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With reference to Xin Diao Sun Zhen Ren Qian Jin Fang,the Xindiao's edition of Bei Ji Qian Jin Yao Fang(Invaluable Prescriptions for Emergencies)which was the popular edition before official block printing of the Northern Song Dynasty),we analyzed the collation for proof-reading method in Song's edition of Bei Ji Qian Jin Yao Fang(Invaluable Prescriptions for Emergencies)printed by Bureau of Correcting Medical Books in Northern Song Dynasty.The results showed that there are many omissions and erroneous annotations in the collation records of the Song's edition,indicating that the judgment of the scholarly value of textual difference and the criteria of selecting and omitting the annotations of textual difference in the Song's edition require further studies.Some of the collation records in the Song's edition were consistent with those of the Xindiao's edition,suggesting that the Xindiao's edition was referenced during the collation by the officials of the Song Dynasty.In compiling Bei Ji Qian Jin Yao Fang,the original edition and the collated edition were not defined by the officials of the Song Dynasty,multiple hand copies in Tang Dynasty were collected for reference,and multiple medical records in Tang Dynasty and before Tang Dynasty were referenced.For the proofreading work of the Bureau for Revising Medical Books was in charge by scholars and Confucian ministers,we proposed that the complexity during compiling the book and the uncertainty of the text should be paid more attention.It is necessary to further clarify the basic issues such as the origin,basic structure,references and citation methods of the Song's edition,so as to provide reference for understanding the characteristics of the edition correctly and making effective use of the literature.
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Objective:To observe the effect of Zhibitai capsule combined with pitavastatin on blood lipid levels in pa-tients with coronary heart disease(CHD).Methods:A total of 180 CHD patients who were treated in our hospital from Mar 2018 to Feb 2021 were selected.According to random number table method,they were divided into pita-vastatin group(n=90)and combined treatment group(n=90,received Zhibitai capsule combined with pitavasta-tin),and both groups were treated for eight weeks.Clinical therapeutic effect,levels of blood lipids and inflamma-tory factors before and after treatment,and incidence of adverse reactions were observed and compared between two groups.Results:Total effective rate of combined treatment group was significantly higher than that of pitavas-tatin group(94.44%vs.80.00%,P=0.001).Compared with pitavastatin group after treatment,there were signif-icant reductions in serum levels of total cholesterol(TC)[(4.39±0.71)mmol/L vs.(2.86±0.56)mmol/L],tri-glyceride(TG)[(2.28±0.43)mmol/L vs.(1.46±0.39)mmol/L],low density lipoprotein cholesterol(LDL-C)[(2.93±0.50)mmol/L vs.(1.84±0.52)mmol/L],lipoprotein(a)[(124.57±11.37)mmol/L vs.(85.83± 11.96)mmol/L],interleukin-6(IL-6)[(21.28±3.64)pg/mlvs.(12.39±2.08)pg/ml],high mobility group box-1 protein B1(HMGB1)[(3.84±0.98)μg/L vs.(1.28±0.79)μg/L],tumor necrosis factor-α(TNF-α)[(4.06±0.62)ng/ml vs.(2.39±0.48)ng/ml],and significant rise in level of high density lipoprotein cholesterol(HDL-C)[(1.89±0.26)mmol/L vs.(2.63±0.31)mmol/L]in combined treatment group,P=0.001 all.There was no significant difference in incidence rate of adverse reactions between two groups,P=0.600.Conclu-sion:Zhibitai capsule combined with pitavastatin can effectively regulate blood lipids,reduce the levels of inflamma-tory factors in patients with coronary heart disease,which is safe and effective.
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Chronic cough is caused by low levels of heat, mechanical or chemical exposure, which is characterized by the disorders of channels and receptors in neuroregulation such as the peripheral and central nerves. Potential regulatory targets of peripheral nerves include P2X3 receptors and transient receptor potential channels, while potential regulatory targets of central nerves include voltage-gated sodium channels, neurokinin-1 receptors, α-7acetylcholine receptors and gamma aminobutyric acid receptors. This paper focuses on the principle and clinical research evidence of several ongoing targeted therapy strategies, in order to provide new ideas for the development of drugs for the treatment of chronic cough.
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Objective: To develop a quantitative evaluation software for three-dimensional morphology of pathological scars based on photo modeling technology, and to verify its accuracy and feasibility in clinical application. Methods: The method of prospective observational study was adopted. From April 2019 to January 2022, 59 patients with pathological scars (totally 107 scars) who met the inclusion criteria were admitted to the First Medical Center of Chinese PLA General Hospital, including 27 males and 32 females, aged 33 (26, 44) years. Based on photo modeling technology, a software for measuring three-dimensional morphological parameters of pathological scars was developed with functions of collecting patients' basic information, and scar photography, three-dimensional reconstruction, browsing the models, and generating reports. This software and the clinical routine methods (vernier calipers, color Doppler ultrasonic diagnostic equipment, and elastomeric impression water injection method measurement) were used to measure the longest length, maximum thickness, and volume of scars, respectively. For scars with successful modelling, the number, distribution of scars, number of patients, and the longest length, maximum thickness, and volume of scars measured by both the software and clinical routine methods were collected. For scars with failed modelling, the number, distribution, type of scars, and the number of patients were collected. The correlation and consistency of the software and clinical routine methods in measuring the longest length, maximum thickness, and volume of scars were analyzed by unital linear regression analysis and the Bland-Altman method, respectively, and the intraclass correlation coefficients (ICCs), mean absolute error (MAE), and mean absolute percentage error (MAPE) were calculated. Results: A total of 102 scars from 54 patients were successfully modeled, which located in the chest (43 scars), in the shoulder and back (27 scars), in the limb (12 scars), in the face and neck (9 scars), in the auricle (6 scars), and in the abdomen (5 scars). The longest length, maximum thickness, and volume measured by the software and clinical routine methods were 3.61 (2.13, 5.19) and 3.53 (2.02, 5.11) cm, 0.45 (0.28, 0.70) and 0.43 (0.24, 0.72) cm, 1.17 (0.43, 3.57) and 0.96 (0.36, 3.26) mL. The 5 hypertrophic scars and auricular keloids from 5 patients were unsuccessfully modeled. The longest length, maximum thickness, and volume measured by the software and clinical routine methods showed obvious linear correlation (with r values of 0.985, 0.917, and 0.998, P<0.05). The ICCs of the longest length, maximum thickness, and volume of scars measured by the software and clinical routine methods were 0.993, 0.958, and 0.999 (with 95% confidence intervals of 0.989-0.995, 0.938-0.971, and 0.998-0.999, respectively). The longest length, maximum thickness, and volume of scars measured by the software and clinical routine methods had good consistency. The Bland-Altman method showed that 3.92% (4/102), 7.84% (8/102), and 8.82% (9/102) of the scars with the longest length, maximum thickness, and volume respectively were outside the 95% consistency limit. Within the 95% consistency limit, 2.04% (2/98) scars had the longest length error of more than 0.5 cm, 1.06% (1/94) scars had the maximum thickness error of more than 0.2 cm, and 2.15% (2/93) scars had the volume error of more than 0.5 mL. The MAE and MAPE of the longest length, maximum thickness, and volume of scars measured by the software and clinical routine methods were 0.21 cm, 0.10 cm, 0.24 mL, and 5.75%, 21.21%, 24.80%, respectively. Conclusions: The quantitative evaluation software for three-dimensional morphology of pathological scars based on photo modeling technology can realize the three-dimensional modeling and measurement of morphological parameters of most pathological scars. Its measurement results were in good consistency with those of clinical routine methods, and the errors were acceptable in clinic. This software can be used as an auxiliary method for clinical diagnosis and treatment of pathological scars.
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Femelle , Humains , Mâle , Adulte , Asiatiques , Cicatrice hypertrophique/imagerie diagnostique , Membres , Chéloïde/imagerie diagnostique , Études prospectivesRésumé
@#Objective To investigate the perioperative clinical effects and follow-up results of minimally invasive coronary artery bypass grafting (MICS CABG) versus conventional coronary artery bypass grafting (CABG) in thoracotomy. Methods The patients who received off-pump CABG in Beijing Anzhen Hospital from January 2017 to October 2021 were collected. Among them, the patients receiving MICS CABG performed by the same surgeon were divided into a minimally invasive group, and the patients receiving median thoracotomy were into a conventional group. By propensity score matching, preoperative data were balanced. Perioperative and postoperative follow-up data of the two groups were compared. Results A total of 890 patients were collected. There were 211 males and 28 females, aged 60.54±9.40 years in the minimally invasive group, and 487 males and 164 females, aged 62.31±8.64 years in the conventional group. After propensity score matching, there were 239 patients in each group. Compared with the conventional group, patients in the minimally invasive group had longer operation time, shorter drainage duration, less drainage volume on the first postoperative day, shorter postoperative hospital stay, and lower rate of positive inotropenic drugs use, while there was no statistical difference in the mean number of bypass grafts, ICU stay, ventilator-assisted time, blood transfusion rate or perioperative complications (P>0.05). During the median follow-up of 2.25 years, there was no statistical difference in major adverse cardiovascular and cerebrovascular events, including all-cause death, stroke or revascularization between the two groups (P>0.05). Conclusion Reasonable clinical strategies can ensure perioperative and mid-term surgical outcomes of MICS CABG not inferior to conventional CABG. In addition, MICS CABG has the advantages in terms of postoperative hospital stay, postoperative drainage volume, and rate of positive inotropic drugs use.
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Objective To observe the expression and significance of helper T cells 9(Th9),helper T cells 22(Th22)and their ef-fector factors in peripheral blood of drug-induced liver injury(DILI).Methods Fifty-six patients with DILI were selected as DILI group and 15healthy volunteers as healthy control group.The DILI group was divided into four groups:mild liver injury group(15 cases),moderate liver injury group(15 cases),severe liver injury group(15 cases)and acute liver failure group(11 cases).Meanwhile,serum liver function,peripheral blood Th9 and Th22,serum interleukin-9(IL-9)and interleukin-22(IL-22)were detected before and after treatment.To observe and analyze the changes of Th9,Th22,IL-9 and IL-22 in DILI,as well as their relationship with the de-gree and type of liver injury.Results There were significant differences in total bilirubin(TBIL),alanine aminotransferase(ALT),as-partate aminotranferase(AST)and alkaline phosphatase(ALP)before and after treatment in the mild DILI group(t were 5.777,10.347,4.225,2.948;P<0.05),but no significant differences in international normalized ratio(INR)(t=0.210,P>0.05).There were significant differences in TBIL,ALT,AST,ALP and INR before and after treatment in moderate liver injury group(t were 7.642,5.842,5.747,3.924,5.206;P<0.05).There were significant differences in TBIL,ALT,AST,ALP and INR before and after treat-ment in severe liver injury group(t were 6.410,5.369,4.726,3.893,6.487;P<0.05).There were no significant differences in TBIL,ALP and INR before and after treatment in acute liver failure group(t were 0.669,0.072,0.521;P>0.05),while there were significant differences in ALT and AST(t were 5.466,7.184;P<0.05).The levels of Th9 and Th22 in peripheral blood and serum IL-9 and IL-22 of related cytokines in patients with DILI were higher than those in healthy control group,and the differences between the two groups were statistically significant(t were 2.269,2.481,6.014,4.987;P<0.05).There were statistically significant differ-ences in Th9,Th22,IL-9 and IL-22 before and after treatment in mild and moderate liver injury groups(t were 3.556,-5.906,8.258,-2.219,5.906,-8.500,7.982,-5.403;P<0.05).There were statistically significant differences in Th9 and IL-9 be-fore and after treatment in the severe liver injury group(t were 8.411,7.250;P<0.05),but no significant differences in Th22 and IL-22(t were-1.463,-2.038;P>0.05).There was no significant difference in Th9 and IL-9 before and after treatment in acute liver failure group(t were 1.614,0.504;P>0.05),but there was significant difference in Th22 and IL-22 before and after treatment(t were-3.825,-2.482;P<0.05).There were no significant differences in Th9,Th22,IL-9 and IL-22 among different types of liver injury(F were 0.636,0.330,0.051,0.376;P>0.05).Th9 was positively correlated with ALT(r=0.547,P<0.001).Th22 was negatively correlated with TBIL(r=-0.657,P<0.001)and ALT(r=-0.301,P=0.024).Conclusion Peripheral blood Th9,Th22 and related cytokines IL-9 and IL-22 are involved in the pathogenesis of DILI.Th9may play a pro-inflammatory role,while Th22may play an anti-inflammatory role,which may have nothing to do with the type of liver injury.
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Objective:The perioperative and early follow-up data of the simultaneous hybrid CAS+ OPCABG and sequential CAS+ OPCABG were compared to evaluate the safety and efficacy of the simultaneous CAS+ OPCABG.Methods:A total of 26 patients with coronary heart disease complicated with carotid artery stenosis received CAS plus OPCABG hybrid surgery in our hospital from January 2020 to July 2021, among which 12 patients received simultaneous CAS+ OPCABG and 14 patients received staged sequential CAS+ OPCABG.The perioperative and postoperative follow-up data of 3 months were compared and analyzed.Results:There were no significant differences in the operation time, drainage on the first day after surgery, ventilator assisted time and ICU time between the two groups.The amount of intraoperative blood loss in the simultaneous group was more than that in the staged group, but no secondary thoracotomy occurred in both groups. The number of days in hospital after operation was significantly less in the simultaneous group. There was 1 case of perioperative cerebral infarction and 1 case of myocardial infarction in the staged group, but there was no statistical difference between the two groups. There was no new cerebral infarction in the two groups, carotid artery ultrasound stent was unobstructed, and there was no statistical difference in cardiac function grading and left ventricular ejection fraction 3 months after operation.Conclusion:Simultaneous CAS+ OPCABG surgery is safe and feasible, it is recommended as the first choice especially for patients with severe myocardial ischemiaor severe left main artery disease caused.How to reduce the risk of bleeding and alleviat carotid sinus reflex are major issues that need to be concerned.
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Objective:To compare the perioperative outcomes and short-term graft patency between patients who underwent multivessel off-pump coronary artery bypass graft(OPCABG) via left intercoastal space or sternotomy.Methods:Between January 2017 and August 2019, 100 patients who underwent minimal invasive coronary artery bypass graft(MICS CABG) were compared with 235 patients who underwent OPCABG by single surgeon at our institute. Among them, 257 cases were male and 78 were female, aged 34 to 84 years, with mean age(61.35±8.79)years old. Due to important differences in patients’ characteristics, a propensity score-matched analysis based on 12 covariates was performed to match in a 1∶2 fashion. 82 patients(MICS group) were matched with 127 patients(OPCABG group). Surgical and postoperative outcomes were evaluated.Results:There was no statistical difference of perioperative mortality, myocardial infarction, and stroke rate( P>0.05). In MICS group, use of internal thoracic artery was higher and conversion to cardiopulmonary bypass was lower( P<0.05), but reoperation, new onset atrial fibrillation , and the use of mechanical device were similar( P>0.05). In addition, operation duration was longer but transfusion rate, postoperative chest tube drainage within 24 hours and postoperative hospital stays were less in the MICS group( P<0.05). LIMA, vein and overall graft patency were similar in the two groups shown by postoperative one-year CTA( P>0.05). Conclusion:MICS CABG is safe and feasible for patients with multiple coronary lesions. It has similar in-hospital outcomes and short-term graft patency but less transfusion and faster recovery compared to conventional OPCABG via sternotomy.
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@#Objective To compare the mid- and long-term efficacy of minimally invasive coronary artery bypass grafting (MICS) versus conventional coronary artery bypass grafting (CABG). Methods This study analyzed 679 patients with coronary heart disease treated in the Minimally Invasive Heart Center of Beijing Anzhen Hospital from 2015 to 2019, including 532 males and 147 females with an average age of 61.16 years. A total of 281 patients underwent MICS (a MICS group) and 398 patients underwent conventional CABG (a CABG group). The clinical data of the patients in the two groups were analyzed. Results The average operation time was longer (P<0.001), the total hospital stay was shorter (P<0.001), and the amount of drainage 24 h after the operation was less (P=0.029) in the MICS group. There was no statistical difference in the incidence of perioperative complications between the two groups. The median follow-up time was 2.68 years. The follow-up results showed that the total incidence of cumulative main adverse cardiovascular and cerebrovascular events in the CABG group was higher at 2 years (6.2% vs. 3.8%) and 4 years (9.3% vs. 7.6%), but the difference was not statistically significant (P>0.05). There was no statistical difference in 2- or 4-year all-cause death between the two groups (3.5% vs. 2.8%, 5.6% vs. 2.8%, P>0.05). At the same time, there was no statistical difference in the incidence of myocardial infarction, stroke or revascularization between the two groups (P>0.05). Conclusion Compared with conventional CABG, MICS can achieve satisfactory mid- and long-term outcomes.
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Objective:To explore the application of interactive communication mode combined with problem-based learning in clinical teaching of undergraduate nursing students so as to provide basis for nursing teaching reform.Methods:A total of 62 undergraduate nursing students in Beijing Jishuitan Hospital were selected. Among them, 32 cases from September to November 2018 received traditional teaching (the control group), and 30 cases from September to November 2019 were given interactive communication mode combined with problem-based learning (the observation group). The assessment results, comprehensive ability, clinical communication ability, scientific research ability, and feedback results of teaching quality were compared between the two groups.Results:After intervention, the total score of assessment in the observation group was (90.62 ± 4.75) points, higher than that in the control group (83.84 ± 5.01) points, there was significant difference ( t=5.46, P<0.05). After intervention, the scores of observation ability, operation ability and teamwork ability in the observation group were (3.51 ± 0.59), (3.75 ± 0.50), (4.30 ± 0.77) points, higher than those in the control group (3.18 ± 0.44), (3.22 ± 0.46), (3.53 ± 0.81) points, there were significant differences ( t=2.51,4.35, 3.83, all P<0.05). After intervention, the scores of clinical communication and keen listening, determining patients′ problems, participating together, sending effective information, establishing harmonious doctor-patient relationship, and verifying perception ability in the observation group were (83.61 ± 10.18), (81.66 ± 8.92), (84.01 ± 9.17), (83.25 ± 9.73), (80.90 ± 9.99), (84.15 ± 8.08) points, higher than those in the control group (73.91 ± 9.73), (74.95 ± 8.05), (76.02 ± 8.22), (73.16 ± 8.02), (74.61 ± 8.54), (76.08 ± 8.25) points, there were significant differences ( t values were 2.67-4.47, all P<0.05). After intervention, the scores of literature reading ability, data processing ability and paper writing ability in the observation group were (14.29 ± 1.54), (13.02 ± 1.29), (14.91 ± 1.50) points, higher than those in the control group (13.08 ± 1.43), (11.44 ± 1.24), (12.36 ± 1.28) points, there were significant differences ( t=3.21, 4.92, 7.22, all P<0.05). The feedback scores of students about improving nursing humanistic quality, professional self-identity, learning interest, communication ability, clinical thinking ability and innovation ability in the observation group were (4.26 ± 0.75), (4.43 ± 0.81), (4.25 ± 0.77), (4.18 ± 0.66), (4.44 ± 0.90), (4.38 ± 0.94) points, higher than those in the control group (3.51 ± 0.64), (3.79 ± 0.70), (3.48 ± 0.84), (3.40 ± 0.76), (3.83 ± 0.89), (3.60 ± 0.89) points, there were significant differences ( t values were 2.68-4.30, all P<0.05). Conclusions:The interactive communication mode combined with problem-based learning can effectively improve assessment results of undergraduate nursing students, and promote the improvement of their comprehensive quality, which is conducive to the improvement of clinical communication ability and scientific research ability in nursing students.
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Preoperative detection of biomarkers that can predict postoperative survival of gastric cancer patients has important implications for surgical procedures, postoperative chemoradiotherapy and followup. Using multi-center cancer database and online analysis and verifying by qRT-PCR and Western blotting, we found that Osteomodulin (OMD) was highly expressed in gastric cancer tissues (P =0. 015) and could affect the survival of gastric cancer patients (P < 0. 001) and can be detected preoperatively to evaluate the prognosis of gastric cancer patients. The mRNA expression of OMD was significantly correlated with age (P = 0. 034), Lauren typing (P < 0. 001) and clinical stage (P =0. 001) of gastric cancer patients. It also associated with a variety of immune cells (dendritic cellsresting, eosinophils) and the immune checkpoint regulator ENTPD1 (rho = 0. 634, P < 0. 001) and chemokine CXCL12 (rho = 0. 625, P < 0. 001), which affects the occurrence and development of gastriccancer through the immune microenvironment. Therefore, OMD may become a clinically feasible prognostic biomarker of gastric cancer and a new target for immunotherapy.
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Long non-coding RNA (lncRNA) are non-coding RNA (ncRNA) greater than 200nt inlength, which were initially considered as transcriptional " junk" with no biological function. As researchprogressed, lncRNA were found to be involved in many biological regulatory processes, such aschromosome silencing, chromatin modification, transcriptional activation and interference. Thesebiological regulatory processes are closely related to the structure and spatial and temporal specificexpression of lncRNA. In addition, the corresponding regulatory mechanisms of lncRNA with differentstructures and locations are different. When lncRNA are located in the nucleus, they mostly regulate geneexpression at the transcriptional level and epigenetically, including histone modifications, DNAmethylation, chromosome remodeling and other modification processes. In contrast, lncRNA in thecytoplasm mostly play regulatory roles at the post-transcriptional and translational levels, and themechanisms of action and functions of lncRNA vary among different organelles, all of which illustrate theimportance of the location of lncRNA on their functional performance. In addition, exosomes are also richin lncRNA, and these lncRNA can be delivered to the corresponding sensitive cells through intercellularcommunication to generate the corresponding regulatory mechanisms. In addition, aberrant expression oflncRNA in different structures is often a key factor in the development and progression of related diseasesand cancers. Studying the enrichment of lncRNA in different subcellular structures can help understandthe specific roles played by lncRNA in regulating body homeostasis, disease and cancer occurrence anddevelopment, as well as growth and development of plants and animals, as well as provide a newtheoretical basis for subsequent studies on targeted therapies and improving animal productionperformance. This paper outlines the latest research progress on the different regulatory mechanisms oflncRNA in chromosomes, membraneless substructures, cytoplasm (endoplasmic reticulum, ribosomes, mitochondria, lysosomes), exosomes and other locations, as well as describes the processes of relateddiseases and cancers caused by lncRNA abnormalities within the corresponding structures. Finally, anoutlook on lncRNA research is given with the aim of providing a corresponding theoretical basis for futurestudies.
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@#Objective To study the learning curve of minimal invasive coronary artery bypass grafting (MICS CABG) and the influence on the perioperative clinical effects by analyzing operation time. Methods From March 2012 to November 2020, 212 patients underwent MICS CABG by the same surgeon. Among them, 59 patients (52 males and average age of 62.89±8.27 years) with single vessel bypass grafting were as a single-vessel group and 153 patients (138 males, average age of 59.80±9.22 years) with multi-vessel bypass grafting were as a multi-vessel group. Two sets of operation time-operation sequence scatter plots were made and learning curve was analyzed by cumulative summation (CUSUM) and regression method of operation time. The surgical data of each group before and after the inflection point of the learning curve were compared with the main clinical outcome events within 30 days after surgery. Results There was no death, perioperative myocardial infarction and stroke in 212 MICS CABG patients and no transfer to cardiopulmonary bypass or redo thoracotomy. The learning curve conformed to the cubic fitting formula. In the single- vessel group, CUSUM (x operation number)=–1.93+93.45×x–2.33×x2+0.01×x3, P=0.000, R2=0.986, the tipping point was 27 patients. In the multi-vessel group, CUSUM (x)=y=2.87+1.15×x–1.29× x2+3.463×x3, P=0.000, R2=0.993, and the tipping point was 59 patients. The two sets of case data were compared before and after the learning curve and there was no statistical difference in main clinical outcomes within 30 days (mortality, acute myocardial infarction, stroke, perioperative blood transfusion rate), ventilator tube, and intensive care unit retention. Conclusion The learning curve of MICS CABG conforms to the cubic formula, and the process transitions from single to multiple vessels bypass. To enter the mature stage of the learning phase, a certain number of patients need to be done. Reasonable surgical procedures and quality control measures can ensure the safety during the learning phase.
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BACKGROUND@#Drug-coated balloons (DCBs) have emerged as potential alternatives to drug-eluting stents in specific lesion subsets for de novo coronary lesions. Quantitative flow ratio (QFR) is a method based on the three-dimensional quantitative coronary angiography and contrast flow velocity during coronary angiography (CAG), obviating the need for an invasive fractional flow reserve procedural. This study aimed to assess the serial angiographic changes of de novo lesions post-DCB therapy and further explore the cut-off values of lesion and vessel QFR, which predict vessel restenosis (diameter stenosis [DS] ≥50%) at mid-term follow-up.@*METHODS@#The data of patients who underwent DCB therapy between January 2014 and December 2019 from the multicenter hospital were retrospectively collected for QFR analysis. From their QFR performances, which were analyzed by CAG images at follow-up, we divided them into two groups: group A, showing target vessel DS ≥50%, and group B, showing target vessel DS <50%. The median follow-up time was 287 days in group A and 227 days in group B. We compared the clinical characteristics, parameters during DCB therapy, and QFR performances, which were analyzed by CAG images between the two groups, in need to explore the cut-off value of lesion/vessel QFR which can predict vessel restenosis. Student's t test was used for the comparison of normally distributed continuous data, Mann-Whitney U test for the comparison of non-normally distributed continuous data, and receiver operating characteristic (ROC) curves for the evaluation of QFR performance which can predict vessel restenosis (DS ≥50%) at mid-term follow-up using the area under the curve (AUC).@*RESULTS@#A total of 112 patients with 112 target vessels were enrolled in this study. Group A had 41 patients, while group B had 71. Vessel QFR and lesion QFR were lower in group A than in group B post-DCB therapy, and the cut-off values of lesion QFR and vessel QFR in the ROC analysis to predict target vessel DS ≥50% post-DCB therapy were 0.905 (AUC, 0.741 [95% confidence interval, CI: 0.645, 0.837]; sensitivity, 0.817; specificity, 0.561; P < 0.001) and 0.890 (AUC, 0.796 [95% CI: 0.709, 0.882]; sensitivity, 0.746; specificity, 0.780; P < 0.001).@*CONCLUSIONS@#The cut-off values of lesion QFR and vessel QFR can assist in predicting the angiographic changes post-DCB therapy. When lesion/vessel QFR values are <0.905/0.890 post-DCB therapy, a higher risk of vessel restenosis is potentially predicted at follow-up.
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Humains , Sténose pathologique , Coronarographie , Maladie des artères coronaires/thérapie , Resténose coronaire , Études de suivi , Fraction du flux de réserve coronaire , Préparations pharmaceutiques , Valeur prédictive des tests , Études rétrospectives , Résultat thérapeutiqueRésumé
By systematically sorting out the ancient medical books and modern clinical literature of Yiguanjian, the historical evolution of this formula, including its source, composition, origin, processing, dosage, preparation and usage, functions and indications, evolution of prescription meaning, is textual so as to clarify the historical evolution and clinical application of Yiguanjian. On the basis of fully considering the actual demand of development of famous classical formula preparation and the usage habit of modern clinical practice, the feasible development suggestions were put forward. Yiguanjian is composed of six herbs, which is derived from Yifang Jiedu (《医方絜度》) . It is an ancient book of traditional Chinese medicine edited by QIAN Min-jie in Qing dynasty. The original medicinal plants and medicinal parts of the formula were basically the same as those recorded in the 2020 edition of Chinese Pharmacopoeia. The raw products should be selected for decoction pieces and processed according to the methods recorded in the 2020 edition of Chinese Pharmacopoeia. The reference dose of the medicine in this formula is set out in Yifang Jiedu. According to dosage of one Qian(钱)=3.73 g, the dosages of Glehniae Radix, Ophiopogonis Radix and Angelicae Sinensis Radix were 5.60 g, the dosages of Lycii Fructus and Rehmanniae Radix were 11.19 g, the dosage of Toosendan Fructus was 7.46 g. These decoction pieces were boiled and warm decoction was taken. According to ancient medical records, the formula always has the effect of nourishing Yin and relieving Qi of liver. It is used to treat syndrome of stagnation of liver-Qi and deficiency of liver-Yin and kidney-Yin, which can be seen with pain in chest, stomach and flank, acerbity and vomiting, dry throat and mouth, red tongue, weak pulse or deficiency of string and hernia. Here, the source, processing and others of Yiguanjian were clarified, providing a literature reference for the development and application of this famous classical formula.
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@#Objective To investigate the safety and effectiveness of minimally invasive coronary artery bypass grafting (MICABG) through comparing the perioperative clinical effects of conventional surgery and MICABG. Methods A total of 543 patients in the single medical group of Beijing Anzhen Hospital who underwent beating coronary artery bypass grafting from January 2017 to September 2020 were collected, including 161 patients receiving MICABG (a minimally invasive group, 143 males and 18 females, aged 60.08±9.21 years), 382 patients receiving median thoracotomy (a conventional group, 284 males and 98 females, aged 61.68±8.81 years). The propensity score was used to match 143 patients in each of the two groups, and the perioperative data of the two groups were summarized and analyzed. Results There was no death, perioperative myocardial infarction or stroke in the minimally invasive group. Compared with the conventional group, the minimally invasive group had longer operation time (296.36±89.4 min vs. 217.80±50.63 min, P=0.000), less number of bypass grafts (2.86±1.03 vs. 3.17±0.78, P=0.005), shorter postoperative hospital stay (6.29±1.46 d vs. 6.78±2.61 d, P=0.031), less drainage on postoperative day 1 (339.57±180.63 mL vs. 441.92±262.63 mL, P=0.001) and lower usage rate of inotropic drugs (9.09% vs. 26.57%, P=0.001). There was no statistical difference between the two groups in postoperative ICU stay ventilator assistance time, blood transfusion rate, secondary thoracotomy rate, or use of mechanical equipment. Conclusion Reasonable clinical strategies can ensure the satisfactory overall safety of MICABG. In addition, it has the advantages of shorter postoperative hospital stay, less bleeding and smaller dosage of inotropic drugs.
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OBJECTIVE@#To explore the molecular mechanism by which miR-218 targeting Bmi-1 inhibits the proliferation of acute promyelocytic leukemia (APL) cells.@*METHODS@#APL cell line HL-60 was transfected by miR-218 and RNA-negative control sequences, respectively. The expression of miR-218 in cells was detected by real-time fluorescence quantitative PCR. The effect of transfected miR-218 on the proliferation of APL cells was detected by MTT assay. Cell apoptosis was detected by flow cytometry. The regulation effect of miR-218 on Bmi-1 expression was determined by Western blot. The correlation of miR-218 expressions with Bmi-1 was analyzed by Spearman test. The targeted relationship between miR-218 and Bmi-1 was verified by luciferase assay.@*RESULTS@#MTT assay showed that the proliferation of HL-60 cells in vitro was inhibited by high expression miR-218 significantly. Flow cytometry showed that the G1 and G2 phase cells increased while the S phase cells decreased after transfected by miR-218. Western blot showed that the level of Bmi-1 protein in HL-60 cells decreased significantly after transfection of miR-218 (P<0.05). Spearman correlation analysis showed that the mRNA level of miR-218 negatively correlated with the protein content of Bmi-1 (r=-0.326, P<0.01). Luciferase assay indicated that Bmi-1 could targeted on miR-218 directly.@*CONCLUSION@#miR-218 can inhibit the proliferation, metastasis and invasion of APL cells, which can be related with the down-regulated of Bmi-1.
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Humains , Apoptose , Prolifération cellulaire , Régulation de l'expression des gènes tumoraux , Cellules HL-60 , Leucémie aiguë promyélocytaire , Génétique , microARN , Génétique , Complexe répresseur Polycomb-1 , GénétiqueRésumé
Objective To analyze epidemic characteristics of COVID-19 epidemic in Qingpu District of Shanghai and provide evidence for prevention and control of COVID-19. Methods The COVID-19 cases diagnosed in the medical facilities in Qingpu District were included in the study.Descriptive epidemiology was employed to describe diagnosis, clinical symptoms and possible exposure. Results There were 53 suspected cases identified in Qingpu District, 47 of which were excluded and 6 were confirmed.Two confirmed cases were identified when seeking medical treatment and 4 by other means.Of the confirmed cases, 83.3% were male and 66.7% were imported.Their initial symptom was mainly cough.The 75.0% of the confirmed cases had underlying diseases.By PCR testing of SARS-CoV-2, 100.0% of the sputum specimens tested positive, 50.0% of the nasopharyngeal swabs were positive, whereas 100.0% of the throat swabs were negative. Conclusion COVID-19 is more common in men than in women.The positive rate of SARS-CoV-2 in sputum samples is highest, followed by nasopharyngeal swabs and throat swabs.It is crucial to implement the countermeasures at earlier stages, such as strengthening the road entrance monitoring, at-home or intensive health observation of foreign visitors for early identification of suspected COVID-19 cases.
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Objective To learn the status and influencing factors of health literacy among Shanghai farmers, providing references for further health literacy intervention. Methods Subjects were selected whose occupation was filled in as farmer in health literacy monitoring of Shanghai residents in 2018. Results Among the 4 380 farmers selected, 1 878(42.88%) were males and 2 502(57.12%) were females.The overall level of health literacy among farmers was 13.42%, the proportion of their basic health concepts and knowledge, healthy lifestyle and behavior, and basic health skills being 22.28%, 15.53% and 14.45% respectively.In addition, they had health literacy in six aspects:attitude towards health, safety and first aid, health information, chronic diseases prevention and control, basic medical care and infectious diseases prevention and control; their proportions were 40.53%, 39.84%, 21.67%, 18.33%, 15.80% and 15.73%, respectively.Logistic regression analysis showed that the region and education level were the influencing factors of the health literacy among farmers. Conclusion The health literacy of farmers in Shanghai is lower than that of the city residents, and their literacy of basic health skill, primary medical care and infectious disease prevention needs to be improved.
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Objective Based on the Health Shanghai Action 2019-2030, combined with the monitoring results of Shanghai residents′ health literacy, we analyzed the data, looked for the existing problems and the possible causes in the improvement of health literacy, and put forward corresponding suggestions and strategies. Methods Using the monitoring data and results of Shanghai residents′ health literacy from 2008 to 2018, we made aggregate analysis of residents′ health literacy and comparative analysis of different years, different ages and different regions in this regard. Results The health literacy level of Shanghai residents was 28.38% in 2018.The absolute value of growth is 21.41% and the average annual growth rate was 13.61% compared with 2008.The literacy levels of infectious disease prevention, healthy behavior, and basic medical treatment were relatively low.There had been a big gap between urban and rural residents in literacy levels of health information, health knowledge, and health skill. Conclusion The health literacy level of Shanghai residents has been improved significantly.In future, we should strengthen the health education of infectious disease prevention, healthy behavior, and basic medical treatment, using different health education methods for different age groups or different education level people.Moreover, we need to establish and strengthen the authoritative health information release platform, so the residents especially rural ones, can get the reliable health education information in time.