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The irrational use of Chinese patent medicines (CPM) is becoming more and more prominent, which makes the demand for clinical practice guidelines of CPM gradually increase. In order to make domestic scholars understand the latest developments and existing problems of the CPM guidelines, and promote its development, this paper introduced the concept of CPM guidelines, summarized the characteristics of the two development modes, namely “taking CPM as the key” and “taking disease/syndrome as the key”, and analyzed the current methodological status of developing and reporting CPM guidelines. Based on the existed problems, three suggestions have been put forward to optimize the quality of CPM guidelines, which were clarifying the target users and scope of CPM guidelines, establishing an open and transparent mechanism of the personnel involvement and process steps, and formulating implementable and operable recommendations for the use of CPM.
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The identification of clinical questions for clinical practice guidelines of Chinese patent medicine (CPM) is important for subsequent evidence retrieval, evaluation of evidence quality, formation of recommendations. This paper described a methodological proposal for the identification of clinical questions for CPM guidelines to highlight the characteristics of Chinese patent medicine and reflect its effect in specific stage of the disease. Considering four aspects, namely, the drug of Chinese patent medicine (D), the specific disease stage (S), comparison (C), and specific outcome (O), DSCO framework has been proposed to formulate the clinical questions. Multi-source information through scientific research, policy or standard documents, and clinical data are suggested for collecting clinical questions, and clear selection criteria should be set to finalize the clinical questions to be addressed by the guideline. In addition, the above process needs to be transparently and publicly reported in order to ensure the clarity and completeness of the guidelines.
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Chalcone isomerase is a key rate-limiting enzyme in the biosynthesis of flavonoids in higher plants, which determines the production of flavonoids in plants. In this study, RNA was extracted from different parts of Isatis indigotica and reverse-transcribed into cDNA. Specific primers with enzyme restriction sites were designed, and a chalcone isomerase gene was cloned from I. indigotica, named IiCHI. IiCHI was 756 bp in length, containing a complete open reading frame and encoding 251 amino acids. Homology analysis showed that IiCHI was closely related to CHI protein of Arabidopsis thaliana and had typical active sites of chalcone isomerase. Phylogenetic tree analysis showed that IiCHI was classified into type Ⅰ CHI clade. Recombinant prokaryotic expression vector pET28a-IiCHI was constructed and purified to obtain IiCHI recombinant protein. In vitro enzymatic analysis showed that the IiCHI protein could convert naringenin chalcone into naringenin, but could not catalyze the production of liquiritigenin by isoliquiritigenin. The results of real-time quantitative polymerase chain reaction(qPCR) showed that the expression level of IiCHI in the aboveground parts was higher than that in the underground parts and the expression level was the highest in the flowers of the aboveground parts, followed by leaves and stems, and no expression was observed in the roots and rhizomes of the underground parts. This study has confirmed the function of chalcone isomerase in I. indigotica and provided references for the biosynthesis of flavonoid components.
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Isatis/genética , Proteínas de Plantas/metabolismo , Filogenia , Arabidopsis/genética , Flavonoides , Clonación MolecularRESUMEN
BACKGROUND@#Extreme temperature events, including extreme cold, are becoming more frequent worldwide, which might be harmful to pregnant women and cause adverse birth outcomes. We aimed to investigate the association between exposure to low ambient temperature in pregnant women and adverse birth outcomes, such as preterm birth, low birth weight, and stillbirth, and to summarize the evidence herein.@*METHODS@#Relevant studies were searched in PubMed, Cochrane, and Embase electronic databases until November 2021. Studies involving low ambient temperature, preterm birth, birth weight, and stillbirth were included. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses were followed to conduct this study risk of bias and methods for data synthesis.@*RESULTS@#A total of 34 studies were included. First, pregnant women exposed to low ambient temperature had an increased risk of preterm birth (risk ratio [RR] 1.08; 95% confidence interval [CI] 1.04-1.13). Subgroup analyses revealed that exposure during late pregnancy was more likely to induce preterm birth. In addition, only pregnant women exposed to <1st percentile of the mean temperature suffered increased risk of preterm birth. Moreover, pregnant women living in medium or hot areas were more prone to have preterm births than those in cold areas when exposed to low ambient temperatures. Asians and Blacks were more susceptible to low ambient temperatures than Caucasians. Second, pregnant women exposed to low ambient temperature had an increased risk of low birth weight (RR 1.07; 95% CI 1.03-1.12). Third, pregnant women had an increased risk of stillbirth while exposed to low ambient temperature during the entire pregnancy (RR 4.63; 95% CI 3.99-5.38).@*CONCLUSIONS@#Exposure to low ambient temperature during pregnancy increases the risk of adverse birth outcomes. Pregnant women should avoid exposure to extremely low ambient temperature (<1st percentile of the mean temperature), especially in their late pregnancy. This study could provide clues for preventing adverse outcomes from meteorological factors.@*REGISTRATION@#No. CRD42021259776 at PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ).
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Embarazo , Recién Nacido , Femenino , Humanos , Resultado del Embarazo , Nacimiento Prematuro/epidemiología , Mortinato/epidemiología , Temperatura , Complicaciones del EmbarazoRESUMEN
OBJECTIVE@#To explore clinical features, treatment methods and clinical effects of cervical spondylosis with proximal muscular atrophy.@*METHODS@#Eleven patients with proximal-type cervical spondylotic amyotrophy were retrospectively studied from September 2016 to November 2020, including 7 males and 4 females, aged 38 to 68 years old. Clinical symptoms, MRI and neuroelectrophysiological manifestations were analyzed, and patients were treated with conservative treatment or anterior cervical decompression fusion surgery, respectively. The efficacy was evaluated by manual muscle test (MMT) before and after treatment, and patients' satisfaction was followed up at the same time.@*RESULTS@#All patients were followed up for 6 to 19 months. All 11 patients were unilateral, mainly manifested by atrophy of deltoid muscle, supraspinatus muscle and infraspinatus muscle, and may be accompanied by ipsilateral neck and shoulder pain at early stage. MRI showed lesions at C4,5, C5,6 segments were more common. Electrophysiological examination showed the affected muscle was denervated, and amplitude of compound muscle action potential (CMAP) of innervated nerve on the affected side was lower than that on the healthy side. All patients were obtained bone fusion. One patient who were underwent anterior cervical corpectomy and fusion (ACCF) occurred developed contralateral C5 nerve root paralysis after operation, which recovered completely after 10 weeks of symptomatic treatment. At 12 months after operation, the efficacy was evaluated according to MMT, 3 patients were treated conservatively, 2 patients excellent and 1 good;in 8 patients treated by operation, 3 patients were excellent, 4 good, and 1 moderate.@*CONCLUSION@#The incidence of cervical spondylosis with proximal muscular atrophy is low, which is manifested as unilateral proximal muscle atrophy and may be accompanied by ipsilateral neck and shoulder pain in the early stage. Combined with MRI and neuroelectrophysiological examination, misdiagnosis could be reduced. In the early stage of disease, especially in the case of nucleus pulposus protrusion leading to nerve compression, conservative treatment could be taken. When the conservative treatment is ineffective or the pain cannot be tolerated, anterior decompression surgery is recommended, and the overall effect is satisfactory.
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Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Dolor de Hombro , Vértebras Cervicales/patología , Atrofia Muscular/cirugía , Descompresión Quirúrgica/métodos , Espondilosis/cirugía , Resultado del Tratamiento , Fusión Vertebral/efectos adversosRESUMEN
The last essential enzyme in the biosynthetic pathway of trilobatin, phloretin-4'-O glycosyltransferase (P4'-OGT), catalyzes the conversion of trilobatin to phloretin in vitro. However, only a few P4'-OGTs have been found in plants. This study used Malus domestica phloretin-4'-O glycosyltransferase (MdPh-4'-OGT) as a query to identify and clone two UDP-glucuronosyltransferase (UGT) genes, designated UGT74L2 and UGT74L3, from the transcriptome of Andrographis paniculata. According to a phylogenetic tree analysis, UGT74L2 and UGT74L3 belonged to the UGT74 family, which has been linked to several activities in other species. The in vitro enzymatic reaction demonstrated that UGT74L2 could particularly catalyze the formation of trilobatin from phloretin, but UGT74L3 had no effects. By using Ni-NTA affinity chromatography to extract the soluble UGT74L2 recombinant protein, the enzymatic kinetics of the activity was investigated using phloretin as the substrate. The results showed that the optimal temperature and pH for UGT74L2 enzymatic reaction were 40 ℃ and 8.0 (Tris-HCl system), respectively. Three metal ions (Ca2+, Mn2+ and Co2+) showed inhibitory effect on the activity of UGT74L2, while Mg2+ could improve the activity of UGT74L2. Other tested metal ions have no significant effect on UGT74L2. The results of enzymatic kinetic parameters that the Km value was 29.84 μmol·L-1, the kcat was 0.02 s-1, and the kcat·Km-1 was 572.6 mol-1·s-1. By homology modeling, molecular docking and mutation experiments, we found that multiple amino acids residues around the substrate binding pocket play quite an important role during catalytic process, In summary, we identified a novel P4'-OGT gene from medicinal plant Andrographis paniculata and provided a new efficient catalyst to synthesize trilobatin. Meanwhile, this study provides a reference for mining new efficient glycosylation modules from plants.
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Traditional Chinese medicine(TCM) carries the experience and theoretical knowledge of the ancients, and the use of "toxic" Chinese medicines is a major feature and advantage of TCM. "Toxic" Chinese medicines have unique clinical value and certain medication risk under the guidance of TCM theories such as compatibility for detoxification and treatment based on syndrome differentiation. In recent years, the safety events of Chinese medicines have occurred frequently, which has made the safety of Chinese medicine a public concern in China and abroad. However, limited by conventional cognitive laws and technical methods, basic research on toxicity of Chinese medicines fails to be combined with the clinical application. As a result, it is difficult to identify the clinical characteristics of, predict toxic and side effects of, or form a universal precise medication regimen for "toxic" Chinese medicines, which restricts the clinical application of them. In view of the problem that the toxicity of "toxic" Chinese medicines is difficult to be predicted and restricts the clinical application, the evidence-based research concept will provide new ideas for safe applcation of them in clinical practice. The integrated development of multiple disciplines and techniques in the field of big data and artificial intelligence will also promote the renewal and development of the research models for "toxic" Chinese medicines. Our team tried to propose the academic concept of evidence-based Chinese medicine toxicology and establish the data-intelligence research mode for "toxic" Chinese medicines and the intelligent risk prediction method for medicinal combination in the early stage, which provided methodological supports for solving the above problem. Thus, on the basis of summarizing the research status and problems of the clinical medication regimen of "toxic" Chinese medicines, our team took the evidence-based toxicology of TCM as the core concept, and tried to construct the multiple-evidence integrated evaluation and prediction method for "toxic" Chinese medicine, so as to guide the establishment of the non-toxic medication regimen of "toxic" Chinese medicines. Specifically, through the analysis of multivariate data obtained from the basic research, the evidence-based toxicology database of Chinese medicines and the individualized "toxicity-effect" intelligent prediction platform were built based on the disease-syndrome virtual patients, so as to identify the clinical characteristics and risks of "toxic" Chinese medicines and develop individualized medication regime. This study is expected to provide a methodological reference for the establishment of medication regimen and risk prevention strategy for "toxic" Chinese medicines. The method established in this study will bridge clinical research and basic research, enhance the transformation of the scientific connotation of attenuated compatibility, promote the development of evidence-based Chinese medicine toxicology, and ensure the clinical safety of "toxic" Chinese medicines.
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Humanos , Inteligencia Artificial , China , Medicamentos Herbarios Chinos/farmacología , Medicina Tradicional China , Proyectos de Investigación , SíndromeRESUMEN
Sweat gland is one of the important appendage organs of the skin, which plays an important role in thermoregulation and homeostasis maintenance. Sweat glands are damaged and unable to self-repair after burns, resulting in perspiration disorders eventually. However, current clinical strategies cannot restore the function of the damaged sweat glands effectively. Therefore, it is urgent to seek treatments that can promote the regeneration of sweat glands and restore their normal functions. Stem cells have extensive sources, low immunogenicity, high proliferation capacity, and multi-directional differentiation potential, which have become a focus in the field of regenerative medicine. In recent years, a variety of stem cells have been induced to differentiate into sweat gland-like tissue with certain secretory function, which provides treatment direction for sweat gland regeneration after burns in clinic. This article reviews the recent research advances on the application of stem cells in sweat gland regeneration from the perspectives of the manner by which stem cells transform into sweat gland cells in different environments and their influencing factors.
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Diferenciación Celular/fisiología , Regeneración/fisiología , Piel , Células Madre , Glándulas Sudoríparas/fisiologíaRESUMEN
Objective:To study the relationship between morphologic classification and prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods:The clinicopathologic data of 125 ICC patients who underwent R 0 resection at the Ningbo Medical Center Li Huili Hospital from January 2011 to May 2019 were retrospectively analyzed. This cohort consisted of 67 males and 58 females, aged 26.0 to 82.0 (63.5±9.5) years old. Based on the resected specimens, the patients were divided into the mass forming type, periductal infiltrating type and mixed type. The survival rates and recurrence-free survival outcomes of the patients among the three types were compared, and the risk factors that influenced prognosis were analyzed. Results:Using the predetermined inclusion and exclusion criteria, 16 patients with missing data and other causes of death were excluded from the initial 125 patients. Also, as the number of the mixed type was small, these patients were excluded. Finally 62 patients in the mass forming type and 42 patients in the periductal infiltrating type were analyzed. In the mass forming group, there were 32 males and 30 females, aged (63.1±9.1) years. In the perivascular infiltration group, there were 22 males and 20 females, aged (64.1±10.2) years. The 1-, 3-, 5-year survival rates of the mass forming group were 78.1%, 33.2%, 18.9% (median survival 25 months). The 1-, 3-, 5-year survival rates of the periductal infiltrating type were 63.3%, 8.3%, 6.1% (median survival 15 months). There were statistically significant differences between the two groups ( P<0.05). The median recurrence-free survival for the mass forming and the periductal infiltrating groups were 18 and 11 months, respectively, with a statistically significant differences between them ( P<0.05). Univariate and multivariate analysis showed that TNM staging Ⅲ~Ⅳ ( HR=2.966, 95% CI: 1.549-5.679) and periductal infiltrating type ( HR=2.403, 95% CI: 1.236-4.670) were independent risk factors for survival of these patients after operations. TNM staging Ⅲ~Ⅳ ( HR=2.466, 95% CI: 1.325-4.589), low grade differentiation ( HR=0.528, 95% CI: 0.299-0.934) and periductal infiltrating type ( HR=2.432, 95% CI: 1.295-4.565) were independent risk factors for relapse-free survival of these patients ( P<0.05). Conclusions:Morphological classification was found to be an independent risk factor for prognosis of ICC patients in this study, with significantly worse long-term prognosis when compared with the mass forming type.
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Objective@#To explore the predictive significance of logarithm of lymph node positive number to lymph node negative number (LODDS) in patients with gallbladder cancer, and to establish a predictive model of gallbladder cancer based on LODDS.@*Methods@#The clinical data of 1321 gallbladder cancer patients who underwent lymphadenectomy in SEER database from 2010 to 2014 were collected. They were randomly divided into test group (n=793) and verification group (n=528). COX multivariate analysis was used to determine independent prognostic factor, and a Nomogram prediction model was established. C index was used to evaluate the accuracy of patient Nomogram and TNM. ROC curve was used to evaluate the accuracy of the contour map and TNM staging in predicting survival rates.@*Results@#Independent risk factors for COX analysis were selected including age, tumor size, grade, TNM stage and LODDS analysis, and the contour map was drawn. In the experimental group, the C index was 0.744 (95% CI, 0.707-0.781), and the AUC values of ROC curves predicting 3-year and 5-year survival were 0.815 and 0.823, respectively. The predictive value of C index for TNM staging in the test group was 0.699 (95% CI, 0.662-0.736), and the AUC value of ROC curve for TNM staging predicting 3-year and 5-year survival was 0.779 and 0.790, respectively.@*Conclusion@#LODDS is an independent prognostic factor for gallbladder cancer. The prediction model based on LODDS is more accurate than TNM staging.
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Objective To explore the predictive significance of logarithm of lymph node positive number to lymph node negative number (LODDS) in patients with gallbladder cancer,and to establish a predictive model of gallbladder cancer based on LODDS.Methods The clinical data of 1321 gallbladder cancer patients who underwent lymphadenectomy in SEER database from 2010 to 2014 were collected.They were randomly divided into test group (n =793) and verification group (n =528).COX multivariate analysis was used to determine independent prognostic factor,and a Nomogram prediction model was established.C index was used to evaluate the accuracy of patient Nomogram and TNM.ROC curve was used to evaluate the accuracy of the contour map and TNM staging in predicting survival rates.Results Independent risk factors for COX analysis were selected including age,tumor size,grade,TNM stage and LODDS analysis,and the contour map was drawn.In the experimental group,the C index was 0.744 (95% CI,0.707-0.781),and the AUC values of ROC curves predicting 3-year and 5-year survival were 0.815 and 0.823,respectively.The predictive value of C index for TNM staging in the test group was 0.699 (95 % CI,0.662-0.736),and the AUC value of ROC curve for TNM staging predicting 3-year and 5-year survival was 0.779 and 0.790,respectively.Conclusion LODDS is an independent prognostic factor for gallbladder cancer.The prediction model based on LODDS is more accurate than TNM staging.
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Objective: To conduct a comprehensive and systematic review of the efficacy and safety of Wenxin Keli (WXKL) in the treatment of atrial fibrillation (AF) . Methods: Seven databases (PubMed, The Cochrane Library, Web ofScience, CNKI, Wanfang Database, VIP and SinoMed) were searched to identify relevant randomized controlled trials (RCTs) from inceptions to 1 October, 2018. Two review authors independently assessed the methodological quality andanalyzed data by Cochrane handbook and the Rev Man 5.3 software. Begg.s test was conducted to assess publication biasvia Stata 14 software. Results: Twenty-four RCTs with 2246 patients were included in this review. Compared with blankcontrol, placebo or western medicine alone, WXKL alone or combined with western medicine could effectively reducerapid ventricular rate (MD=-7.14, 95%CI:-8.42——5.87), the frequency and duration of AF. It could also shorten thesinus rhythm conversion time (MD=-3.04, 95%CI:-3.47——2.61), increase the sinus rhythm conversion rate (RR=1.19, 95% CI: 1.09~1.29) and decrease recurrence rate of AF (RR=0.28, 95% CI: 0.13-0.59) . Besides, WXKL alone orcombined with western medicine was beneficial for improving the left ventricular ejection fraction (LVEF) (MD=3.44, 95% CI: 0.87-6.01), left ventricular end diastolic diameter (LVEDD) (MD=-2.47, 95% CI:-2.86——2.08), left atrialdiameter (LAd) (MD=-0.91, 95%CI:-1.58——0.25) and P wave dispersion (Pd) (MD=-4.04, 95%CI:-4.15——3.93) .WXKL combined with low-dose amiodarone was superior to conventional-dose amiodarone alone in improving themaximum P wave (Pmax) (MD=-8.25, 95% CI:-10.33——6.17), and WXKL combined with conventional-doseamiodarone is more effective (MD=-13.10, 95%CI:-13.65——12.55) . Compared with the control group, the treatmentgroup had fewer adverse reactions, and the Begg.s test did not find any publication bias. Conclusion: WXKL alone orcombined with western medicine exhibited better therapeutic effects in the treatment of AF, but these results still needhigh-quality evidence to verify.
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Traditional Chinese medicine (TCM) emphasizes treatment timing, and it believes that the timing of treatment is closely related to the curative effect. In the era of the Chinese and Western medicine combined application, it attaches new connotations on how to choose the timing of interventions. Defining the timing of intervention is one of the key links to make the best effect of Chinese medicine, and it is also the focus of clinical decision-making, which deserves research attention. This article expounded the significance of TCM intervention timing research, and pointed out that the alternative timing should be based on the baseline investigation and mechanism clues. This article also demonstrated some key points of intervention timing trial design, like the outcome indicators setting, sample size estimation, blinding and data analysis. With the examples of national key research and development program"evidence-based optimization and mechanism research of traditional Chinese medicine therapies for coronary artery disease (angina pectoris-myocardial infarction-heart failure) ", the timing of TCM intervention in myocardial infarction perioperative period and coronary heart disease related research cases aboard, we hope to provide reference for the intervention timing optimization research.
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In review of recent literature on the treatment of heart failure with coronary heart disease by injection of Yiqi Fumai (freeze-dried), clinical evidence for the treatment of coronary heart disease with heart failure was reviewed from relevant systematic reviews, clinical randomized controlled trials, and safety evaluation, from the experiments in vivo and in vitro on its working mechanism of the treatment of coronary heart disease, heart failure, for more in-depth research on clinical and basic research in the future to lay the foundation.
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Background Corneal collagen cross-linking (CXL) shows good clinical effects for keratoconus,and de-epithelized CXL appears to be benefit to the distribution and absorption of riboflavin in cornea stroma.However,de-epithelization of CXL will increase the infective risk and corneal healing time.It is very important to understand and control the affecting factors of corneal repair after de-epithelization of CXL.Objective This study was to evaluate the characteristics of corneal epithelial repair and analyze the relevant factors affecting corneal healing time after de-epithelized CXL.Methods A series-cases observational study was performed.De-epithelized CXL was performed on 77 eyes of 68 keratoconus patients in Shandong Eye Hospital from September 2013 to September 2015 under the approval of Ethic Committee of this hospital and informed consent of each patient.The age,corneal curvature,corneal thickness,breakup time of tear film (BUT),corneal front astigmatism (Astig) and epithelial healing time of the patients were recorded after surgery.The correlations between corneal epithelium healing time and above-mentioned factors were analyzed.Results De-epithelized CXL was smoothly finished in all the eyes.The corneal epithelium healing time was 2-12 days after surgery,with the average healing time 5 (4,6) days.The mean age,thickness at corneal thinnest point,minimal cornea curvature (Kf),maximal corneal curvature (Ks),corneal average curvature (Km) and Astig was 22.00 (18.00,25.00) years,436 (412,470) μm,47.40 (44.70,50.45) D,52.10 (49.00,54.55) D,50.00 (47.15,53.15) D and-3.30 (-5.45,1.70) D,respectively.Spearman rank correlation analysis showed significant negative correlations between corneal epithelium healing time and BUT or the thickness at corneal thinnest point (BUT:rs =-0.334,P =0.003;corneal thickness:rs =-0.417,P =0.000),and thesignificant positive correlations were found between corneal epithelium healing time and Km,Kf and Ks (Km:rs =0.449,P =0.000;Kf:rs =0.300,P =0.008;Ks:rs =0.432,P =0.000).There were no considerable correlarions between corneal epithelium healing time and age or Astig (age:rs =0.023,P =0.845;Astig:rs =-0.190,P =0.098).Multiple linear regression analysis were carried out to study the dependent variable and independent factors.Because of the multiple co-linearity between variables,this paper corrects the model by using ridge regression.There is significant negative correlation between BUT,corneal thickness and corneal healing time,respectively (both at P<0.05),corneal curvature Km and Kf is positively correlated with corneal healing time (both at P < 0.05).Conclusions The corneal thickness,Kf,Km,as well as BUT are influencing factors of epithelial healing after CXL.
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Objective To study the neurobehavioral manifestations of pilocarpine-induced temporal lobe epilepsy (TLE) rats in different kinds of learning and memory ability tests at chronic stage.Methods Thirty SD rats were randomized into TLE group (n=20) and control group (n=10).Intraperitoneal injection of lithium-pilocarpine (LIP) was performed in rats of the TLE group,and saline was given to the control group.Six weeks after modeling,rats were investigated in spatial,object,time and space combined episodic memory tests,and received 7.0 T MR imaging for structural images.Results Immediately after LIP treatment,13 rats in the TLE group exhibited status epilepticus.Six weeks later,11 of the 13 rats in the TLE group were observed spontaneous seizures.T2 images from MR imaging implied gray matter damage in the hippocampus in the TLE group and intact structure in the control group.The ranges of motion in the spatial memory,object memory and episodic memory in the control group were (90.56±19.9) m/min,(92.58±14.83) m/min and (94.20±30.99) m/min,respectively;those in the TLE group were (95.09±21.51) m/min,(117.10±44.38) m/min and (104.90±35.22) m/min;no significant differences were noted between the two groups (P>0.05).In the control group,more exploration time on novel location in the spatial test,novel object in the object test,familiar location-familiar object and novel location-novel object in the episodic test were showed than that on the other objects,with significant difference (P<0.05).In all the tests,there were no significant differences in the exploration times between/among the objects in the TLE group (P>0.05).Conclusion All spatial,object and episodic memory are impaired in chronic LIP-TLE rats.
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Objective To analyze the related risk factors for delayed gastric emptying ( DGE) after pancreaticoduodenectomy .Methods Clinical data on 308 patients who underwent pancreaticoduodenectomy at Ningbo Lihuili hospital from January 2009 to December 2014 were retrospectively analyzed , and patients were divided into DGE group and non-DGE group.Univariate analysis and multivariate logistic regression analysis were used to study the risk factors associated with DGE during perioperative period .Results DGE occurred in 55 patients (17.9%).The incidences of grade A, grade B and grade C DGE were 7.1%(22/308), 6.2%(19/308) and 4.5%(14/308), respectively.The univariate analysis showed the method of pancreatic digestive tract reconstruction ( pancreaticogastrostomy or pancreaticojejunostomy ) , postoperative pancreatic fistula, postoperative biliary fistula and postoperative intraabdominal infection were risk factors for DGE after surgery. Multivariate analysis indicated that the method of pancreatic digestive tract reconstruction (OR=1.19, P=0.046), postoperative pancreatic fistula ( OR=1.33, P=0.014), postoperative biliary fistula (OR=1.43, P=0.047) and postoperative intraabdominal infection (OR=1.51, P=0.001) were independently associated with DGE . Postoperative pancreatic fistula (OR=3.692, P=0.021) and intraabdominal infection (OR=3.725,P=0.003)were also the independent risk factors for Grade B and Grade C DGE. Conclusions DGE after pancreaticoduodenectomy was strongly related to the postoperative complications .Postoperative pancreatic fistula , biliary fistula and intraabdominal infection were associated with increased risk of DGE , while pancreaticogastrostomy reduced the incidence of DGE by decreasing the incidence of pancreatic or biliary fistula .
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Objective To investigate the distribution and the change of drug resistance of staphylococcus aureus(SAU)isolated from female genital tract, and provide evidence for rational use of antibiotic. Methods Non-repetitive staphy-lococcus aureus isolates were collected from female genital tract from January 2008 to December 2013. The identifica-tion and susceptibility of the isolates were determined using auto-microbe analyzer. The data were analyzed by WHONET 5.6. Results A total of 247 SAU stains were determined, mainly from the outpatient (69.2%), mean age(26.3±4.2) years old. The rate of Methicillin-resistant Staphylococcus aureus(MRSA) isolates rose from 13.5% in 2008 to 31.9% in 2013, and showed an increasing trend year by year. The results of antibiotic susceptibility test dis-played that the resistance rates of SAU to penicillin and erythromycin were higher than 58.7%,and the resistance rates to others antibiotic were low(<25.9%). No isolate was resistant to linezolid and vancomycin. Resistance rates to oxacillin,levofloxacin, tetracycline had a significant increasing trend from 2008 to 2013(P<0.05). MRSA strains to oxacillin,ampicillin/sulbactam,gentamicin,levofloxacin, moxifloxacin, clindamycin, erythromycin and tetracycline were higher than MSSA (P<0.05). Conclusion The female reproductive tract infection with MRSA had an upward trend, and its resistance became increasingly serious. therefore,we should reinforce the surveillance of this kind of strains for the guide of rational use of antimicrobial agents in clinic.
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<p><b>BACKGROUND</b>The optimal age at which to initiate for auricular reconstruction is controversial. Rib cartilage growth is closely related to age and determines the feasibility and outcomes of auricular reconstruction. We developed a method to guide the timing of auricular reconstruction in children with microtia ranging in age from 5 to 10 years.</p><p><b>METHODS</b>Rib cartilage and the healthy ear were assessed using low-dose multi-slice computed tomography. The lengths of the eighth rib cartilage and the helix of the healthy ear (from the helical crus to the joint of the helix and the earlobe) were measured. Surgery was performed when the two lengths were approximately equal.</p><p><b>RESULTS</b>The preoperative eighth rib measurements significantly correlated with the intraoperative measurements (P < 0.05). From 5 to 10 years of age, eighth rib growth was not linear. In 76 (62.8%) of 121 patients, the eighth rib length was approximately equal to the helix length in the healthy ear; satisfactory outcomes were achieved in these patients. In 18 (14.9%) patients, the eighth rib was slightly shorter than the helix, helix fabrication was accomplished by adjusting the length of the helical crus of stent, and satisfactory outcomes were also achieved. Acceptable outcomes were achieved in 17 (14.0%) patients in whom helix fabrication was accomplished by cartilage splicing. In 9 (7.4%) patients with insufficient rib cartilage length, the operation was delayed. In one (0.8%) patient with insufficient rib cartilage length, which left no cartilage for helix splicing, the result was unsatisfactory.</p><p><b>CONCLUSIONS</b>Eighth rib cartilage growth is variable. Rib cartilage assessment relative to the healthy ear can guide auricular reconstruction and personalize treatment in young patients with microtia.</p>
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Niño , Preescolar , Femenino , Humanos , Masculino , Factores de Edad , Autoinjertos , Cartílago , Diagnóstico por Imagen , Trasplante , Microtia Congénita , Cirugía General , Oído Externo , Diagnóstico por Imagen , Procedimientos de Cirugía Plástica , Costillas , Diagnóstico por Imagen , Tomografía Computarizada por Rayos XRESUMEN
ECM is a supporting structure for stabilizing the location of cells and preserving the structure of tissues. Recently, it has been discovered that ECM and its degradation products may exert profound influences on tissues and cells, such as activities of inflammatory cells and immune cells. Angiogenesis may be stimulated or inhibited by degradation products of ECM. Matrikines, liberated by partial proteolysis of ECM macromolecules, are found to regulate cell functional activities and play a significant role in wound healing or tumor invasion. Post-burn denatured dermal matrix is being studied in burn healing now. The study of post-burn denatured or necrotic dermal matrix should be emphasized in future.