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Objective To analyze the short-term clinical efficacy and influencing factors of ustekinumab monoclonal antibody(UST)in the treatment of Crohn′s disease(CD).Methods Retrospective cohort study was used to collect the clinical data of CD patients treated with UST in the 10th People′s Hospital affiliated to Tongji University from December 2020 to October 2022.The main analysis is the short-term clinical efficacy and influencing factors of UST treatment for CD at weeks 8 and 16,And analyze the endoscopic response rate of some patients.Results A total of 91 CD patients who first used UST were included.The 8-week clinical response rate of UST treat-ment for CD was 61.5%,and the clinical response rate was 45%;The clinical response rate at 16 weeks was 71.4%,and the clinical response rate was 54.9%.56 cases underwent endoscopic re-examination in our hospital,and the endoscopic response rate at 16 weeks was 41.1%.Univariate analysis showed that fistula(including anal fistula,personal history of anal fistula,and intestinal skin fistula)is associated with clinical remission in Crohn′s disease patients at 8/16 weeks.Further multivariate COX regression analysis showed that the presence of a history of anal fistula surgery was an independent protective factor affecting clinical remission in CD patients treated with UST at 8 weeks(HR = 0.04,95%CI:0.00~0.38;P = 0.005)and 16 weeks(HR = 0.04,95%CI:0.01~0.34;P = 0.003)compared to those without fistula;Narrow lesions are an independent risk factor for 16 week clinical remission in CD patients compared to non-narrow and non-penetrating lesions(HR = 1.75,95%CI:1.08~2.84;P = 0.023).No patients were found to have stopped medication due to serious adverse reactions.Conclusions UST can improve the clinical remission and response of CD patients at 8/16 weeks,and has good short-term clinical efficacy.CD patients with a personal history of anal fistula are recommended to use UST monoclonal antibodies,while patients with stenotic lesions should be cautious in using UST monoclonal antibodies.Whether the patient has undergone surgical treatment in the past,as well as whether UST has been used on the first or non-first line,has no significant impact on clinical remission.
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Objective:To compare the detection and amplitude of epileptiform discharges (EDs) between surface sphenoidal electrode and anterior temporal electrode in patients with interictal EDs in the temporal region, and to explore the value of surface sphenoidal electrode.Methods:A total of 1 356 outpatients with epilepsy who underwent 2-hour video electroencephalogram (EEG) monitoring in Xuanwu Hospital from October to December 2021 were retrospectively enrolled. All patients were hooked up with scalp electrode according to the international 10-20 system as well as surface sphenoidal electrode and anterior temporal electrode. The EEGs with EDs recorded by surface sphenoidal electrode and/or anterior temporal electrode were selected for analysis. The detection rate and the amplitude of EDs by surface sphenoidal electrode and anterior temporal electrode were compared.Results:Seventy-three EEGs were collected and 250 EDs were counted. The detection rate of the anterior temporal electrode and surface sphenoidal electrode were 88.0% (220/250) and 98.4% (246/250) respectively. The difference in detection rate was statistically significant (χ 2=18.38, P<0.001). For the EDs from anterior temporal regions (taking the discharges recorded by anterior temporal electrode as "gold standard"), the detection rate of surface sphenoidal electrode was 98.2% (216/220). There was no statistically significant difference in detection rate between the anterior temporal electrode and surface sphenoidal electrode (χ 2=2.27, P=0.132). There were 216 EDs recorded by these two kinds of electrode simultaneously. The average amplitude of the EDs on surface sphenoidal electrode and anterior temporal electrode was (77.1±38.9) μV and (80.2±44.9) μV, respectively. The difference was statistically significant ( t=2.28, P=0.031). Conclusions:The detection rate of surface sphenoid electrodes was higher than that of anterior temporal electrodes for the EDs in the temporal region, and surface sphenoidal electrodes can be used routinely in outpatient. The surface sphenoidal electrode had more chance to detect EDs originating from regions out of the anterior temporal regions.
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OBJECTIVE@#To observe the effect of Shenbing Decoction Ⅲ for improving renal function and pathology in rats with 5/6 nephrectomy and analyze its therapeutic mechanism for renal fibrosis in chronic kidney disease using network pharmacology combined with molecular docking.@*METHODS@#Forty male SD rats were randomized into two groups to receive two-staged 5/6 nephrectomy (n=30) or sham operation (n=10), and 2 weeks after the final operation, serum creatinine level of the rats was measured. The rats with nephrectomy were further randomized into Shenbing Decoction Ⅲ group, losartan group and model group for daily treatment with the corresponding drugs via gavage starting at 1 week after 5/6 nephrectomy. After 16 weeks of treatment, serum creatinine and urea nitrogen levels of the rats were measured, and HE staining and Western blotting were used to examine the changes in renal pathology and fibrosis-related factors. Network pharmacology combined with molecular docking study was performed to explore the therapeutic mechanism Shenbing Decoction Ⅲ against renal fibrosis in chronic kidney disease, and Western blotting was used to verify the expressions of the core targets.@*RESULTS@#Compared with those in the model group, the rats receiving 5/6 nephrectomy and Shenbing Decoction Ⅲ treatment showed significantly reduced serum creatinine and urea nitrogen levels, lessened renal pathologies, and improvement of the changes in epithelial mesenchymal transition-related proteins. Network pharmacological analysis showed that the main active ingredients of Shenbing Decoction Ⅲ were acacetin, apigenin, eupatilin, quercetin, kaempferol and luteolin, and the key targets included STAT3, SRC, CTNNB1, PIK3R1 and AKT1. Molecular docking study revealed that the active ingredients of Shenbing Decoction Ⅲ had good binding activity to the key targets. Western blotting showed that in rats with 5/6 nephrectomy, treatment with Shenbing Decoction Ⅲ obviously restored the protein expression of STAT3, PI3K, and AKT in renal tissue.@*CONCLUSION@#Shenbing Decoction Ⅲ can reduce renal injury induced by 5/6 nephrectomy in rats, and its therapeutic effects are mediated possibly by its main pharmacologically active ingredients that alleviate renal fibrosis via modulating multiple targets including STAT3, PIK3R1, and AKT1.
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Masculino , Animales , Ratas , Ratas Sprague-Dawley , Simulación del Acoplamiento Molecular , Farmacología en Red , Creatinina , Insuficiencia Renal Crónica/tratamiento farmacológico , Fibrosis , UreaRESUMEN
Transketolase (EC 2.2.1.1, TK) is a thiamine diphosphate-dependent enzyme that catalyzes the transfer of a two-carbon hydroxyacetyl unit with reversible C-C bond cleavage and formation. It is widely used in the production of chemicals, drug precursors, and asymmetric synthesis by cascade enzyme catalysis. In this paper, the activity of transketolase TKTA from Escherichia coli K12 on non-phosphorylated substrates was enhanced through site-directed saturation mutation and combined mutation. On this basis, the synthesis of tartaric semialdehyde was explored. The results showed that the optimal reaction temperature and pH of TKTA_M (R358I/H461S/R520Q) were 32 ℃ and 7.0, respectively. The specific activity on d-glyceraldehyde was (6.57±0.14) U/mg, which was 9.25 times higher than that of the wild type ((0.71±0.02) U/mg). Based on the characterization of TKTA_M, tartaric acid semialdehyde was synthesized with 50 mmol/L 5-keto-d-gluconate and 50 mmol/L non-phosphorylated ethanolaldehyde. The final yield of tartaric acid semialdehyde was 3.71 g with a molar conversion rate of 55.34%. Hence, the results may facilitate the preparation of l-(+)-tartaric acid from biomass, and provide an example for transketolase-catalyzed non-phosphorylated substrates.
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Escherichia coli/genética , Transcetolasa/química , Tartratos , Proteínas de Escherichia coli/genéticaRESUMEN
Objective:To evaluate the efficacy and safety of adalimumab (ADA) in the treatment of Crohn′s disease (CD), and to analyze the predictive factors of ADA efficacy.Methods:From January 2020 to December 2020, 49 CD patients treated with ADA at the Department of Gastroenterology, Tenth People′s Hospital of Tongji University of Shanghai were enrolled. The clinical data before treatment were collected. During 12 weeks of ADA treatment, the patients were followed up every 2 weeks, the laboratory examinations were conducted every 4 weeks, and colonoscopy examination was rechecked at the 12th week. The improvement of the main symptoms of patients was assessed at 2nd, 4th, and 6th week during ADA treatment. At the 12th week after ADA treatment, the clinical response (Crohn′s disease activity index (CDAI) score decreased ≥70 points from baseline), clinical remission (CDAI score < 150 points), endoscopic response (simple endoscopic score for Crohn′s disease (SES-CD) decreased >50% from baseline) and endoscopic remission (SES-CD ≤2 points or Rutgeerts score ≤1 point), closure of anal fistula of CD patients complicated with anal fistula and occurrence of adverse reactions during treatment were recorded. The predictive factors of clinical remission of CD patients after ADA treatment for 12 weeks were analyzed. The Mann-Whitney U test and binary logistic regression analysis were used for statistical analysis. Results:The main symptom improved rates of 49 CD patients received ADA treatment at 2nd, 4th and 6th week were 75.5% (37/49), 95.9% (47/49) and 98.0% (48/49), respectively, and the main symptom improved time was 14.0 d (7.0 d, 17.0 d). After ADA treatment for 12 weeks, the clinical remission rate was 55.1% (27/49), the clinical response rate was 73.5% (36/49), the endoscopic remission rate was 43.3% (13/30), the endoscopic response rate was 55.6% (15/27), the anal fistula closure rate was 7/18, and the overall incidence of adverse reactions was 24.5% (12/49). The baseline of fecal calprotectin (FC) level of patients in the clinical remission group (27 cases) was lower than that of the patients in the active disease group (22 cases) (111.0 μg/g, 26.3 μg/g to 125.6 μg/g vs. 540.5 μg/g, 420.2 μg/g to 866.9 μg/g), and the difference was statistically significant ( Z=-4.44, P<0.001). The results of binary logistic regression analysis showed that baseline FC level was an independent predictive factor of clinical remission in CD patients treated with ADA for 12 weeks ( OR=1.08, 95%confidence interval 1.02 to 1.14, P=0.013). When the baseline FC cut-off value was 172.39 g/g, the sensitivity and specificity of it in predicting clinical remission in CD patients treated with ADA for 12 weeks were 81.48% and 90.91%, and the area under the receiver operator characteristic curve was 0.87 ( P<0.001). Conclusions:ADA is safe and effective in the treatment of CD. The baseline FC level is an independent predictive factor of clinical remission in CD patients treated with ADA for 12 weeks.
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Objective:To explore the role of infliximab (IFX) in the repairation of intestinal mucosal barrier in Crohn′s disease (CD).Methods:From January 2018 to October 2019, in Shanghai Tenth People′s Hospital, 382 CD patients were selected. All the patients were treated with IFX. And 103 individuals who underwent colonoscopy were selected as healthy control group. The general clinical data, fasting blood samples and intestinal mucosa tissue samples of CD patients and healthy controls were collected. The body mass index (BMI), hemoglobin, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and relative inflammation factors, including tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 and IL-17A, and their mRNA expression levels were detected. Crohn′s disease activity index (CDAI) and simplified endoscopic score for Crohn′s disease (SES-CD) were used to evaluate the disease activity of CD patients. The expression levels of occudin, claudin-1, zonula occluden-1 (ZO-1) and junctional adhesion molecule-A (JAM-A) were measured by Western blotting. The intestinal mucosal epithelial cells were observed by transmission electron microscope. T test was used for statistical analysis. Results:Before treatment, BMI, and hemoglobin and albumin levels of CD patients were all lower than those of healthy control group ((18.3±1.8) kg/m 2 vs. (20.2±1.2) kg/m 2, (95.3±8.4) g/L vs. (129.2±5.7) g/L, (33.2±5.4) g/L vs. (50.3±3.2) g/L), and the differences were statistically significant ( t=3.457, 5.342 and 2.674, all P<0.05). After treatment the BMI and hemoglobin levels of CD patients were higher than those before treatment ((19.5±2.1) kg/m 2 vs. (18.3±1.8) kg/m 2, (117.2±10.3) g/L vs. (95.3±8.4) g/L), and the CRP level, CDAI score and SES-CD score were lower than those before treatment ((16.3±2.3) mg/L vs. (47.2±9.3) mg/L, 113.2±12.5 vs. 245.2±23.5, 5.0±2.1 vs. 10.0±4.3), and the differences were statistically significant ( t=2.090, 2.339, 2.432, 6.345 and 5.234, all P<0.05). The expression levels of TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-17A and their mRNA levels of healthy control group were lower than those of CD patients before treatment ((1.1±0.4) ng/L vs.(158.2±38.3) ng/L, (3.2±0.8) ng/L vs. (28.3±13.4) ng/L, (2.7±1.3) ng/L vs. (3.3±2.4) ng/L, (5.2±0.3) ng/L vs. (16.3±7.4) ng/L, (16.3±6.3) ng/L vs. (18.9±10.2) ng/L, (10.5±2.3) ng/L vs. (38.5±11.2) ng/L; 1.00±0.00 vs. 4.68±0.34, 7.83±0.32, 1.25±0.46, 8.36±0.44, 2.01±0.89 and 6.83±0.53, respectively), and the differences were statistically significant ( t=2.345, 6.456, 3.008, 4.009, 7.045, 10.223, 8.345, 11.235, 1.114, 12.334, 5.304 and 5.678, all P<0.05). After treatment the TNF-α, IFN-γ, IL-2, IL-6, IL-8, IL-17A expression levels and their mRNA levels of CD patients were lower than those before treatment ((106.4±29.9) ng/L vs. (158.2±38.3) ng/L, (25.7±10.8) ng/L vs. (28.3±13.4) ng/L, (2.9±1.7) ng/L vs. (3.3±2.4) ng/L, (15.4±4.2) ng/L vs. (16.3±7.4) ng/L, (17.2±8.7) ng/L vs. (18.9±10.2) ng/L, (29.9±12.7) ng/L vs. (38.5±11.2) ng/L, 2.45±0.21 vs. 4.68±0.34, 3.75±0.18 vs. 7.83±0.32, 1.09±0.22 vs. 1.25±0.46, 3.78±0.21 vs. 8.36±0.44, 1.67±0.33 vs. 2.01±0.89, 2.96±0.11 vs. 6.83±0.53), and the differences were statistically significant ( t=9.345, 2.456, 2.334, 2.090, 3.009, 8.345, 4.567, 6.445, 2.046, 7.774, 3.008 and 8.867, all P<0.05). The results of Western blotting showed that the expression levels of occudin, claudin-1, ZO-1 and JAM-A in the intestinal mucosa of CD patients before treatment were lower than those of the healthy control group (0.21±0.03 vs. 1.00±0.02, 0.17±0.07 vs. 1.00±0.01, 0.16±0.06 vs. 1.00±0.04, 0.26±0.08 vs. 1.03±0.04). After treatment the expression levels of occudin, claudin-1, ZO-1 and JAM- A mRNA in the intestinal mucosa of CD patients were higher than those before treatment (0.77±0.08 vs. 0.21±0.03, 0.69±0.08 vs. 0.17±0.07, 0.78±0.09 vs. 0.16 ±0.06, 0.72±0.07 vs. 0.26±0.08), and the differences were statistically significant ( t=4.567, 6.346, 5.557, 8.456, 9.678, 8.671, 10.456 and 7.456, all P<0.05). Conclusions:IFX can effectively relieve the disease activity and improve the nutritional status of CD patients. IFX maintains the expression of intestinal epithelial tight junction protein by reducing inflammatory response, and repairs the intestinal mucosal barrier of CD patients.
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Objective:To screen the risk factors of psychology problems and quality of life of patients with inflammatory bowel disease (IBD) by questionnaire, and to explore the impact of anxiety and depression on the quality of life and disease of IBD patients, in order to guide the treatment of IBD.Methods:From June 15 to July 15 in 2019, 171 IBD patients diagnosed in the Department of Gastroenterology, the Tenth People′s Hospital of Tongji University in Shanghai were investigated by internet questionnaire. Finally 136 IBD patients (IBD group) were enrolled. During the same period 121 healthy individuals with no difference in age and gender were selected as healthy control group. IBD clinical questionnaire, the generalized anxiety disorder (GAD)-7, patient health questionnare (PHQ)-9 depression screening and the short form 36-item health survey (SF-36) quality of life evaluation scale were used in IBD group. General situation questionnaire, GAD-7, PHQ-9 and SF-36 scale were conducted in healthy control group. Chi-square test, Binary logistic regression analysis, Ordinal logistic regression analysis, and Pearson correlation analysis were used for statistical analysis.Results:In IBD group, 87(64.0%) were males and 49(36.0%) were females; 25 cases (18.4%) were ulcerative colitis (UC) and 111 cases (81.6%) were Crohn′s disease (CD); and the median age was (32(26, 40)) years old. In healthy control group, 68 (56.2%) were males and 53(43.8%) were females; the median age was (32(26, 37)) years old. The incidence of anxiety in UC patients and CD patients was 64.0%(16/25) and 64.9%(72/111), respectively, and the incidence of depression in UC and CD was 72.0%(18/25) and 58.6%(65/111), respectively. There were no significant differences in the incidence of anxiety and depression between UC patients and CD patients (both P>0.05). Role-emotional (odds ratio ( OR)=0.965, 95% confidence interval ( CI) 0.937 to 0.994, P=0.017) and mental health ( OR=0.940, 95% CI 0.896 to 0.985, P=0.010) may be the independent factors of depression. Physiological function ( OR=1.040, 95% CI 1.010 to 2.730, P=0.022) was the independent factors of depression. There was no significant correlation between the duration of disease and the quality of life ( P>0.05). There was no significant correlation between disease activity and quality of life, however it was related to physiological function ( r=0.15, P=0.046). The physiological function of IBD patients in remission stage was better than that of patients in activity stage. Depression was negatively correlated with quality of life ( r=-0.55, P<0.01), and with a linear relationship ( r=19.429, intercept was 744.455, P<0.01). Anxiety was not correlated with quality of life ( P>0.05). Depression was negatively correlated with changes of physical function, role-physical function, physical pain, general health, vitality, social function, emotional function, mental health, and reported health transition ( r=-0.234, -0.358, -0.454, -0.449, -0.566, -0.485, -0.441, -0.597, and -0.193, all P<0.05). Conclusions:IBD patients are prone to anxiety and depression. Depression is negative correlated with quality of life. It is very important to screen and intervene mental disorders in IBD patients, especially in patients with depression. Controlling the activity of IBD and relieving the clinical symptoms of patients may be effective in improving anxiety and depression. The treatment of IBD itself is the basis of IBD psychotherapy.
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OBJECTIVE@#To identify the main active components in Ⅲ and their targets and explore the mechanism by which Ⅲ alleviates proteinuria in chronic kidney disease (CKD) based on network pharmacology.@*METHODS@#The active components of Ⅲ and their potential targets, along with the oral bioavailability and drug-like properties of each component were searched in the TCMSP database. The proteinuria-related targets were searched in the GeneCards database. The active component-target network was constructed using Cytoscape software, and the acquired information of the targets from ClueGO was used for enrichment analysis of the gene pathways.@*RESULTS@#A total of 102 active components were identified from Ⅲ. These active components acted on 126 targets, among which 69 were related to proteinuria. Enrichment analysis revealed fluid shear stress- and atherosclerosisrelated pathways as the highly significant pathways in proteinuria associated with CKD.@*CONCLUSIONS@#We preliminarily validated the prescription of Ⅲ and obtained scientific evidence that supported its use for treatment of proteinuria in CKD. The findings in this study provide a theoretical basis for further study of the mechanism of Ⅲ in the treatment of proteinuria in CKD.
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Humanos , Disponibilidad Biológica , Medicamentos Herbarios Chinos , Química , Farmacocinética , Usos Terapéuticos , Proteinuria , Quimioterapia , Metabolismo , Insuficiencia Renal Crónica , MetabolismoRESUMEN
Objective:To investigate the changes of expressions of NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome in the peripheral blood mononuclear cells and downstream factors interleukin-1β (IL-1β) and interleukin-18 (IL-18) in serum in the children with asthma, and to explore their significances on assessing the condition of the children.Methods:A total of 176cases of children with asthma were divided into acute exacerbation group (n=91) , chronic persistent group (n=49) and clinical remission group (n=36) according to the clinical manifestation.During the same period, 60healthy children were selected from the outpatient physical examination center as control group.The pulmonary function of children was checked with lung function instrument.The expression levels of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC) and cysteinyl aspartate-specific proteinase-1 (Caspase-1) mRNA in peripheral blood mononuclear cells of the subjects in various groups were detected by using real-time quantitative PCR.The serum levels of IL-1βand IL-18of the subjects in various groups were detected by using enzyme-linked immunosorbent assay (ELISA) .Results:Compared with control group, the forced expiratory volume in 1second percentage of predicted value (FEV1%) and fixed ratio of forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) of the children in acute exacerbation, chronic persistent and clinical remission groups were decreased (P<0.05) ;acute exacerbation group<chronic persistent group<clinical remission group, and there were significant differences between various groups (P<0.05) .The levels of NLRP3, ASC and Caspase-1mRNA in the peripheral blood mononuclear cells and serum levels of IL-1βand IL-18in the children with asthma were higher than those in control group (P<0.01) .The expression levels of NLRP3, ASC and Caspase-1mRNA in the peripheral blood mononuclear cells of the children in acute exacerbation group were higher than those in chronic persistent and clinical remission groups (P<0.05) , and the expression levels of NLRP3, ASC and Caspase-1mRNA in chronic persistent group were higher than those in clinical remission group (P<0.05) .Pearson correlation analysis showed that the expression level of NLRP3mRNA in the peripheral blood mononuclear cells of asthmatic children was positively correlated with the expression levels of ASC, Caspase-1 mRNA and the serum levels of IL-1βand IL-18 (P<0.05) , while it was negatively correlated with FEV1%and FEV1/FVC;the expression level of ASC mRNA was positively correlated with the expression level of Caspase-1mRNA and the serum levels of IL-1βand IL-18 (P<0.05) , while it was negatively correlated with FEV1%and FEV1/FVC (P<0.05) ;the expression level of Caspase-1 mRNA was positively correlated with the expression level of Caspase-1mRNA and the serum levels of IL-1βand IL-18 (P<0.05) , while it was negatively correlated with FEV1%and FEV1/FVC (P<0.05) ;the serum level of IL-1βwas negatively correlated with FEV1%and FEV1/FVC (P<0.05) , and the serum level of IL-18was negatively correlated with FEV1%and FEV1/FVC (P<0.05) .Conclusion:The expression levels of NLRP3inflammasome and the downstream factor IL-1βand IL-18in peripheral blood of the children with asthma are increased, and they are related to the clinical stage of the children with asthma.NLRP3inflammasome pathway might promote the pathogenesis of asthma in the children.
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With an increasing proportion of sedentary lifestyle related chronic diseases, an efficient way to help fight the growing world epidemic of non-communicable diseases (NCDs) and promote public health in a fast-changing world is urgently needed. Exercise and medicine science have played an important role in prevention and control of NCDs. However, the current status and future development directions regarding the integration of exercise science and medicine (IESM) in China have not been well discussed. During 2017 Belt and Road Initiative Global Health International Congress & 2017 Chinese Preventive Medicine Association-Chinese Society on Global Health Annual Meeting, Xi'an Jiaotong University Global Health Institute, and the Integration of Sport and Medicine Innovation Research Center, China Institute of Sport Science organized the IESM Forum on September 27. Six leaders and experts from China and abroad presented excellent research reports in the IESM Forum from several aspects. Experts reached a consensus at the end of their discussions that, in the near future, the IESM will be a key part of a sustainable health care system and as such should contribute to prosperity in China and around the world. However, Abstract compared with European, American and Japanese universities, the development of the IESM in China is in its early stages with huge development potential.
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<p><b>OBJECTIVE</b>To evaluate systematically the short- and long-term outcomes between laparoscope-assisted transanal total mesorectal excision (LA-taTME) and laparoscopic total mesorectal excision (L-TME) in the treatment of mid and low rectal cancer.</p><p><b>METHODS</b>Literatures comparing LA-taTME with L-TME published from January 2014 to January 2018 were systematically selected through searching PubMed, Ovid, EMbase, Cochrane Library, CNKI and Wanfang databases. Literature screening and methodology quality evaluation were carried out by two surgeons independently. Randomized controlled trial (RCT) was evaluated by the modified Jadad rating scale, in which 1 to 3 and 4 to 7 were considered as low and high quality,respectively(total scores: 7). Non-randomized controlled trial (NRCT) was assessed by the modified Newcastle Ottawa Scale (NOS), in which 1 to 3, 4 to 6, and 7 to 9 were defined as low, moderate, and high quality, respectively (total score: 9). Ratio of incomplete mesorectum, positive rate of circumferential resection margin (CRM), number of harvested lymph node, distance of distal resection margin, operation time, intraoperative blood loss, morbidity of postoperative complication, conversion rate, hospital stay, recurrence, 2-year disease-free survival (DFS) and 2-year overall survival (OS) were compared and analyzed by using Stata/SE12.0 software.</p><p><b>RESULTS</b>Fourteen studies including 1 RCT and 13 NRCTs were enrolled finally. Among them, the RCT with a score of 6 was considered to be of high quality; all NRCTs (2 with 6 stars, 5 with 7 stars, and another 6 with 8 stars) were indicative of moderate to high quality; 450 patients underwent LA-taTME and 498 patients underwent L-TME. No significant differences were observed in terms of age, gender, tumor location and TNM stage between two approaches (all P>0.05). Compared to L-TME, LA-taTME had lower ratio of incomplete mesorectum (RR=0.53, 95%CI: 0.31 to 0.93, P=0.026), lower positive rate of CRM (RR=0.50, 95%CI: 0.29 to 0.86, P=0.012), lower conversion rate(RR=0.48, 95%CI: 0.26 to 0.86, P=0.014), lower morbidity of postoperative complication (RR=0.81, 95%CI: 0.67 to 0.99, P=0.036) and less intraoperative blood loss (SMD=-0.38, 95%CI:-0.68 to -0.08, P=0.013). While the differences between two groups had no statistical significance in terms of operative duration, number of harvested lymph node, distance of distal resection margin, hospital stay, overall recurrence, 2-year DFS and 2-year OS (all P>0.05).</p><p><b>CONCLUSION</b>The short- and long-term outcomes of LA-taTME and L-TME for the treatment of mid and low rectal cancer are comparable, while LA-taTME can reduce the ratio of incomplete mesorectum, positive rate of CRM, conversion rate, and morbidity of postoperative complication, and intraoperative blood loss.</p>
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Humanos , Laparoscopios , Laparoscopía , Recurrencia Local de Neoplasia , Complicaciones Posoperatorias , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias del Recto , Cirugía General , Recto , Cirugía General , Cirugía Endoscópica Transanal , Resultado del TratamientoRESUMEN
With the rapid development of new technologies and global trade and increasing collaboration among countries worldwide,public health has become a global issue.Global health,as a new discipline,has been drawing more attention from both academia and governments.The Belt and Road (B&R) Initiative,proposed by China in 2013,aims to promote trade and resource exchange,including education,research,and health issues,with over 60 countries in Asia,Africa,and Europe.The B&R Initiative provides good opportunities for involved countries to address health problems jointly as well.In response to the B&R Initiative and to promote international collaboration on global health issues,"The 2017 Belt and Road Initiative Global Health International Congress & 2017 Chinese Preventive Medicine Association-Chinese Society on Global Health Annual Meeting" was held on September 24-27,2017 in Xi'an,China.Thus far,this is the largest high-quality international conference held in China that focused on the B&R Initiative global health issues.This article summarizes the background,key sessions and topics covered during the congress,important events and highlights different perspectives of the B&R Initiative and global health by invited experts from China and abroad.The conference included 17 sessions (3 keynote speech forums and 10 scientific sessions,3 young scholar forums,and a research poster session) and about 100 speakers,around 40 of which were leading experts outside of China.All the major sessions were held in English.More than 40 leaders and experts of health sectors from 13 countries presented their work in the congress.Approximately 400 delegates from 29 countries attended the congress.Delegates had extensive discussions about global health related issues,future cooperation and development in global health.The congress fostered international exchange and collaboration.
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To clarify the effect of the sympathetic nerves on the body's physiopathological changes and acupuncture effect by the alphal-AR mediation in the past 30 years.The paper has referred to the database of CNKI and Pubmed,and systematically reviewed the publications in the past 30 years about the research of the alphal-AR mediation of the sympathetic nerves to the body's physiological andpathological changes and acupuncture effect.Alphal-AR not only mediated the sympathetic nerves on the inotropic change of the heart,and the contraction of the vascular smooth muscles,bladder sphincter,and uterine smooth muscles and other physiological effect,but also mediated cardiac arrhythmia,myocardial hypertrophy and other pathological process.In addition,Alphal-AR also mediated the acupuncture signal transmission,and acupuncture was able to adjust the sympathetic nervous tension.The body's physiopathological changes are closely related to alpha1-AR and subtype alteration.The in-depth study of alphal-AR helps to explain physiopathological mechanism of the body,as well as provide theoretical basis and the corresponding pharmacological models for better selective drugs.Studying Alpha1-AR on meridians contributes to the discovery of meridian essence and the substantial basis of acupuncture effects.
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Objective To seek for the differentially-expressed proteins in patients with kidney-yin deficiency syndrome and to screen out the specific proteins,so as to provide evidence for the establishment of objective standard of kidney deficiency syndrome of traditional Chinese medicine (TCM).Methods Five patients with typical kidney-yin deficiency syndrome and 6 normal healthy volunteers were enrolled into the study.Plasma proteins in both groups were detected by antibody chip,and then the plasma proteins profile was compared and analyzed.Results A total of 25 differentially-expressed proteins between kidney-yin deficiency group and normal control group were found,of which 2 were up-regulated and 23 were down-regulated.Conclusion The differentially-expressed proteins in patients with kidney-yin deficiency syndrome are mainly related to immune disorder,protein biosynthesis,metabolism,oxidative stress,cell apoptosis,signal transduction,and so on.
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Objective To observe over-time changes in rat blood flow in the skins of related meridian points during physiological status, the pathological state of ischemic myocardial injury and low or high frequency electroacupuncture intervention and explore the post effect of different frequency electroacupuncture on related meridian points after treating ischemic myocardial injury. Method Fifty male Wister rats were randomized into five groups: blank control, sham operation, model, low frequency electroacupuncture (meridian point A) and high frequency electroacupuncture (meridian point B), 10 rats each. Blood flow in the skins of bilateral points Neiguan (PC6), Ximen (PC4) and Tianquan (PC2), and non-meridian and non-acupoint control points was measured by laser speckle contrast imaging in every group immediately and at 30 and 60 min after the end of three treatments. Statistical analysis was made. Result Blood flow in the skins of bilateral points Neiguan, Ximen and Tianquan was significantly lower in the blank control group than in the model group (P<0.01,P<0.05). Blood flow in the skin of every acupoint increased in varing degrees after low or high frequency electroacupuncture treatment. Blood flow in bilateral points Neiguan, Ximen and Tianquan regions in meridian point group A was closer to that in the blank control group immediately after treatment. Blood flow in three left-side and three right-side acupoint regions in meridian point group B was closer to that in the blank control group at 30 and 60 min, respectively, after treatment. Conclusion The immediate effect of low frequency electroacupuncture on blood flow in acupoint regions is better than high frequency electroacupuncture during intervention in ischemic myocardial injury. The post effect of high frequency electroacupuncture on blood flow in acupoint regions is better than low frequency electroacupuncture during intervention in ischemic myocardial injury.
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Objective:To understand the cognitive differences and its influential factors of medical dispute and physician′s professionalism between medical personnel and patients, and further to provide evidence for the preven-tion and treatment of medical dispute. Methods:In the case of quality control, we surveyed on the cognitive of medical dispute and physician′s professionalism in medical personnel and patients using self-designed question-naire. Stratified cluster sampling method was used in this study, which recruited 847 medical workers and 577 pa-tients. Data analysis was conducted with SPSS 16. 0. The two sample rates were compared using Chi squaretest (α=0. 05). Results:There is a statistically significance in doctor-patient relationship evaluation, dispute pre-vention, dispute responsibility, fair treatment,impact on the doctors and patients, causes of medical disturbance, attitude tomedical disturbance, medical disturbance elimination, physician′s professionalism evaluation, improve-ment approach, and the physician′s professional value between the two samples, having a direct impact on the con-struction of physician′s professionalism. Conclusion:For medical personnel, they should strengthen the construc-tion of physician′s professionalism and establish effective mechanism to prevent medical dispute. For patienes, they should understand, trust and respect the doctors, and solve medical dispute rationally. For government, they should establish a reasonable mechanism for the settlement of medical dispute, create a rational atmosphere respon-ding to the medical dispute, and reduce the intensification of medical dispute.
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Objective:To explore the causes of immune dysfunction in neonatal rats with hyperbilirubinemia.Methods: A total of 60 newborn SD rats were equally randomized into normal saline (NS) group, LPS control group, bilirubin control group, low-dose group and high-dose group. After anesthesia, 0.1 mL NS was given to the NS and LPS control group and different doses of bilirubin for the other groups; 1 h later, the NS and bilirubin control group received the intraperitoneal injection of 0.05 mL NS and 1mg/kg LPS for the other groups. After 5 or 24 hours of model establishment, spleens were collected for detecting the expression levels of MyD88 and p-TAK1 protein and the spleen cells apoptosis by immunohistochemmistry and TUNEL method. After 24 hours of model establishment, serum inflammatory factors levels and T cell subsets distribution were determined by ELISA and flow cytometry.Results: In contrast to low-dose bilirubin, high-dose bilirubin could induce spleen cells apoptosis in coordination with LPS. After 5 hours of model establishment, compared with NS group, MyD88 expression level in low-dose group elevated while p-TAK1 level in high-dose group reduced (P<0.05). In high-dose group, inflammotory factors levels and CD8+ T cells percentage were all higher than LPS control and NS group (P<0.05), while CD4+ T cells percentage was lower than NS group (P<0.05).Conclusions:High-concentration plasma bilirubin in coordination with LPS could inhibit NF-κB signal pathways activation and aggravate inflammatory reaction, thus caused immunosuppression with inflammation cascade, which resulted in the immune dysfunction.
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Objective To explore the correlation of fatigue with health-promoting lifestyle in the udnergraduate students, so as to provide scientific evidence for the intervention. Methods A cross-section trial was carried out in the undergraduate students from a medical university in Guangzhou. By a self-designed questionnaire, the incidence of fatigue in the undergraduate students was figured out after data processing and statistical analysis. Results A total of 6 100 questionnaires were released, and 5 843 were responded, with a respondent rate being 95.79%. The number of effective questionnaires arrived 5 676. The results showed that the prevalence of fatigue among undergraduate students was 49.6%. The female had a higher risk than the male ( 51.6% vs 45.8%, P0.05). The students with poor level of health-promoting lifestyle had a higher risk of suffering from fatigue (OR=6.647, 95%CI: 4.913-8.993). Conclusion Fatigue is prevalent among the undergraduate students. The incidence of fatigue can be reduced by increasing the level of self-actualization, physical exercise and pressure management.
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Objective To observe the therapeutic effect of Yougui Pills and its separate formula for the treatment of kidney-yang deficiency syndrome. Methods A total of 60 patients of kidney-yang deficiency syndrome were randomly divided into treatment group and control group, 30 cases in each group. Treatment group was treated with Yougui Pills, and the control group was given the separate formula from Yougui Pills which had the actions of warming kidney yang. Four weeks constituted one treatment course and the treatment covered 2 courses. The changes of major clinical symptom scores, total effectives rate and associated indexes such as peripheral white blood cells, serum antibodies, and complements were compared between the two groups following the treatment for 8 weeks. Results The total effective rate, and improvement of major clinical symptoms and the peripheral white blood cells in the treatment group were superior to those in the control group ( P0.05) .Conclusion Yougui Pills show better effect than its kidney-yang-warming separate formula for the treatment of kidney-yang deficiency syndrome, indicating that the method of generating yang by activating yin is superior to the method of simply nourishing kidney yang.
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<p><b>OBJECTIVE</b>To explore the relationship between the occurrence of sub-health and health promotion lifestyle in Guangdong province to provide epidemiological evidences for prevention of sub-health.</p><p><b>METHODS</b>A 1:1 nested case-control study was carried out involving 133 cases from the cohort study paired with 133 control case matched for gender and age.</p><p><b>RESULTS</b>The univariate conditional logistic regression model showed no significant association of marital status, education level, or body mass index with the occurrence of sub-health, but a significant correlation was found between lifestyle and sub-health with an odd ratio of 5.90 (95% CI: 3.12-11.16, P=0.000). Analysis of the multivariate conditional logistic regression model on the 6 subscales of health promotion lifestyle showed that stress management was significantly correlated with the occurrence of sub-health with an odd ratio of 4.00 (95% CI: 1.54-10.40, P=0.004).</p><p><b>CONCLUSION</b>A unhealthy lifestyle, especially in terms of stress management, is the major risk factor contributing to the occurrence of sub-health.</p>