/L acteoside and modeling]. After corresponding treatment ,the apoptotic rate ,release of lactate dehydrogenase (LDH),malondialdehyde(MDA)level,the activity of superoxide dismutase (SOD),the level of tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β)and interleukin- 6(IL-6), mRNA and protein expression of Rnd 3 and NF-κB subunit p65(NF-κB p65),the expression of aspartate proteolytic enzyme 3 (Cleaved Caspase- 3)protein and Cleaved Caspase- 9 protein were detected. RESULTS Different concentrations of acteoside could reduce the apoptotic rate of H/R-induced H 9c2 cardiomyocyte,the protein expressions of Cleaved Caspase- 3 and Cleaved Caspase-9,mRNA and protein expressions of NF-κB p65,the levels of LDH release and MDA ,TNF-α,IL-1β and IL-6,while increase the activity of SOD and mRNA and protein expressions of Rnd 3(P<0.05),in a dose-dependent manner. Overexpression of Rnd 3 could decrease the apoptotic rate of H 9c2 cardiomyocyte,protein expressions of NF-κB p65,Cleaved Caspase- 3 and Cleaved Caspase- 9, the levels of LDH release , MDA, TNF-α,IL-1β and IL-6,while increase the protein expression of Rnd 3 and the activity of SOD (P<0.05). The inhibition overexpression of Rnd 3 could weaken the inhibitory effects of acteoside on H/R-induced apoptosis of H 9c2 cardiomyocyte, oxidative stress and inflammatory reaction (P<0.05). CONCLUSIONS Acteoside could regulate Rnd 3/NF-κ B pathway by promoting the expression of Rnd 3 and inhibiting the expression of NF-κB p65,inhibit cardiomyocyte apoptosis ,oxidative stress and inflammation reaction so as to relieve the H/R-induced cardiomyocyte damage.

3.
Article in Chinese | WPRIM | ID: wpr-920378

ABSTRACT

Objective To assess the schistosomiasis transmission risk after flood disaster in Hubei Province in 2021, so as to provide a scientific basis for schistosomiasis prevention and control in corresponding areas. Methods The data pertaining to the endemic situation of schistosomiasis were collected from Hubei, including oncomelania snail distribution, and humans and livestock schistosomiasis infection. The warning water level and actual water situation were collected in corresponding water areas. The cumulative numbers of S. japonicum egg-positive people and cattle from 2014 to 2020, the distribution area of oncomelania snail in 2020, and the water levels from May 1 to August 31, 2021, were estimated and employed as parameters for classification of schistosomiasis transmission risk. The cumulative value of each risk index was calculated in each epidemic county (city and district) to comprehensively assess the risk of schistosomiasis transmission after flood disaster in each region. Results After the flood disaster in Hubei province in 2021, there were 2 counties (districts) at high risk of schistosomiasis transmission in Hubei based on the single risk index of fecal positive number. Based on comprehensive risk indices, there were 2 counties identified at grade 4 risk of schistosomiasis transmission. Conclusion After the flood in 2021, schistosomiasis in Hubei Province is mainly at low and medium epidemic risk. Xiantao City and Hanchuan City in Hanjiang River Basin are the two most seriously affected schistosomiasis epidemic cities. Flood disasters can increase the risk of schistosomiasis transmission and epidemic, so the monitoring and control of schistosomiasis after flood should be strengthened to control the disease transmission to the maximum extent.

4.
Article in Chinese | WPRIM | ID: wpr-913153

ABSTRACT

With the advent of the era of 5G and big data, complex medical data with multiple dimensions and a large sample size bring both opportunities and challenges for clinical medicine in the new era. Compared with conventional methods, artificial intelligence can detect the hidden patterns within large datasets, and more and more scholars are applying such advanced technology in the diagnosis and treatment of diseases. After development and perfection for more than half a century, liver transplantation has become the most effective treatment method for end-stage liver diseases. Unlike the analysis of "single-patient" data in other fields, liver transplantation usually requires the consideration of the features of both the donor and the recipient and the variables during transplantation, thus generating a larger volume of medical data than other diseases, which is particularly in line with the advantages of artificial intelligence. Effective application of artificial intelligence and its combination with clinical research will usher in the new era of precision medicine. The advantages and limitations of artificial intelligence technology should be comprehensively discussed for the cross-application of artificial intelligence in liver transplantation, and the future directions of this field should also be proposed.

5.
Journal of Clinical Hepatology ; (12): 110-116, 2022.
Article in Chinese | WPRIM | ID: wpr-913123

ABSTRACT

Objective To establish a nomogram for overall survival rate after liver resection for primary small hepatocellular carcinoma based on SEER data and external validation of Chinese data. Methods The data of 1809 patients, registered in National Cancer Institute SEER database in 2004-2015, who underwent hepatectomy for primary small hepatocellular carcinoma were extracted as modeling group, and 158 patients with small hepatocellular carcinoma who underwent hepatectomy in Affiliated Hospital of North Sichuan Medical College from 2010 to 2017 were collected as validation group. The univariate Cox risk regression analysis, lasso regression analysis, and multivariate Cox hazard regression analysis were used to investigate the influencing factors for OS after hepatectomy in patients with small hepatocellular carcinoma. A nomogram was established based on the independent influencing factors for OS, and index of concordance (C-index), calibration curves, and receiver operating characteristic (ROC) curve were used to analyze the predictive ability of the nomogram. The Kaplan-Meier survival analysis and the log-rank test were used to investigate the difference in survival between the high- and low-risk groups. Results The multivariate Cox hazard regression analysis showed that sex (hazard ratio [ HR ]=1.22, 95% confidence interval [ CI ]: 1.05-1.41, P =0.010), Seer stage ( HR =1.51, 95% CI : 1.23-1.85, P < 0.001; HR =10.31, 95% CI : 2.53-42.04, P =0.001), tumor diameter ( HR =1.22, 95% CI : 1.06-1.39, P =0.004), vascular invasion or metastasis ( HR =1.43, 95% CI : 1.24-1.65, P < 0.001), and alpha-fetoprotein ( HR =1.33, 95% CI : 1.16-1.54, P < 0.001) were independent risk factors for OS after hepatectomy for small hepatocellular carcinoma. The modeling group had a C-index of 0.621, and its area under the ROC curve at 1, 2, and 3 years was 0.666(95% CI 0.628-0.704), 0.678(95% CI 0.647-0.708), and 0.663(95% CI : 0.635-0.690), respectively; the validation group had a C-index of 0.718, and its area under the ROC curve at 1, 2, and 3 years was 0.695(95% CI : 0.593-0.797), 0.781(95% CI : 0.706-0.856), and 0.759(95% CI 0.669-0.848), respectively. Risk stratification was performed based on the nomogram, and the Kaplan-Meier survival analysis showed that for both the modeling group and the validation group, the low-risk group had a significantly better prognosis than the high-risk group ( P < 0.01). Conclusion The model established for survival rate after liver resection for primary small hepatocellular carcinoma can predict the 1-, 2-, and 3-year OS rates and can thus be used in clinical practice in China.

6.
J. venom. anim. toxins incl. trop. dis ; 28: e20210040, 2022. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1365074

ABSTRACT

Background: Naja atra is a venomous snake species medically relevant in China. In the current study, we evaluated the composition and toxicological profile of venom collected from farm-raised N. atra. Methods: Venom was collected from third-generation captive bred N. atra on a snake farm in Hunan Province, China. The venom was analyzed using sodium dodecyl sulfate polyacrylamide gel electrophoresis and nano-liquid chromatography with electrospray ionization tandem mass spectrometry. In addition, hemolytic activity, median lethal dose, serum biochemical and histopathological parameters were accessed. Results: N. atra venom proteome was dominated by phospholipase A2 (46.5%) and three-finger toxins (41.4 %), and a set of common low relative abundance proteins, including cysteine-rich secretory proteins (4.7%), NGF-beta (2.4%), snake venom metalloproteinase (1.5%), glutathione peroxidase (0.6%), vespryn (0.3%), and 5ʹ-nucleotidases (0.2%) were also found. Furthermore, the venom exhibited direct hemolytic activity, neurotoxicity, myotoxicity, and high lethal potency in mice, with a subcutaneous median lethal dose of 1.02 mg/kg. Histopathological analysis and serum biochemical tests revealed that venom caused acute hepatic, pulmonary and renal injury in mice. Conclusion: This study revealed the composition and toxicity of venom collected from farm-raised N. atra, thereby providing a reference for the analysis of venom samples collected from captive-born venomous snakes in the future.(AU)


Subject(s)
Animals , Snake Venoms/toxicity , Phospholipases A2 , Naja naja , Myotoxicity , Nucleotidases
7.
Article in English | WPRIM | ID: wpr-888787

ABSTRACT

Mushrooms are abundant in bioactive natural compounds. Due to strict growth conditions and long fermentation-time, microbe as a production host is an alternative and sustainable approach for the production of natural compounds. This review focuses on the biosynthetic pathways of mushroom originated natural compounds and microbes as the production host for the production of the above natural compounds.


Subject(s)
Agaricales/chemistry , Bacteria/metabolism , Biological Products/metabolism , Biosynthetic Pathways , Fermentation , Metabolic Engineering
8.
Article in English | WPRIM | ID: wpr-888493

ABSTRACT

Haploidentical hematopoietic stem cell transplantation is a recommended alternative therapy for children with severe aplastic anemia who lack a human leukocyte antigen (HLA)-identical sibling donor and do not respond well to immunosuppressive therapy; however, due to non-identical HLA, the patients may have donor-specific anti-HLA antibody, which may lead to a relatively high incidence rate of poor graft function. Compared with HLA-identical transplantation, conditioning regimen for haploidentical transplantation still needs to be explored. This article reviews the detection and treatment of donor-specific anti-HLA antibody, the selection of conditioning regimen, and the mechanism and treatment of poor graft function in haploidentical hematopoietic stem cell transplantation.


Subject(s)
Anemia, Aplastic/therapy , Child , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Transplantation Conditioning , Transplantation, Homologous
9.
Asian Journal of Andrology ; (6): 479-483, 2021.
Article in English | WPRIM | ID: wpr-888459

ABSTRACT

The novel coronavirus disease (COVID-19) pandemic is emerging as a global health threat and shows a higher risk for men than women. Thus far, the studies on andrological consequences of COVID-19 are limited. To ascertain the consequences of COVID-19 on sperm parameters after recovery, we recruited 41 reproductive-aged male patients who had recovered from COVID-19, and analyzed their semen parameters and serum sex hormones at a median time of 56 days after hospital discharge. For longitudinal analysis, a second sampling was obtained from 22 of the 41 patients after a median time interval of 29 days from first sampling. Compared with controls who had not suffered from COVID-19, the total sperm count, sperm concentration, and percentages of motile and progressively motile spermatozoa in the patients were significantly lower at first sampling, while sperm vitality and morphology were not affected. The total sperm count, sperm concentration, and number of motile spermatozoa per ejaculate were significantly increased and the percentage of morphologically abnormal sperm was reduced at the second sampling compared with those at first in the 22 patients examined. Though there were higher prolactin and lower progesterone levels in patients at first sampling than those in controls, no significant alterations were detected for any sex hormones examined over time following COVID-19 recovery in the 22 patients. Although it should be interpreted carefully, these findings indicate an adverse but potentially reversible consequence of COVID-19 on sperm quality.


Subject(s)
Adult , Asthenozoospermia/virology , COVID-19/physiopathology , China , Gonadal Steroid Hormones/blood , Humans , Male , Progesterone/blood , Prolactin/blood , SARS-CoV-2 , Semen/physiology , Semen Analysis , Sperm Count , Sperm Motility , Spermatozoa/physiology , Time Factors
10.
Article in Chinese | WPRIM | ID: wpr-888320

ABSTRACT

Nonspecific low back pain is closely associated with afferent nerve ingrowth into degenerated IVDs and increasing the inflammatory response. Members of the class 3 semaphorins signal their response through two prominent receptors; the NRP (Neuropilin-1) and the Plexin A. Sema3A (Semaphorin3A) is primarily known for their role in modulating neuronal survival as well as neurite outgrowth and guidance via regulation of Sema3A-NRP-1-plexinA signal pathway. Also, sema3A is shown to be conductive to innervate the inner painful degenerated IVDs (Intervertebral discs). Furthermore, sema3A is thought to act as a barrier to endothelial cells survival and migration on vascular endothelial growth factor (VEGF) and inhibition of KLF5-induced (Krüppel-like factor 5) inflammatory mediators within degenerated IVDs. Therefore, Sema3A produce a new perspective of dual-action therapeutic agent for attenuating the regulator of innervation and angiogenesis into degenerated IVDs and inhibition of KLF5-induced inflammation.


Subject(s)
Endothelial Cells , Humans , Low Back Pain , Neuropilin-1 , Semaphorin-3A , Vascular Endothelial Growth Factor A
11.
Article in Chinese | WPRIM | ID: wpr-888310

ABSTRACT

OBJECTIVE@#To investigate the short-term clinical effect of double channel decompression and bone grafting through the greater trochanter combined with allograft fibula propping in the treatment of osteonecrosis of femoral head (ONFH).@*METHODS@#Twenty two patients (23 hips) with osteonecrosis of the femoral head were included from November 2017 to February 2019. According to Association Research Cirulation Osseous(ARCO) staging, there were 13 hips at stageⅡgroup, aged from 20 to 48 years old with an average of(32.5±8.5)years old;10 hips at stageⅢgroup, aged from 18 to 45 years old with an average of(32.7±8.6) years old. A single approach through the greater trochanterwas used for decompression, bone grafting and fibula support. Harris scoring system was used to evaluate the function of hip joint before and after implantation, and the anteroposterior and lateral X-ray films of hip joint were taken at 3, 6, 12 and 18 months after implantation to observe and analyze the progress of femoral head necrosis and regeneration.@*RESULTS@#All patients were followed up, and the duration ranged from 12 to 18 months with an average of (14.6±2.1) months. Harris score of stageⅡand stageⅢpatients increased from 73.2± 5.5 and 66.5±3.4 to 87.6±8.7(@*CONCLUSION@#The effect of double trochanteric decompression and bone grafting combined with fibular allograft propping in the treatment of early and middle stage avascular necrosis of the femoral head is good, especially suitable for young and middle aged patients with ARCOⅡstage avascular necrosis of the femoral head.


Subject(s)
Adolescent , Adult , Allografts , Bone Transplantation , Decompression , Femur Head , Femur Head Necrosis , Fibula , Follow-Up Studies , Humans , Middle Aged , Treatment Outcome , Young Adult
12.
Article in Chinese | WPRIM | ID: wpr-880108

ABSTRACT

OBJECTIVE@#To analyze the influence of serum homocysteine (Hcy) levels to the prognosis of newly diagnosed multiple myeloma (MM) patients, and to explore related factors affecting the prognosis of the patients.@*METHODS@#The clinical pathological data of 180 newly diagnosed MM patients treated in our hospital from March 2013 to February 2015 were collected, and the patients were divided into high and low Hcy groups based on the median Hcy. The survival curves of the patients in the two groups were drawn to compare the differences of the survival; univariate and multivariate survival analysis was used to observe the influence of serum cysteine to the prognosis of newly diagnosed MM patients; the clinicopathological data of the patients with high and low Hcy in the two groups was compared, Pearson test was used to further analyzes the relationship between Hcy and different factors, and explores the related factors of Hcy affecting the prognosis of the patients.@*RESULTS@#The median survival times of patients in the high and low Hcy groups were 32 (5-59) and 41 (7-71) months, respectively. The 3-year survival rate of the patients in high Hcy group was significantly lower than those in low Hcy group, and the difference shows statistically significant (P<0.05). The results of univariate survival analysis showed that the OS of newly diagnosed MM patients whom with advanced age, high bone disease grade, high-level bone marrow plasma cell count, LDH, C-reactive protein, Cr, β@*CONCLUSION@#Serum Hcy level has a correlation trend with the survival of newly diagnosed MM, which is affected by factors such as Hb.


Subject(s)
Bone Marrow Cells , Homocysteine , Humans , Multiple Myeloma , Prognosis , Risk Factors
13.
Article in Chinese | WPRIM | ID: wpr-880055

ABSTRACT

OBJECTIVE@#To explore the relationship between the change of lymphocyte subsets before and after immunosuppressive therapy (IST) with disease severity of severe aplastic anemia (SAA) and hematologic response to IST.@*METHODS@#The clinical data of 94 patients with SAA/VSAA treated by r-ATG and CsA in our hospital from December 2009 to October 2011 was analyzed retrospectively. Among them, 26 patients who had sequential data of lymphocyte subsets and cytokines before and after treatment were enrolled. The relationship between lymphocyte subsets, cytokine level before IST and disease severity, as well as the relationship between changes if lymphocyte subsets, changes of cytokine and the HR after IST for 6 months was analyzed.@*RESULTS@#There were no statistical differences in the ratio and absolute count of lymphocyte, the ratio and absolute count of each lymphocyte subsets, including CD3@*CONCLUSION@#The hematopoietic recovery and early hematologic remission may be affected by the intensity of immune suppression reflected from the changes of lymphocyte subsets and the immune reconstruction reflected from the recovery of lymphocyte subsets. The immune reconstruction is most significant within 3 months after IST.


Subject(s)
Anemia, Aplastic , Humans , Immunosuppression , Immunosuppressive Agents/therapeutic use , Lymphocyte Subsets , Retrospective Studies
14.
Chinese Journal of Radiology ; (12): 1202-1208, 2021.
Article in Chinese | WPRIM | ID: wpr-910286

ABSTRACT

Objective:To compare the diagnostic efficacy of MR elastography (MRE), Gd-EOB-DTPA dynamic contrast-enhanced MRI (DCE-MRI) in early quantitative evaluation of liver fibrosis (LF) staging of experimental rabbits.Methods:From April to December 2019, 200 healthy rabbits were randomly divided into LF group ( n=160) and control group ( n=40). LF group were injected subcutaneously with 50% CCl 4 oil solution, while control group were injected with normal saline solution. The LF group ( n=40) and control group ( n=10) were randomly selected at the end of the 4th, 8th, 12th and 16th weeks respectively to undergo axial MRI scan including MRE and Gd-EOB-DTPA DCE-MRI. The quantitative parameter values were obtained, including liver stiffness (LS), volume transfer constant (K trans), reflux rate constant (K ep), volume fraction of extravascular extracellular space (V e) and volume fraction of plasma (V p). Histopathological LF staging was based on Scheuer staging. One-way ANOVA analysis was used to evaluate the differences of LS, K trans, K ep, V e and V p among different LF stages. The Spearman correlation analysis was used to evaluate the correlations between pathological LF staging and quantitative parameter values. The ROC curve was used to compare the diagnositic performance of all quantitative parameter values. Results:Among the final qualified 150 rabbits, there were 32 in F0, 32 in F1, 35 in F2, 30 in F3, 21 in F4. Significant differences of LS, K trans, K ep, V e and V p were found among different LF stages. There was correlation between LS, K trans, K ep and LF stages ( r=0.832, 0.730, -0.617, all P<0.001), respectively. However, no statistically correlation was found between V e, V p and LF stages ( r=-0.074, P=0.367; r=-0.078, P=0.342). The area under the ROC curve (AUCs) of LS were the greatest (0.920 for F0 vs F1-F4, 0.900 for F0 vs F1-F2, 0.945 for F0 vs F3-F4, 0.926 for F1-F2 vs F3-F4), while the AUCs of K trans were 0.897, 0.863, 0.942, 0.809, respectively. Conclusion:The early quantitative diagnostic efficacy for LF staging by MRE was superior to Gd-EOB-DTPA DCE-MRI in rabbits.

15.
Article in Chinese | WPRIM | ID: wpr-910175

ABSTRACT

Objective:To speculate the effect of birth spacing on the pelvic floor type Ⅰ and Ⅱ fiber muscle strength of postpartum women with parities of two in different delivery modes.Methods:Totally 2 361 parturients who were investigated in Xuzhou Central Hospital from June 2016 to December 2020 were included in the questionnaire, clinical examination and pelvic floor surface electromyography assessment. According to the interval years between two parities and the pelvic floor typeⅠ and Ⅱ fiber muscle strength under different modes of delivery, curve fitting function equation was performed using curve regression method. The accuracy of the equation was verified by the receiver operating characteristic curve and the maximum area under the curve, and calculating the relative error rate.Results:A total of 2 357 parturients were included in the study and were divided into 4 groups based on delivery modes, women with both normal vaginal delivery were assigned to group A (589 cases); women with a first vaginal delivery and a second cesarean section were assigned to group B (480 cases); women with both cesarean deliveries were assigned to group C (1 273 cases); women with a first cesarean section and a second vaginal delivery were assigned to group D (15 cases). All of the curve fitting results were quadratic curves, and the appropriate interval years were selected when the muscle strength of type Ⅰ muscle fibers was>35 μV and that of type Ⅱ muscle fibers was>40 μV: 6-8 years in the group A, 5-10 years in the group B, and 1-11 years in the group C. The peak values of the quadratic curve were as follows: 7-8 years in the group A, 7-8 years in the group B, and 6 years in the group C. The maximum area under the curve of the function equations were all>0.6 (all P<0.05), the average relative error rate was 4.909%. Conclusions:The pelvic floor function of postpartum women with parities of two increases firstly and then decreases over time, showing a quadratic curve shape. In order to protect the pelvic floor function, the appropriate interval of birth spacing is 6-8 years.

16.
Article in Chinese | WPRIM | ID: wpr-910046

ABSTRACT

Objective:To evaluate collared and bipolar hemiarthroplasty combined with medial femoral calcar reconstruction in the treatment of senile patients with osteoporotic unstable intertrochanteric fracture.Methods:The data of 28 senile patients with unstable femoral intertrochanteric fracture were retrospectively analyzed who had been admitted to Department of Orthopedics, The First Affiliated Hospital to Zhejiang University of Chinese Medicine from March 2014 to February 2020. They were 8 males and 20 females, aged from 75 to 99 years (average, 81.5 years). All the fractures were low violence injuries due to falls. By the Evans-Jensen classification, there were 2 cases of type Ⅲ, 5 cases of type Ⅳ and 21 cases of type Ⅴ. All patients were osteoporotic, with a BMD T-score ranging from -4.5 to -2.0. Surgery was performed 2 to 6 days after injury (3.8 days on average). Corail collared femoral stems and bipolar ball heads produced by DePuy company were selected for implantation during surgery. Their fractures were reduced and fixated by titanium wire bundling system or bifilar winding wire bundles. The femoral calcar reconstruction was accomplished by inserting the beak-shaped distal part of the head-neck fracture fragment into the femoral medullary cavity together with the medial side of the stem just under the collar and impacting it to a tight position.Results:The average operation time for this group of patients was 62 min (from 50 to 85 min) and the average intraoperative blood loss 170 mL (from 110 to 320 mL). All the 28 patients were followed up for 10 to 71 months (average, 46 months). Their Harris hip scores averaged 92 points (from 89 to 96 points) at 6 months after operation. Two patients developed intermuscular venous thrombosis in the calf after operation. During follow-up, none of the patients had such complications as deep iliac femoral vein thrombosis, pulmonary embolism, incision infection, or deep prosthesis infection. At the last follow-up, their Harris hip scores averaged 88 points (from 82 to 96 points).Conclusion:For some senile patients with osteoporotic unstable intertrochanteric fracture, collared and bipolar hemiarthroplasty combined with medial femoral calcar reconstruction can achieve fine therapeutic efficacy.

17.
Article in Chinese | WPRIM | ID: wpr-909479

ABSTRACT

Objective:To investigate the relationship between the activation level of Nod-like receptor pyrin domain-containing 3 (NLRP3) inflammasome and the change of cognitive functions in patients with acute ischemic stroke.Methods:A total of 88 patients with acute ischemic stroke in Department of Neurology from October 2018 to July 2020 were selected as case group and 100 healthy physical examinees were selected as control group.Peripheral blood of the case group and the control group was collected, and peripheral blood mononuclear cells (PBMCs) were isolated by centrifugation.Then the NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), Caspase-1 and interleukin-1β (IL-1β) expression were detected by Western blot.The cognitive function of patients with acute ischemic stroke was detected by Montreal Cognitive Assessment (MoCA). The differences in expression levels of NLRP3, ASC, Caspase-1 and IL-1β were compared between the case group and the control group.Pearson correlation analysis was used to analyze the correlation between expression levels of NLRP3, ASC, Caspase-1, IL-1β and MoCA score.Logistic multivariate regression was used to analyze the relationship between expression levels of NLRP3, ASC, caspase-1, IL-1β and the cognitive dysfunction.Results:(1)Western blot results showed that NLRP3, ASC, Caspase-1 and IL-1β expressions in PBMCs cells in the case group were higher than those in the control group (all P<0.05). (2)The expression level of NLRP3 in stroke patients with hypertension, hyperlipidemia, National Institutes of Health Stroke Scale (NIHSS) score ≥ 8 points was significantly higher than that in patients without hypertension, hyperlipidemia and NIHSS score<8 points ( P<0.05); (3)The incidence of cognitive dysfunction in the case group was 34.09% (30/88). The MoCA scores of the cognitive dysfunction group and the non-cognitive dysfunction group were 20 (24, 28) and 27 (26, 28) points respectively, and the difference between the groups was statistically significant ( P<0.05); (4)Pearson correlation analysis showed that NLRP3, ASC, caspase-1 and IL-1β expression in PBMCs cells were negatively correlated with MoCA scores ( r=-0.426, -0.396, -0.417, -0.320 respectively, all P<0.05). (5)Logistic regression analysis showed that hyperlipidemia, NIHSS scores, frontotemporal lobe infarction, and NLRP3 expression were the influencing factors for the occurrence of cognitive dysfunction (all P<0.05). Conclusion:Patients with acute ischemic stroke have high activated NLRP3 inflammasome, and its activation degree is closely related to the condition and the occurrence of cognitive dysfunction after stroke.Targeted inhibition or regulation of NLRP3 inflammasome activation may become a new idea of neuroprotection for acute ischemic stroke.

18.
Article in Chinese | WPRIM | ID: wpr-908833

ABSTRACT

Objective:To explore the application effect of flipped classroom teaching method in musculoskeletal ultrasound teaching for standardized residency training of ultrasound department.Methods:In the study, 30 residents in ultrasound department of The Second Affiliated Hospital of Chongqing Medical University were collected and divided into control group ( n=15) and experimental group ( n=15). The control group was taught by traditional teaching method and the flipped teaching method was adopted in the experimental group. All residents were trained for 3 months. At the end of the training, theoretical test and operating skill test as well as the questionnaire survey were performed to evaluate the effects of these 2 teaching methods. SPSS 17.0 was used for t test and chi-square test. Results:The experimental group were superior to the control group in the aspects of the theoretical test scores, operating skill test scores, improving learning efficiency, building clinical thinking patterns, improving self-study ability, and there were significant differences. The satisfaction degree of teaching methods in the experiment group was higher than that in the control group, with significant differences ( P<0.001). Conclusion:Flipped classroom teaching method can improve the teaching outcomes and quality to ensure smooth completion of the teaching objectives.

19.
Article in Chinese | WPRIM | ID: wpr-908533

ABSTRACT

Objective:To study the risk factors of hemodynamically significant patent ductus arteriosus (hsPDA) in extremely preterm infants (EPI).Method:From July 2017 to April 2020, EPI (gestational age <28 weeks) admitted to the Department of Neonatology of our hospital were included and analyzed retrospectively. According to whether hsPDA existed or not, the infants were assigned into non-hsPDA group and hsPDA group. Demographic findings and possible risk factors of hsPDA were collected.The cumulative fluid overload (FO) within 3 days after birth was calculated. Univariate and multivariate analysis were used to determine the risk factors of hsPDA.Result:A total of 79 infants with gestational age of (27.0±0.9) weeks and birth weight of (987±173)g were enrolled, including 23 cases in non-hsPDA group and 56 cases in hsPDA group. Univariate analysis showed that thrombocytopenia ( P=0.044), respiratory distress syndrome (RDS) treated with pulmonary surfactant (PS) ( P=0.006) and high FO level ( P=0.002) were associated with hsPDA. Multivariate analysis showed that RDS treated with PS ( OR=5.933, 95% CI 1.360~25.883, P=0.018) and high FO level ( OR=1.261, 95% CI 1.063~1.496, P=0.008) were independent risk factors for hsPDA in EPIs. ROC curve analysis showed that the cut-off value of FO was -0.2%, with 85.7% sensitivity and 56.5% specificity distinguishing the presence of hsPDA (AUC=0.712, Youden index=0.422). Conclusion:High level of FO within the first 3 days of life and RDS treated with PS are independent risk factors for hsPDA in EPI. After PS treatment, hemodynamic changes of infants with RDS should be monitored closely. During early fluid management of EPI, FO should be strictly monitored to avoid high FO level.

20.
Article in Chinese | WPRIM | ID: wpr-908532

ABSTRACT

Objective:To study the early predictive value of vasoactive inotropic score (VIS) for mortality in persistent pulmonary hypertension of the newborn (PPHN).Method:From July 2017 to November 2020, clinical data of infants diagnosed with PPHN (gestational age ≥34 weeks and admission age <7 days) admitted to our department of neonatology were retrospectively analyzed. According to their clinical outcome, the infants were assigned into survival group and death group. Demographics, risk factors of mortality and the series of VIS within 12 hours after admission were collected. These indicators were compared between the two groups to determine the confounding factors of mortality. Logistic regression was used to determine the correlation between VIS and mortality. The predictive value of VIS for the mortality of infants with PPHN was calculated using ROC curve.Result:A total of 105 infants with PPHN were enrolled, including 75 in survival group and 30 in death group. The overall mortality rate was 28.6% (30/105). Compared with survival group, the death group had higher gestational age [(39.1±1.8) weeks vs. (37.9±2.0) weeks], lower Apgar score at 1 minute [8.0 (6.0, 9.3) vs. 9.0 (8.0, 10.0)] and lower PaO 2/FiO 2 within 12 hours after admission [40 (30, 50) vs. 80 (60, 100)]. After adjusting for gestational age, Apgar score at 1min and lowest PaO 2/FiO 2 within 12 hours after admission, the maximal VIS (VISmax) >27.8 within 12 hours after admission was independently correlated with increased risk of mortality ( OR=23.055, 95% CI 4.885~108.800, P<0.001). ROC curve analysis showed that the cut-off value was 27.8, with 70.0% sensitivity and 90.7% specificity predicting mortality (AUC=0.828, Youden index=0.607). Conclusion:VIS could be used as an early predictor of mortality in PPHN. The infants with VISmax greater than 27.8 within 12 hours after admission have increased risk of mortality.

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