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Objective To investigate the influence of type 2 diabetes mellitus(T2DM)on cognitive function and the effective connectivity with in the default mode network(DMN)in the brain.Methods A total of 93 hospitalized patients diagnosed with T2DM were enrolled in this study as T2DM group from The First Affiliated Hospital of Guangzhou University of Chinese Medicine during September 2021 to December 2022.Simultaneously,108 healthy individuals were recruited from the community as normal control(NC)group.The cognitive functions were evaluated in the two groups.A random dynamic causal modeling approach was employed to analyze the effective connectivity within DMN in both groups.Additionally,Pearson correlation analysis was performed to examine the association between differential connectivity,clinical indicators,and cognitive scores in both groups.Results In comparison to the NC group,T2DM individuals exhibited statistically significant reductions in scores in the auditory verbal learning test(AVLT)for immediate recall and the digit symbol substitution test(DSST)(P＜0.05).Additionally,they displayed a notable decrease in effective connectivity from the left lateral parietal cortex(LLPC)to the posterior cingulate cortex(PCC),as well as from the LLPC to the right lateral parietal cortex(RLPC)within the DMN(P＜0.05).Pearson correlation analysis unveiled a negative association between HbA1c levels and the strength of effective connectivity from LLPC to PCC.Conversely,a positive correlation was observed between AVLT(immediate)scores and the strength of effective connectivity from LLPC to PCC and LLPC to RLPC.Additionally,DSST scores displayed a positive correlation with the strength of effective connectivity from LLPC to PCC(P＜0.05).Conclusion Patients with T2DM display compromised effective connectivity from LLPC to PCC and LLPC to RLPC within the DMN network,and this alteration may associated with cognitive impairment.
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BACKGROUND:In recent years,increasing studies have focused on the abnormal proliferation and differentiation of acinous cells in the meibomian gland,suggesting that this process is closely related to the occurrence and development of dry eye.Structural and functional abnormalities such as blockage of the lumen of the meibomian gland and atrophy of the glands can cause or exacerbate dry eye.Therefore,the study of changes in the meibomian glands in dry eyes is important for understanding the pathogenesis of dry eyes in depth and finding new targets for the treatment and prevention of dry eyes. OBJECTIVE:To investigate the changes of the meibomian gland in a mouse model of aqueous deficient dry eyes. METHODS:Thirty-two female C57/B6 mice at 6-8 weeks were selected and randomly divided into experimental and control groups with 16 mice in each group.The mice in the experimental group were constructed by removing both the extra-orbital and intra-orbital lacrimal glands,while those in the control group were not treated.After 2 weeks of normal feeding,the corneal changes of both groups were observed under a slit lamp,and the tear secretion of both groups was measured.The meibomian glands of the two groups of mice were removed after decapitation.The changes in the gross morphology of the meibomian glands were observed and the meibomian glands were made into frozen sections.Hematoxylin-eosin staining was used to observe the structure of the meibomian glands,oil red staining was used to evaluate the function of the meibomian glands,and immunofluorescence staining and RT-qPCR were used to observe the expression of cytokeratin 14,Ki67 and abnormally differentiated small proline-rich protein 1B in the meibomian glands of mice. RESULTS AND CONCLUSION:Two weeks after modeling,lamellar defects were seen in the corneas of the experimental mice,and neovascularization of the limbal corneal was generated and invaded the central cornea.(2)Tear secretion volume was significantly reduced in the experimental group compared with the control group(P<0.05).Microscopic findings showed that the ducts of the meibomian glands in the experimental group were interrupted and atrophied,and their arrangement was disorganized.Hematoxylin-eosin staining results showed a significant increase in lipid vacuoles in the meibomian glands of the experimental mice compared with the control group.Lipid deposition was seen in oil red staining in the experimental group.Immunofluorescence and RT-qPCR results showed a significant increase in the expression of cytokeratin 14,Ki67 and small proline-rich protein 1B in the meibomian glands of mice in the experimental group compared with the control group(P<0.05).To conclude,aqueous deficient dry eye can lead to compensatory hypertrophy,increased proliferation,and abnormal lipid metabolism in the meibomian gland,as well as abnormal differentiation of the meibomian gland.
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BACKGROUND:Most balance disorders after total hip arthroplasty require a variety of rehabilitation methods to improve.Body weight support Tai Chi footwork can be used as a safe and effective balance training method. OBJECTIVE:To observe the effect of body weight support Tai Chi footwork on the balance function of patients after total hip arthroplasty. METHODS:Totally 74 subjects undergoing total hip arthroplasty were recruited and randomly divided into a control group(n=37)and a trial group(n=37).The control group received 30 minutes of body weight support walking training and 60 minutes of routine rehabilitation training;the trial group received 30 minutes of body weight support Tai Chi footwork training and 60 minutes of routine rehabilitation training,once a day,5 times a week,for 12 consecutive weeks.Before the intervention,4,8,and 12 weeks after intervention,the Berg balance scale and the dynamic balance ability test were used to evaluate the balance function.Harris score was used to evaluate the hip joint function,and the fall risk index was used to evaluate the fall risk. RESULTS AND CONCLUSION:(1)The four observation indicators all showed significant time effects(P<0.001).(2)Berg balance scale,Harris score and fall risk index all had an interaction effect(P<0.001),and there was a significant inter-group difference after 12 weeks of intervention(P<0.001),and the effect of the trial group was better than that of the control group.(3)After 12 weeks of intervention,there was an interaction and group effect in the scores of the front and left directions of the dynamic balance test(P<0.001),and there were significant group differences in the scores of the overall,front,left and right directions(P<0.001).(4)The results showed that after 12 weeks of intervention,the balance functions of the trial group and the control group were improved,and the improvement effect of body weight support Tai Chi footwork training was better than body weight support walking training on patients after total hip arthroplasty.
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ObjectiveTo systematically review the efficacy of robot-assisted training on upper limb motor dysfunction in stroke patients. MethodsRelated literatures were searched in PubMed, Medline, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, SinoMed, VIP data from July 1, 2019 to July 1, 2022. Two researchers screened the studies and extracted the data independently, and evaluated the methodological quality. Rev Man 5.4 was used for meta-analysis. ResultsA total of 19 randomised controlled trials with 1 258 subjects were finally included. The scores of Fugl-Meyer Assessment-Upper Extremity (SMD = 0.55, 95%CI 0.40 to 0.71, P < 0.001), modified Bathel Index (MD = 7.55, 95%CI 6.55 to 8.54, P < 0.001) and Motor Activity Log (SMD = -0.84, 95%CI -1.38 to -0.31, P = 0.002) were better in the experimental group than in the control group. However, no significant difference was found in the scores of Brunnstrom stages (upper extremity) (SMD = 0.61, 95%CI -0.08 to 1.30, P = 0.08) and modified Ashworth Scale (MD = -0.51, 95%CI -1.18 to 0.17, P = 0.14) between two groups. ConclusionRobot-assisted training could significantly improve the motor function of upper limbs in stroke patients.
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Based on polyketide syntheses gene (PKS) and non-ribosomal peptide synthetases gene (NRPS), one strain with high anti-pathogenic activity was screened from 77 strains isolated from Arctic marine sediments and identified. By optimizing the composition of culture medium and fermentation conditions, the production of this strain's active metabolites was improved and the main metabolites were identified by HRMS, 1H NMR and 13C NMR. The antibacterial spectrum of the main metabolites and the effect of the metabolites on cucumber Fusarium wilt were also determined. The results showed that the strain was Bacillus velezensis and it showed growth promoting effect on plants. When the strain was cultured in 5 g/L maltose, 10 g/L tryptone, 10 g/L sodium chloride, at 30 ℃, 150 r/min for 60 h, the diameter of the inhibition zone increased from (16.23±0.42) to (24.42±0.57) mm. The metabolites of this strain mainly contain macrolide compound macrolactin A, which has antagonistic effect on a variety of pathogenic bacteria and fungi. Cucumber seedling experiments showed that the metabolites of this strain had a protective effect on cucumber Fusarium wilt, and showed a good potential for development and application as a biocontrol agent.
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Policétidos/farmacología , Hongos , Bacterias , Fusarium/genética , Antibacterianos/farmacología , Péptido Sintasas/genéticaRESUMEN
Objective@#To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD.@*Methods@#The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. @*Results@#A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005].@*Conclusions @#The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.
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OBJECTIVE@#To investigate the value of quantitative synthetic magnetic resonance imaging (SyMRI) in distinguishing between benign and malignant breast lesions.@*METHODS@#We retrospectively collected data of preoperative conventional MRI and multi-dynamic multi-echo sequences from 95 patients with breast lesions showing mass-type enhancement on DCE-MRI, including 27 patients with benign lesions and 68 with malignant lesions. The MRI features of the lesions (shape, margin, internal enhancement pattern, time-signal intensity curve, and T2WI signal) were analyzed, and for each lesion, SyMRI-generated quantitative parameters including T1 and T2 relaxation time and proton density (PD) were measured before and after enhancement and recorded as T1p, T2p, PDp and T1e, T2e, and PDe, respectively. The relative change rate of each parameter was calculated. Logistic regression and all-subset regression analyses were performed for variable selection to construct diagnostic models of the breast lesions, and receiver-operating characteristic (ROC) analysis was used to assess the performance of each model for differentiation of benign and malignant lesions.@*RESULTS@#There were significant differences in the MRI features between benign and malignant lesions (P < 0.05). All the SyMRI-generated quantitative parameters, with the exception of T2e and Pdp, showed significant differences between benign and malignant lesions (P < 0.05). Among the constructed diagnostic models, the model based on all the DCE-MRI features combined with SyMRI parameters T2p and T1e (DCE-MRI+T2p+T1e) showed the best performance in the differential diagnosis malignant breast masses with an AUC of 0.995 (95% CI: 0.983-1.000).@*CONCLUSION@#Quantitative SyMRI can be used for differential diagnosis of benign and malignant breast lesions.
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Femenino , Humanos , Mama/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Medios de Contraste , Diagnóstico Diferencial , Imagen por Resonancia Magnética/métodos , Curva ROC , Estudios RetrospectivosRESUMEN
Objective:To investigate the clinical diagnosis value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and Cystatin C (Cys C) of late onset sepsis (LOS) with acute kidney injury(AKI) in preterm infants.Methods:A case-control study was used among preterm infants diagnosed with LOS and admitted to the NICU of Dalian Women and Children′s Medical Group from November 2018 to October 2021, including 24 cases of sepsis AKI group and 40 cases of sepsis non-AKI group. The blood creatinine, urine NGAL, Cys C levels and urine volume were measured at 1 d after birth and 1 d after sepsis. The t-test was used for statistical analysis, and the receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of blood creatinine, urinary NGAL and Cys C in LOS combined with AKI. Results:Blood creatinine, urinary NGAL and Cys C levels were significantly higher in the sepsis AKI group than that in the sepsis non-AKI group: (53.667 ± 20.040) μmol/L vs. (35.975 ± 9.048) μmol/L, (1.613 ± 0.405) μg/L vs. (0.839 ± 0.258) μg/L, (39.524 ± 11.619) μg/L vs. (21.778 ± 3.302) μg/L ( P<0.01). Comparison of ROC curves showed that in sepsis AKI group the AUC (0.946 and 0.965, respectively), sensitivity (97.5% and 100.0%, respectively) and specificity (75.0% and 79.2%, respectively) of the urinary NGAL and Cys C levels were higher in than those of creatinine level (AUC 0.771, sensitivity 95.0%, specificity 62.5%), with statistically significant differences ( P<0.05). Conclusions:Urinary NGAL and Cys C are more sensitive than creatinine and can be used as biological indicators for the early diagnosis of sepsis with AKI in preterm infants.
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OBJECTIVE：To compare the protective effects of different effective components of Astragali radix against DNA damage of human bone marrow mesenchymal stem cells （BMSCs）induced by ionizing radiation. METHODS ：2 Gy X-rays were used to directly irradiate BMSCs to establish a radiation model. CCK- 8 method was used to detect the effects of different mass concentrations（25，50，75，100 μg/mL）of astragalus polysaccharide ，astragalus saponin and astragalus flavonoids for 1 day before radiation + 1 to 5 days after radiation on the proliferation of BMSCs. The dose concentration and the duration of intervention after radiation were selected. The irradiated BMSCs were divided into radiation group ，astragalus polysaccharide group ，astragalus saponin group and astragalus flavonoids group. The last three groups were treated with appropriate dosage of corresponding drugs before and 2 days after radiation ，and a blank groupwas set for comparison. Cytoplasmic division arrest qq.com micronucleus method was used to detect micronucleus cell rate and cell micronucleus rate after appropriate time of was used to detect th e number of 53BP1 foci in cells after appropriare time of intervention following radiation ；the number of 53BP1 foci were compared among different time points （0.5，2，12，24 h）. RESULTS ：Compared with blank group ，OD values of BMSCs were decreased significantly in radiation group （P＜0.05 or P＜0.01）. Compared with radiation group ，the OD values of BMSCs were significantly increased when 50 μ g/mL astragalus polysaccharide，astragalus saponin and astragalus flavonoids continuously intervened radiation for 2-3 days，there was significant difference in other groups at some time point （P＜0.05 or P＜ 0.01）. After consideration ，drug concentration was determined to be 50 μg/mL，and the continuous intervention time was 2 days after radiation. Compared with blank group ，the micronucleus cell rate and cell micronucleus rate of radiation group ，astragalus polysaccharide group ，astragalus saponin group and astragalus flavonoids group increased significantly ，and the number of 53BP1 focus cluster in radiation group and astragalus polysaccharide group increased significantly （P＜0.01）. Compared with radiation group and astragalus flavonoids group ，the micronucleus cell rate ，cell micronucleus rate and the number of 53BP1 focus cluster （continued intervention for 0.5，2，12 h）in the astragalus polysaccharide group and astragalus saponin group were significantly reduced，and the micronucleus cell rate and cell micronucleus rate in the astragalus polysaccharide group were significantly lower than astragalus saponin group （P＜0.05）. 53BP1 focus cluster could not be detected 24 h later （P＜0.05）. CONCLUSIONS ： Astragalus polysaccharide and astragalus saponin both have protective effects on BMSCs DNA damage induced by radiation ，and the protective effect of astragalus polysaccharide is better than that of astragalus saponin ；astragalus flavonoids has no protective effect on radiation-induced DNA damage.
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Objective To investigate the risk factors and prognosis of persistent inflammation-immunosuppressive catabolism syndrome (PICS) in malignant tumor patients with lung infection after chemotherapy.Methods A total of 128 malignant tumor patients with pulmonary infection after chemotherapy from January 2014 to January 2018 in Jilin Cancer Hospital were collected.According to whether the patients were complicated with PICS,the patients were divided into the PICS group (44 cases) and the control group (84 cases).The clinical characteristics and prognosis of the two groups were compared,and the risk factors of PICS during hospitalization were analyzed.Results The acute physiology and chronic health evaluation (APACHE) Ⅱ score and sequential organ failure assessment (SOFA) score in the PICS group were higher than those in the control group [(18.6±3.8) vs.(15.9±4.0),t =3.598,P ＜ 0.01;(4.8±1.5) vs.(4.0±1.6),t =2.832,P =0.005].When compared with the control group,the proportion of lung cancer in the PICS group was increased [47.7％ (21/44) vs.23.8％ (20/84),x2 =8.378,P =0.006],and the albumin was decreased [(28.8±3.3) g/L vs.(30.8±2.9) g/L,t =3.695,P ＜ 0.01],the C reactive protein was increased [(60±8) mg/L vs.(45±8) mg/L,t =9.520,P ＜ 0.01],hospital duration was prolonged [(33±7) d vs.(26±7) d,t =4.820,P ＜ 0.01],hospital mortality was increased [22.7％ (10/44) vs.4.8％ (4/84),x2 =9.567,P =0.002].Multiple factor logistic regression analysis showed that the APACHE Ⅱ score ＞ 20,lung cancer and the albumin ＜ 30 g/L were the risk factors for PICS in the malignant tumor patients with lung infection after chemotherapy (all P ＜ 0.05).Conclusion The incidence of PICS in malignant tumor patients with pulmonary infection after chemotherapy is high,and the risk factors for the poor prognosis include APACHE Ⅱ score ＞20,lung cancer and the albumin ＜30 g/L.
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Objective@#To construct a community pathway of chronic disease management for chronic obstructive pulmonary disease (COPD), which provided a theoretical basis for community management of chronic disease in COPD.@*Methods@#Under the theoretical framework of the PDCA cycle management method, the questionnaire was formed with reference to the clinical pathway. This study conducted two-rounds of expert correspondence by using the Delphi method.@*Results@#After two rounds of expert letters, the effective recovery rate of the volume was 100% (15/15), the authoritative coefficient was 0.85, the familiarity coefficient was 0.76, and the judgment coefficient was 0.93, the path of COPD chronic disease management community was ultimately determined for 6 first-level indicators, including assessment, planning, implementation, variation, evaluation and feedback, 19 second-level indicators and 44 third-level indicators. The coordination coefficient of indicators was 0.12, 0.05, 0.12, and the coordination of expert opinions of the third-level indicators was statistically significant (P<0.05).@*Conclusion@#The community path of COPD chronic disease management has been tested by experts, with concentrated opinions and scientific and reliable, which provides a reference for COPD chronic disease community management.
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Objective To analyze the clinical and endoscopic characteristics of pneumatosis cystoides intestinalis ( PCI) in colon. Methods Data of 116 patients with colonic PCI admitted at Beijing Friendship Hospital from January 2005 to June 2018 were retrospectively collected, including age, gender, clinical manifestations, lesion size, location, and morphology. The clinical and endoscopic characteristics of colonic PCI were analyzed. Results The 116 patients included 54 males and 62 females, with age of 59. 11±13. 13 years (ranged, 17-91 years). Fifty cases (43. 10％) had a single lesion, and 66 cases (56. 90％) had multiple lesions. The detection rate of colonic PCI was 0. 40‰ ( 1/2524) to 2. 03‰(8/3945). Clinical manifestations included no symptom (24. 14％, 28/116), abdominal pain (18. 97％,22/116) , and elevated tumor markers ( 17. 24％, 20/116 ) . A total of 168 lesions were found under colonoscopy, and were single or multiple submucosal hemispherical or spherical cystic eminence of different sizes with soft surface, and some had hyperemia and erosion on the mucosal surface. The size of lesions was clearly recorded in 66 cases among the 116 patients, with 1. 61±0. 87 cm (ranged, 0. 3-5. 0 cm). The diameter of lesions was 1. 0-<2. 0 cm in 30 cases ( 45. 45％) . The single PCI was mostly located in ascending (38. 00％, 19/50) and transverse ( 28. 00％, 14/50) colon, and multiple PCIs were mostly located in ascending ( 28. 81％, 34/118 ) , sigmoid ( 22. 03％, 26/118 ) and descending ( 17. 80％, 21/118) colon. Conclusion Colonic PCI is a rare disease in clinic with non-specific clinical manifestations, and colonoscopy is an effective diagnostic method. It is apt to happen in elder patients and often found in ascending colon.
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Objective To construct engineered corneal epithelium from embryonic stem cells (ESCs) using Rock inhibitor combined with hypoxia-normoxia culture condition. Methods Human ESC line H1 was induced to differentiate into epithelial-like cells by addition of retinoic acid (RA) and bone morphogenetic protein 4(BMP4) in the differentiation medium under the adherent culture condition. The ESCs derived epithelial-like cells were expanded in the mixed medium of SHEM and KSFM with the mixture ratio of 1 : 2 with or without Rock inhibitor Y27632. The H1 derived epithelial-like cells were seeded on the denuded ammonic membrane to construct engineered corneal epithelium under hypoxia,normoxia and hypoxia-normoxia culture conditions,respectively. The inducted effect of ESCs into epithelial-like cells,the expansion ability of the epithelial-like cells and the characteristics of the constructed engineered corneal epithelium were evaluated by morphological observation, real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and immunofluorescence technology. Results Compared with the control group,the relative expressions of ESCs marker Oct4 mRNA, Notch signaling pathway related factors Notch1 and Jagged1 mRNA,and Wnt signaling pathways related factors c-myc and Cyclin D1 mRNA were significantly reduced, and the relative expressions of cutaneous ectoderm markers p63 and K18 mRNA were significantly increased at day 8 after induction in the induced group,with significant differences between them (t =14.63,20.15,93.50,11.60, 19.30,18.44,22.63;all at P<0.05). Compared with the without Y27632 group,the relative expressions of p63 and K14 mRNA,Notch signal pathway receptor Notch1 and Jagged1 mRNA were significantly increased,and Wnt signaling pathways downstream targeted gene c-myc and CylinD1 mRNA were significantly decreased at day 8 after induction in the Y27632 group,with significant differences between them (t =20.29,59.22,2.90,39.59,5.32,10.14;all at P<0.05),and the relative expression of K18 mRNA in the two groups was not significantly changed(t=1.38,P>0.05). The ESCs derived epithelium and constructed under hypoxia-normoxia culture condition showed more obvious stratification and tighter cell arrangement in comparison with those cells cultured in consistent hypoxia culture condition or normoxia culture condition. Epithelial markers Pan-CK and K18 as well as epithelial progenitor cell markers p63 and K14 expressed in the whole cell layers of the ESCs derived epithelium constructed under hypoxia-normoxia culture condition. Conclusions The addition of Y27632 enhances the proliferation ability of H1 derived epithelial cells and actives Notch signaling pathway and inhibits Wnt signaling pathway. The culture and construction in the expansion medium with Y27632 under the hypoxia-normoxia culture condition can promote the stratification of H1 derived engineered corneal epithelium.
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Objective To study the effect of alprostadil combined with epalrestat and methylcobalamin in the treatment of type 2 diabetic peripheral neuropathy.Methods From January 2014 to June 2016,120 patients with type 2 diabetic peripheral neuropathy in the First People's Hospital of Baiyin were randomly divided into two groups according to the random number table method.64 patients of the observation group were given the treatment of alprostadil,epalrestat combined with methylcobalamin.56 patients of the control group were given the treatment of alprostadil and methylcobalamin.And the two groups were treated for 4 weeks.The blood glucose,clinical symptoms,adverse reaction,nerve conduction velocity index were compared between the two groups before and after treatment.Results The fasting blood glucose and 2-hour postprandial blood glucose of the two groups after treatment were significantly decreased (t =18.20,17.61,15.75,23.69,all P ＜ 0.05),and the conduction velocity of the common peroneal nerve,the median nerve and the ulnar nerve in the observation group were significantly higher than those in the control group (t =1.989,2.638,3.026,2.187,2.619,1.997,all P ＜ 0.05).The total effective rate of the observation group was significantly higher than that of the control group(95.3％ vs.82.1％,x2 =4.54,P ＜0.05).There were no statistically significant differences in the blood glucose and the incidence rate of adverse reactions between the two groups (t =0.267,0.176,0.695,0.658,x2 =1.356,all P ＞ 0.05).Conclusion Alprostadil combined with epalrestat and methylcobalamin in the treatment of type 2 diabetic peripheral neuropathy has good effect.
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Objective To observe the impact of adaptive statistical iterative reconstruction-V (ASiR-V) on image quality and radiation dose in abdominal CT imaging,and to optimize combination of pre-and post ASiR-V percentage.Methods Totally 160 patients underwent plain and contrast-enhanced abdominal CT were randomly divided into study group or control group (each n=80).In study group,plain images were reconstructed with 20％ pre ASiR-V combined with 20％,40％,60％ and 80％ post-ASiR-V,the arterial phase images were reconstructed with 40％ pre-ASiR V combined with 40％,60％ and 80％ post-ASiR-V,while the venous phase images with 60％ pre-ASiR-V combined with 60％ and 80％ post-ASiR-V,and the delayed phase images with 80％ pre-ASiR-V combined 80％ post-ASiR-V.In control group,images were reconstructed with filtered back projection (FBP) and 0 pre-ASiR-V combined post-ASiR-V (20％ in plain,40％ in arterial phase,60％ in venous phase and 80％ in delayed phase imaing).The objective parameters (image noise [SD] and CNR) and image quality scores were analyzed and compared.Results CT dose index,dose length product and effective dose of each phase in study group were lower than those in control group (all P＜0.001).In study group,with the increasing of post-ASiR-V percentage,SD values gradually decreased (P＜0.01),and CNR gradually increased or did not change.With the increasing of post-ASiR-V (20％-60％),image quality scores increased,and image quality of 80 ％ post-ASiR-V was low.In study group,image quality of 20％ pre-ASiR-V combined 40％ or 60％ post-ASiR-V was similar to 20％ post-ASiR-V image in control group in plain,and that of 40％ pre-ASiR-V combined 60％ post-ASiR-V was similar to 40％ post-ASiR-V image in control group in arterial phase (all P＞0.05),while image quality scores of other combinations of pre-and post-ASiR-V percentages were lower than those in control group.Conclusion ASiR-V can improve abdominal CT image quality,and 40％ pre-ASiR-V combined 60％ post-ASiR V is recommended.
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Objective@#To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR).@*Methods@#Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis.@*Results@#The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05) . During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO2) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030].@*Conclusions@#IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.
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@#Objective To evaluate cerebral perfusion through brain computed tomography perfusion imaging (CTP) in order to investigate the relationship between cerebral perfusion and vascular cognitive impairment (VCI).Methods A total of 103 patients with ischemic stroke were recruited, who received thrombolytic therapy and CTP test in the Fourth Affiliated Hospital of China Medical University from December, 2016 to May, 2017. The patients were divided into normal cognitive function group (control group, n=43), vascular cognitive impairment-no dementia group (VCIND group, n=48), and vascular dementia group (VD group, n=12) according to the degree of impairment in cognitive function after the assessment of Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT). The characteristics of cerebral blood flow perfusion in region of interest of brain CTP were analyzed.Results There was difference in incidence of diabetes among three groups (χ2=7.556, P<0.05). The rate of diabetes was higher in VCIND group and VD group than in the control group. Age and diabetes were the independent risk factors for VCI (OR>1, P<0.05). There was difference in cerebral blood volume (CBV) in frontal lobe, temporal lobe, and parietal lobe among three groups (F>3.216, P<0.05). CBV in frontal lobe, temporal lobe, and parietal lobe reduced in VD group than in the control group (P<0.05), while CBV in frontal lobe and temporal lobe reduced in VD group than in VCIND group (P<0.05). There was difference in mean transit time (MTT) in left temporal lobe, left parietal lobe, and centrum semiovale among three groups, while there was difference in left occipital lobe in time to peak (TTP) among three groups (F>3.116, P<0.05). MTT and TTP were higher in VD group than in the control group and VCIND group (P<0.05). There was no difference in cerebral blood flow (CBF) in both left and right brain, and MTT and TTP in right brain among three groups (P>0.05). CBV in frontal lobe, parietal lobe and right temporal lobe demonstrated positive relationship with the scores of MMSE (r>0.203, P<0.05). CBV in parietal lobe and left frontal lobe also demonstrated positive relationship with the scores of CDT (r>0.214, P<0.05).Conclusion The cerebral blood flow perfusion reduced in different levels of VCI, especially in frontal lobe, temporal lobe and parietal lobe. Cerebral blood flow perfusion reduced with the progress of cognitive impairment, and the left hemisphere injured earlier than the right one. Brain CTP may be applied in the early recognition of VCI.
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OBJECTIVE@#To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR).@*METHODS@#Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis.@*RESULTS@#The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05). During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO2) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030].@*CONCLUSIONS@#IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.
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Humanos , Reanimación Cardiopulmonar , Cardioversión Eléctrica , Paro Cardíaco , Ultrasonido , Fibrilación VentricularRESUMEN
Sleep deficiency is a common public health problem associated with many diseases, such as obesity and cardiovascular disease. In this study, we established a sleep deprivation (SD) mouse model using a ‘stick over water’ method and observed the effect of sleep deficiency on ocular surface health. We found that SD decreased aqueous tear secretion; increased corneal epithelial cell defects, corneal sensitivity, and apoptosis; and induced squamous metaplasia of the corneal epithelium. These pathological changes mimic the typical features of dry eye. However, there was no obvious corneal inflammation and conjunctival goblet cell change after SD for 10 days. Meanwhile, lacrimal gland hypertrophy along with abnormal lipid metabolites, secretory proteins and free amino-acid profiles became apparent as the SD duration increased. Furthermore, the ocular surface changes induced by SD for 10 days were largely reversed after 14 days of rest. We conclude that SD compromises lacrimal system function and induces dry eye. These findings will benefit the clinical diagnosis and treatment of sleep-disorder-related ocular surface diseases.
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Objective To investigate the protective effects of Angelicae Sinensis Radix and Angelicae Sinensis Radix polysaccharides on immune function injury induced by X rays in SD rats. Methods Forty SD rats were randomly divided into control group, model group, Angelicae Sinensis Radix Decoction group, Angelicae Sinensis Radix polysaccharide group and positive medicine group. After routine feeding for 14 day, each administration group was given relevant medicine for gavage, while control group and model group were given the same amount of distilled water for gavage, once a day for 7 d. From the 8th day, except for the control group, the rats in the rest of groups were subjected to whole-body X ray irradiation, continuous exposure to 2 d; the total absorbed dose was 6 Gy. The rats were killed by femoral artery after irradiate 3 d. The WBC count, RBC, HGB, and PLT in peripheral blood were observed by blood routine test; the number of nucleated cells in the bone marrow was observed by nucleated cell count method; the pathological changes of spleen were observed by HE staining under microscope; the contents of IFN-γ and IL-4 in serum were detected by ELISA. Results Compared with the control group, the spleen index WBC, number of bone marrow nucleated cells and serum contents of IL-4 and IFN-γ in model group was significantly lower (P<0.05), The contents of RBC and HGB increased (P<0.05). Compared with the model group, WBC, number of bone marrow nucleated cells, and the contents of IL-4 and IFN-γ in serum of each administration group increased significantly (P<0.05); RBC and HGB decreased significantly (P<0.05). Conclusion Angelicae Sinensis Radix and Angelicae Sinensis Radix polysaccharides have protective effects on the immune function injure induced by X ray in SD rats.