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Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) have recently been identified to be closely related to the occurrence and development of atherosclerosis (AS). A growing body of evidence has suggested Chinese medicine takes unique advantages in preventing and treating AS. In this review, the related research progress of AS and LOX-1 has been summarized. And the anti-AS effects of 10 active components of herbal medicine through LOX-1 regulation have been further reviewed. As a potential biomarker and target for intervention in AS, LOX-1 targeted therapy might provide a promising and novel approach to atherosclerotic prevention and treatment.
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Humains , Athérosclérose , Récepteurs éboueurs de classe E/physiologie , Marqueurs biologiques , Extraits de plantes , Lipoprotéines LDLRésumé
Dolomiaea plants are perennial herbs in the Asteraceae family with a long medicinal history. They are rich in chemical constituents, mainly including sesquiterpenes, phenylpropanoids, triterpenes, and steroids. The extracts and chemical constituents of Dolomiaea plants have various pharmacological effects, such as anti-inflammatory, antibacterial, antitumor, anti-gastric ulcer, hepatoprotective and choleretic effects. However, there are few reports on Dolomiaea plants. This study systematically reviewed the research progress on the chemical constituents and pharmacological effects of Dolomiaea plants to provide references for the further development and research of Dolomiaea plants.
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Extraits de plantes/pharmacologie , Asteraceae , Triterpènes , Sesquiterpènes/pharmacologie , Anti-inflammatoires , Composés phytochimiques/pharmacologieRésumé
@#As one of the most attention-attracting immunotherapy, immune checkpoint inhibitors (ICIs) have been approved as the first-line drugs for the therapy of various types of cancers.Nevertheless, the single application of ICIs exhibited limited efficacy, and it is easy to develop drug resistance.Therefore, the development of combination therapies become a hot topic in this field to improve the efficacy of ICIs therapy.This article describes some new ICIs targets, reveals the mechanisms of resistance, and introduces the current status of combination other therapies with ICIs therapy systematically including chemotherapy, radiotherapy, hyperthermia, antiangiogenic therapy, tumor vaccines, cytokine therapy and adoptive cellular therapy.Furthermore, the synergistic mechanism of combination therapy to enhance antitumor effect.Thus, this article provides solid references for personalized combination therapy according to the pathological characteristics of patients.
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Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.
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Objective:To investigate the expressions of matrix metalloproteinase 7(MMP7)and secretory leukocyte protease inhibitor(SLPI)in papillary thyroid carcinoma(PTC)and their signifi-cances.Methods:Based on the gene expression data of thyroid cancer in the tumor Genome Atlas(TCGA)database,a total of 567 samples were collected,including 509 cancer tissues and 58 normal tissues.The gene matrix data were extracted and sorted out.Two groups of differentially expressed genes were screened by using the R language edger package,and the potential key genes were screened by the mcode plug-in in Cytoscape.Select a key gene and mine closely related genes through the UALCAN database.Immunohistochemical SABC method was used to detect the ex-pressions of MMP7 and SLPI proteins in PTC tissues and their paracancerous tissues collected from 69 patients in Binzhou People's Hospital Affiliated to Shandong First Medical University from January 2020 to June 2021,and the association of expression levels of MMP7 and SLPI with the clinico-pathological factors of PTC patients was also analyzed.Results:Based on the data of TCGA database,1471 genes were obtained,of which 1000 were up-regulated and 471 were down-regu-lated.Through the mcode plug-in in Cytoscape,20 key genes were screened(MMP7,CCL18,CYR61,SPECC1,CRABP2,PLXNA3,KRT17,TMEM59L,RETN,SRF,ITGB4,PPL,PLEKHN1,RMI2,LCN6,SPX,NRIP1,ARHGEF28,SLC39A14,SNCA).Through the UALCAN database,the correlation between MMP7 and SLPI was retrieved(Pearson correlation coefficient was 0.5,P<0.05).The results of immunohistochemistry showed that the positive expression rates of MMP7 and SLPI proteins in PTC tissues were significantly higher than those in paracancerous tissues[82.6%(57/69)vs 29.0%(20/69),71.0%(49/69)vs 15.9%(11/69)],and the differences were statistically significant(x2 val-ues were 40.222 and 42.579,both P<0.01).The expressions of MMP7 and SLPI in PTC tissues were correlated with TNM stage,differentiation,extramembranous invasion and lymph node metastasis(all P<0.05).There was a positive correlation between MMP7 and SLPI proteins expressions in PTC(r=0.381,P=0.001).Conclusions:The interaction between MMP7 and SLPI proteins can be in-volved in the development and progression of PTC.
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Objective: To investigate the effects of Zhongfeng capsule on the autophagy-related proteins expression in rats with cerebral ischemia/reperfusion injury (CI/ RI), and to explore its neural protection mechanisms of the decoction. Methods: Rat middle cerebral artery ischemia/reperfusion injury model (ischemia for 2 h, reperfusion for 24 h) was prepared by the improved line plug method. Sixty male SD rats were randomly divided into sham operation group, model group, butylphthalide group(0.054 g/kg), Zhongfeng capsule high-dose groups (1.08 g/kg), Zhongfeng capsule middle-dose groups (0.54 g/kg), Zhongfeng capsule low-dose groups (0.27 g/kg), with 10 rats in each group. Rats were treated with Zhongfeng capsule by gavage once a day for 10 days. The rats were sacrificed and the brain tissue was obtained after the experiment in each group. Score neurological deficit was evaluated after 24 h of the last intervention in rat of each group. The pathological changes of brain tissue were observed by HE staining. The serum levels of estradiol (E2) and follicle stimulating hormone (FSH) were determined by ELISA. The expressions of key genes and proteins of PI3K/Akt/Beclin1 signaling pathway in brain tissue were detected by qRT-PCR and Western blot respectively. Results: Compared with the sham operation group, the body weight and protein expressions of p-PI3k and p-Akt in brain tissue of rats were decreased significantly in the model group, while the brain index, neurological deficit score, gene and protein expressions of Beclin1 and LC3 were increased markedly in the model group(P<0.05 or P<0.01). In the model group, nerve cells of brain tissue were loosely packed, interstitial edema, triangular in shape, nuclear pyknosis and dark-blue staining were observed. Compared with the model group, the body weight of rats was increased obviously, the neurological deficit score was decreased significantly and the pathological injury of brain tissue was alleviated evidently in high-dose of Zhongfeng capsule group (P<0.05). The brain index, the gene and protein expressions of Beclin1 and LC3 were decreased apparently in Zhongfeng capsule treatment groups(P<0.05 or P<0.01), while the expressions of p-PI3k and p-Akt in brain tissue were increased evidently in Zhongfeng capsule treatment groups(P<0.05 or P<0.01). Conclusion: Zhongfeng capsule can inhibit autophagy and improve brain neurons lesion of CIRI rats, the mechanism may be related to regulate the expression of Beclin1 and LC3 in PI3K/Akt/Beclin1 signaling pathway.
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Animaux , Mâle , Rats , Protéines associées à l'autophagie/pharmacologie , Bécline-1/métabolisme , Poids , Encéphale , Encéphalopathie ischémique/métabolisme , Phosphatidylinositol 3-kinases/métabolisme , Protéines proto-oncogènes c-akt/métabolisme , Rat Sprague-Dawley , Lésion d'ischémie-reperfusion/traitement médicamenteuxRésumé
Chinese medicine processing is a procedure to process medicinal materials under the guidance of traditional Chinese medicine(TCM) theories by using unique methods in China. The medicinal materials can only be used clinically after proper processing. With the development of the modernization of TCM, it is difficult to solve the problems in the inheritance, development, and internationalization of Chinese medicine processing. Metabonomics, a new omics technology developed at the end of the last century, is used to infer the physiological or pathological conditions of the organism with the methods such as NMR and LC-MS via investigating the changes in endogenous small molecule metabolic network after the organism is stimulated by external environment. Metabonomics coincides with the holistic view of TCM because it displays the characteristics of integrity, comprehensiveness, and dynamics, and it has been widely applied in the field of Chinese medicine processing in recent years. This study summarized the application of metabonomics in the processing mechanism and quality control of Chinese medicine processing and prospected the development of this technology in the field of Chinese medicine processing.
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Chromatographie en phase liquide , Médicaments issus de plantes chinoises , Spectrométrie de masse , Médecine traditionnelle chinoise , Métabolomique/méthodes , Contrôle de qualitéRésumé
Syndrome is a nonlinear "internal-excess external-deficiency", "dynamic spatial-temporal" and "multi-dimensional" complex system and thus only by using a versatile method can the connotation be expounded. Metabonomics, which is dynamic, holistic, and systematic, is consistent with the overall mode of traditional Chinese medicine(TCM)(holistic view and syndrome differentiation and treatment). Therefore, metabonomics is very important for the research on the differentiation, material basis, and metabolic pathways of syndromes, and efficacy on syndromes. This study reviewed the application of metabonomics in the study of TCM syndromes in recent years, which is expected to objectify the research on TCM syndromes.
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Humains , Médicaments issus de plantes chinoises , Médecine traditionnelle chinoise , Métabolomique , SyndromeRésumé
Objective:To compare and analyze the clinical features of patients with severe coronavirus disease 2019 (sCOVID-19) and severe community acquired pneumonia (sCAP) who meet the diagnostic criteria for severe pneumonia of the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS).Methods:A retrospective comparative analysis of the clinical records of 116 patients with sCOVID-19 admitted to the department of critical care medicine of Wuhan Third Hospital from January 1, 2020 to March 31, 2020 and 135 patients with sCAP admitted to the department of critical care medicine of Shanghai First People's Hospital from January 1, 2010 to December 31, 2017 was conducted. The basic information, diagnosis and comorbidities, laboratory data, etiology and imaging results, treatment, prognosis and outcome of the patients were collected. The differences in clinical data between sCOVID-19 and sCAP patients were compared, and the risk factors of death were analyzed.Results:The 28-day mortality of sCOVID-19 and sCAP patients were 50.9% (59/116) and 37.0% (50/135), respectively. The proportion of arterial partial pressure of oxygen/fraction of inspired oxygen (PaO 2/FiO 2)≤250 mmHg (1 mmHg ≈ 0.133 kPa) in sCOVID-19 patients was significantly higher than that of sCAP [62.1% (72/116) vs. 34.8% (47/135), P < 0.01]. The possible reason was that the proportion of multiple lung lobe infiltration in sCOVID-19 was significantly higher than that caused by sCAP [94.0% (109/116) vs. 40.0% (54/135), P < 0.01], but the proportion of sCOVID-19 patients requiring mechanical ventilation was significantly lower than that of sCAP [45.7% (53/116) vs. 60.0% (81/135), P < 0.05]. Further analysis of clinical indicators related to patient death found that for sCOVID-19 patients PaO 2/FiO 2, white blood cell count (WBC), neutrophils (NEU), neutrophil percentage (NEU%), neutrophil/lymphocyte ratio (NLR), total bilirubin (TBil), blood urea nitrogen (BUN), albumin (ALB), Ca 2+, prothrombin time (PT), D-dimer, C-reactive protein (CRP) and other indicators were significantly different between the death group and the survival group, in addition, the proportion of receiving mechanical ventilation, gamma globulin, steroid hormones and fluid resuscitation in death group were higher than survival group. Logistic regression analysis showed that the need for mechanical ventilation, NLR > 10, TBil > 10 μmol/L, lactate dehydrogenase (LDH) > 250 U/L were risk factors for death at 28 days. For sCAP patients, there were significant differences in age, BUN, ALB, blood glucose (GLU), Ca 2+ and D-dimer between the death group and the survival group, but there was no significant difference in treatment. Logistic regression analysis showed that BUN > 7.14 mmol/L and ALB < 30 g/L were risk factors for 28-day death of sCAP patients. Conclusions:The sCOVID-19 patients in this cohort have worse oxygen condition and symptoms than sCAP patients, which may be due to the high proportion of lesions involving the lungs. The indicators of the difference between the death group and the survival group were similar in sCOVID-19 and sCAP patients. It is suggested that the two diseases have similar effects on renal function, nutritional status and coagulation function. But there were still differences in risk factors affecting survival. It may be that sCOVID-19 has a greater impact on lung oxygenation function, inflammatory cascade response, and liver function, while sCAP has a greater impact on renal function and nutritional status.
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Objective:This study aims to evaluate the clinical effect of Changyanqing mixture combined with mesalazine enteric-coated tablets in the maintenance treatment of ulcerative colitis(UC) in remission period. Method:The 140 patients with UC in remission period were randomly divided into control group (70 cases) and observation group (70 cases). The 61 patients in control group completed the therapy (6 cases lost or lost to follow-up and 3 were eliminated), 63 patients in observation group completed the therapy (5 cases lost or lost to follow-up and 2 were eliminated). Both groups′ patients got treatment of lifestyle adjustment, and they also took mesalazine enteric-coated tablets orally, 0.5 g/time, 3 times/day. Patients in observation group took Changyanqing mixture orally for a month in the morning and evening every day, 150 mL/time, and then changed to 150 mL/time, 1 time/day, for 3 consecutive months, finally changed to once every other day for 8 months. Patients in control group took simulated medicine of Changyanqing mixture orally in the same way as observation group. The treatment was continued for 12 months. When UC recurred during the treatment, patients took mesalazine enteric-coated tablets orally at 1 g/time, 3 times/day until remission, when the above intervention plan was continued to be adopted. The recurrence rate, first recurrence time within 12 months (duration from remission to Mayo≥3) and the degree of disease activity at recurrence were recorded. Scores of traditional Chinese medicine(TCM)syndrome and inflammatory bowel disease questionnaire (IBDQ) were evaluated once every 2 months. Before treatment, and at the 6<sup>th</sup> and 12<sup>th</sup> month after treatment, colonoscopy and mucosal histology were performed once, enteroscopic mucosal scores, Geboes index of mucosal histology were evaluated, and fecal calprotectin(FC) levels were detected. Also, safety evaluation was conducted. Result:During 12 months, the recurrence rate in observation group was 20.63% (13/63), lower than 39.34% (24/61) in control group(<italic>P</italic><0.05), the frequency of recurrence and the first recurrence duration in observation group were all less than those in control group(<italic>P</italic><0.01). All these meant the disease activity of patients in observation group was lighter than that in control group (<inline-formula><alternatives><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:msup><mml:mrow><mml:mi>χ</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msup></mml:math><graphic specific-use="big" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/444CE72A-DE9D-4013-BB0B-F487F60C8DC8-M003.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic><graphic specific-use="small" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/444CE72A-DE9D-4013-BB0B-F487F60C8DC8-M003c.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic></alternatives></inline-formula>=5.947, <italic>P</italic><0.05). After repeated measurements of variance analysis, scores of TCM syndrome, enteroscopic mucosal scores, Geboes index and FC levels in two groups gradually increased(<italic>P</italic><0.05), and scores of IBDQ gradually decreased (<italic>P</italic><0.05) during the 12-month period. At the second, fourth, sixth, eighth, tenth and twelfth month, scores of TCM syndromes in observation group were lower than those in control group (<italic>P</italic><0.01), and scores of IBDQ were higher than those in control group (<italic>P</italic><0.01). At the sixth and twelfth month after treatment, intestinal endoscopic mucosal scores, Geboes index and FC levels in observation group were all lower than those in control group (<italic>P</italic><0.01). And there were no adverse reactions related to Changyanqing mixture. Conclusion:Changyanqing mixture combined with mesalazine enteric-coated tablets in the maintenance treatment of patients with UC in remission can control the FC level, further reduce the recurrence rate, delay the recrudescence-time, reduce the frequency of UC and the disease activity, maintain the good remission state of UC, stabilize the quality of life of patients, and ensure the safety of clinical use.
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Objective:To observe the clinical efficacy as well as anti-inflammatory and anti-fibrosis mechanism of Yishen Tongluo decoction in the treatment of chronic glomerulonephritis (CGN) with spleen and kidney Qi deficiency and blood stasis syndrome. Method:According to the random number table method, one hundred and twenty patients were divided into control group (60 cases) and observation group (60 cases). The two groups were given oral valsartan capsules, 160 mg/time, 1 time/day, and dipyridamole tablets orally, 50 mg/time, 3 times/day. Patients in control group additionally took Wubi Shanyao pills orally, 9 g/time, 2 times/day, while patients in observation group additionally took Yishen Tongluo decoction orally, 1 dose/day. Both groups were treated continuously for four months. Before and after treatment, 24 h urine total protein (24 h UTP), creatinine (SCr), urea nitrogen (BUN), serum cystatin C (CysC), tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), interleukin-6 (IL-6), IL-17, interferon-<italic>γ</italic> (IFN-<italic>γ</italic>), transforming growth factor-<italic>β</italic><sub>1</sub> (TGF-<italic>β</italic><sub>1</sub>), connective tissue growth factor (CTGF), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinases (TMP-1) and hypoxia inducible factor-1<italic>α </italic>(HIF-1<italic>α</italic>) levels were detected in both groups. The scores of spleen and kidney Qi deficiency and blood stasis syndrome were graded. Urine protein, and urine red blood cells (urinary RBC) were monitored. Result:The 24 h UTP, SCr, BUN and CysC levels of the observation group were lower than those of the control group (<italic>P</italic><0.01). The score of spleen and kidney Qi deficiency and blood stasis syndrome in the observation group was lower than that in the control group (<italic>P</italic><0.01). The levels of TNF-<italic>α</italic>, IL-6, IL-17 and IFN-<italic>γ </italic>in the observation group were lower than those in the control group (<italic>P</italic><0.01). The levels of TGF-<italic>β</italic><sub>1</sub>, CTGF, TMP-1 and HIF-1<italic>α</italic> in the observation group were lower than those in the control group (<italic>P</italic><0.01). While MMP-9 level was higher than that in control group (<italic>P</italic><0.01). The clinical effective rate was 88.33% (53/60) in the observation group, higher than 73.33% (44/60) in the control group (<inline-formula><alternatives><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:msup><mml:mrow><mml:mi>χ</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msup></mml:math><graphic specific-use="big" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/155A9E27-C0C9-44b4-96FF-AF947372054E-M002.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic><graphic specific-use="small" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/155A9E27-C0C9-44b4-96FF-AF947372054E-M002c.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic></alternatives></inline-formula>=4.356, <italic>P</italic><0.05). Conclusion:On the basis of conventional Western medicine treatment, Yishen Tongluo decoction in the treatment of CGN patients with spleen and kidney Qi deficiency and blood stasis syndrome can reduce proteinuria, and improve traditional Chinese medicine (TCM) syndromes, with anti-inflammatory and anti-kidney fibrosis effects. Thereby, it plays a role in protecting renal function and delaying the malignant progression of renal function, with high clinical efficacy and value of clinical use.
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Objective:To explore the risk factors of intensive care unit-acquired weakness (ICU-AW), and to establishment and verify its risk prediction model.Methods:A modeling group of 231 patients who met the inclusion criteria and were admitted to the intensive care unit (ICU) of the First Hospital of Jiaxing from July 2019 to June 2020 was collected by convenience sampling method. According to whether they developed ICU-AW, they were divided into ICU-AW group (55 cases) and non ICU-AW group (176 cases). The clinical data were collected concerning patients' individual information, disease-related factors, treatment-related factors and laboratory indicators, and the differences of the above indexes between two groups were compared. Logistic regression was used to analyze the ICU-AW risk factors and a risk prediction model was constructed. Calculate the area under ROC curve (AUC) to test the prediction effect of the model. At the same time, 60 patients who admitted to ICU from July to October 2020 and met the standards were collected to verify the model.Results:Compared with non ICU-AW group, there were more males in ICU-AW group [61.8% (34/55) vs. 44.3% (78/176), P < 0.05], with higher levels of systemic inflammatory response syndrome (SIRS), sepsis, immobilization and the use of neuromuscular blockers [SIRS: 30.9% (17/55) vs. 3.4% (6/176), sepsis: 12.7% (7/55) vs. 2.3% (4/176), immobilization: 72.7% (40/55) vs. 39.2% (69/176), the use of neuromuscular blockers: 50.9% (28/55) vs. 14.2% (25/176), all P < 0.05], and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, blood lactic acid level and duration of mechanical ventilation, length of hospital stay were all increased [APACHEⅡ score: 18 (15, 24) vs. 12 (8, 17), blood lactic acid (mmol/L): 2 (1, 2) vs. 1 (1, 2), duration of mechanical ventilation (days): 7 (4, 12) vs. 2 (2, 5), length of hospital stay (days): 10 (6, 16) vs. 5 (3, 9), all P < 0.05]. SIRS, APACHEⅡ score, duration of mechanical ventilation and blood lactic acid were included to construct a risk prediction model [odds ratio ( OR) values were 4.835, 1.083, 1.210, 1.790, P values were 0.018, 0.013, 0.015, 0.013]. The model equation was P = exp [-5.207+(1.576×SIRS)+(0.079×APACHEⅡ)+(0.191×duration of mechanical ventilation)+(0.582×blood lactic acid)]. Internal verification: Calibration diagram showed the calibration curve above the ideal curve, AUC = 0.888, 95% confidence interval (95% CI) was 0.839-0.938; when the cut-off value was 0.166, the sensitivity was 89.1%, the specificity was 75.6%, and the maximum index was 0.649. External verification: Calibration diagram showed that the calibration curve was above the ideal curve, and the plotted AUC = 0.853, 95% CI was 0.753-0.953. When the cut-off value of the corresponding predictive risk value was 0.367, the sensitivity was 68.8%, the specificity was 86.4%, and the maximum approximate index was 0.552. Conclusion:The risk prediction model of ICU-AW constructed in this study has good consistency and prediction efficiency, which can provide reference for medical personnel to identify high-risk groups of ICU-AW patients in the early stage and provide targeted interventions in advance.
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Objective:To explore the effect of mirror visual feedback combined with exercise relearning in rehabilitation of upper extremity dysfunction after stroke.Methods:Patients with upper extremity dysfunction received stroke rehabilitation treatment in the Nanyang No. 9 People's Hospital from August 2016 to August 2018 were enrolled prospectively. According to the random number table method, they were divided into either mirror visual feedback combined with exercise relearning group (mirror therapy group) or exercise relearning alone group (control group). The rehabilitation treatment was 1-2 times a day, 5 d a week, and 1 week was a course of treatment, for a total of 4 courses. Fugl-Meyer Assessment (FMA) was used to assess upper extremity function. Carroll Upper Extremity Function Test (UEFT) was used to assess hand function. Action Research Arm Test (ARAT) was used to assess upper extremity operability and flexibility. Motor Assessment Scale (MAS) was used to assess the motor function of hands, fingers and upper extremities. Visual Analogue Scale (VAS) was used to assess upper extremities pain. The modified Barthel Index (MBI) was used to assess self-care ability in daily life. The modified Ashworth Spasm Scale was used to assess the degree of spasm of shoulder joints, wrist joints, and elbow joints. According to the FMA score, the clinical efficacy of both groups of patients was evaluated, and a score of >31 was defined as excellent.Results:A total of 60 stroke patients with upper extremity dysfunction were enrolled ( n=30 in the mirror therapy group and n=30 in the control group). There were no statistical differences between the two groups in age, gender, course of disease, stroke type, and stroke location, as well as each baseline score. After treatment, the FMA score, UEFT score, ARAT score, MAS score, MBI score and the proportion of the modified Ashworth grade Ⅰ and grade Ⅰ + were significantly higher than those before treatment in both groups (all P<0.05), while VAS score and the proportion of modified Ashworth grade Ⅲ and grade Ⅳ was significantly lower than those before treatment (all P<0.05). After treatment, FMA score, UEFT score, ARAT score, MAS score, MBI score, as well as the proportion of Ashworth grade Ⅰ and grade Ⅰ + in the mirror therapy group was significantly higher than that in the control group (all P<0.05), while VAS score and the proportion of modified Ashworth grade Ⅲ were significantly lower than those in the control group ( P<0.05). According to the FMA score, the excellent and good rate of treatment in the mirror therapy group was significantly higher than that in the control group (93.3% vs. 70.0%; χ2=5.455, P=0.020). Conclusions:The curative effect of mirror visual feedback combined with exercise relearning is superior to exercise relearning alone in rehabilitation therapy for upper extremity dysfunction after stroke.
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Objective::To observe the clinical efficacy of Changyanqing mixture on chronic recurrent ulcerative colitis (UC) with damp-heat syndrome of large intestine and the effect on the recurrence of disease, in order to discuss the mechanism of action in terms of the neuro-endocrine-immune inflammation network. Method::One hundred and twelve patients were randomly divided into control group (55 cases) and observation group (57 cases) by random number table. Patients in control group got mesalazine slow release tablets, 0.1 g/time, 4 times/days, and those the score of Mayo≥7 were added with prednisone acetate tablets, 0.75 mg·kg-1·d-1, and bifidobacterium viable powder with warm water after dinner, 1 pack/day, 2 times/days. In addition to the therapy of control group, patients in observation group were also given Changyanqing mixture in the morning and evening, 1 pack/day. A course of treatment was 6 weeks, and patients got further consultation once a week. During the remission stage, patients in both groups got mesalazine slow release tablets, 0.5 g/time, 3 times/days, and patients in observation group were added with Changyanqing mixture until the score of damp-heat syndrome of large intestine reduced by more than 90%. The number of patients entering the remission stage of 6 weeks and the time of remission stage were recorded. Before and after treatment, colonoscopy was detected, and Geboes index, Baron, damp-heat syndrome of large intestine and Mayo were scored. And levels of peripheral blood interleukin-6 (IL-6), IL-8, IL-10, IL-17, vasoactive intestinal peptide (VIP), motilin (MTL) and neuropeptide (NPY) were detected, and relapse at the 24-week follow-up was recorded. Result::After the 6-week treatment, the clinical efficacy in observation group was 100%, which was higher than 89.09%in control group (P<0.05). And the healing rate of mucosa was 96.4%, which was higher than 81.82%in control group (P<0.05). And the response rate in two groups was 100%. At the 6th month after the treatment, the clinical remission rate in observation group was 91.23%, which was higher than 76.36%in control group (χ2=4.581, P<0.05). And the average remission time was shorter than that in control group (P<0.01). After treatment, scores of colonic mucosa, Geboes index, colonic mucosa and Mayo were all lower than those in control group (P<0.01). And levels of IL-6, IL-8, IL-17, VIP and MTL were lower than those in control group (P<0.01), while levels of IL-10 and NPY were higher than those in control group (P<0.01). The relapse rate in observation group was 17.54%, which was lower than 38.18%in control group (χ2=5.955, P<0.05). And the mean recurrence time was longer than that in control group (P<0.01). Conclusion::In addition to the routine western medicine therapy, Changyanqing mixture can alleviate the condition of patients by shortening the course of the disease, reducing the recurrence rate, delaying the recurrence time, and regulating the nerve-endocrine-immune inflammation network.
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Graves' disease(GD) is the most common cause of endogenous thyrotoxicosis, and current therapeutic options for GD include antithyroid drugs(ATD), radioactive iodine and thyroidectomy. Refractory hyperthyroidism is a rare condition in which hy¬perthyroidism fails to respond to the conventional therapy of anti-thyroidal med¬ications. Enlarged goiter size, high titers of thyrotropin receptor antibodies(TRAb) at diagnosis and/or at the end of the treatment, TSH suppression after drug withdrawal and compliance to the treatment have all been proposed as risk factors that predict the relapse of GD. we propose that a patient-centered professionalism should be consistently followed, and that refractory hyperthyroidism because of unsuitable therapeutic strategies should be strictly avoided in the clinical practice. For the patients with refractory hyperthyroidism, radical treatment is recommended, however,continued long-term low-dose ATD can be considered.
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The present study was aimed to investigate the effects and mechanisms of electro-acupuncture (EA) on proliferation and differentiation of neural stem cells in the hippocampus of C57 mice exposed to different doses of X-ray radiation. Thirty-day-old C57BL/6J mice were randomly divided into control, irradiation, and EA groups. The control group was not treated with irradiation. The irradiation groups were exposed to different doses of X-ray (4, 8 or 16 Gy) for 10 min. The EA groups were electro-acupunctured at Baihui, Fengfu and bilateral Shenyu for 3 courses of treatment after X-ray radiation. Immunohistochemistry was used to evaluate proliferation and differentiation of the hippocampal neural stem cell. RT-PCR and Western blot were used to detect mRNA and protein expressions of Notch1 and Mash1 in the hippocampus, respectively. The results showed that, compared with the control group, the numbers of BrdU positive cells (4, 8 Gy subgroup) and BrdU/NeuN double-labeling positive cells (3 dose subgroups) were decreased significantly in the irradiation group, but the above changes could be reversed by EA. Compared with the control group, the number of BrdU/GFAP double-labeling positive cells in each dose subgroup of irradiation group was decreased significantly, while EA could reverse the change of 4 and 8 Gy dose subgroups. In addition, compared with the control group, the expression levels of Notch1 mRNA and protein in hippocampus were up-regulated, and the expression levels of Mash1 mRNA and protein were significantly decreased in each dose subgroup of irradiation group. Compared with irradiation group, the expression levels of Notch1 mRNA and protein in hippocampus of EA group were decreased significantly in each dose subgroup, and the expression levels of Mash1 mRNA and protein were increased significantly in 4 and 8 Gy subgroups. These results suggest that irradiation affects the proliferation and differentiation of neural stem cells in hippocampus of mice, whereas EA may significantly increase the proliferation and differentiation of hippocampal neural stem cells via the regulation of Notch signaling pathway.
Sujets)
Animaux , Facteurs de transcription à motif basique hélice-boucle-hélice , Métabolisme , Différenciation cellulaire , Prolifération cellulaire , Électroacupuncture , Hippocampe , Biologie cellulaire , Effets des rayonnements , Souris de lignée C57BL , Cellules souches neurales , Biologie cellulaire , Effets des rayonnements , Répartition aléatoire , Récepteur Notch1 , Métabolisme , Rayons XRésumé
Objective To analyze the relevant factors of early warning in emergency patients with high risk of acute sores, explore the application value of transcutaneous oxygen pressure(TcPO2) and transcutaneous carbon dioxide pressure(TcPCO2)monitoring in the early warning of emergency patients with pressure ulcers. Methods This was a study of 186 consecutive emergency patients who were under care in the emergency department. The transcutaneous oxygen/carbon dioxide pressure monitor was used in monitoring the oxygen saturation of the skin of sacrococcygeal region and the chest. Meanwhile,the Braden scale was used in assessing risk factors for pressure ulcers and the receiver operating characteristic curve (ROC curve) was applied to evaluate the early prediction of pressure sore with TcPO 2/TcPCO2 monitor. Results Implementing the logistic regression model with six indicators, this research concluded that TcPO2 CV and PO2 were independent risk factors for the development of Braden scale in patients with high risk. The area under the ROC curve showed that TcPO2 CV had a excellent predictive value for the high-risk group and determined its cut-off value to be 20%. Which means patient with both a value of TcPO2CV over 20% and a high risk of Braden scale had a larger possibility of pressure ulcers. Conclusions TcPO2 CV was an independent risk factor for patients under emergency care to develop pressure ulcers. A value of TcPO2CV over 20%indicated a high risk of pressure ulcers.
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HER3 belongs to the human epidermal growth factor receptor (HER) family which also includes HER1/EGFR/erbB1, HER2/erbB2, and HER4/erbB4. As a unique member of the HER family, HER3 lacks or has little intrinsic tyrosine kinase activity. It frequently co-expresses and forms heterodimers with other receptor tyrosine kinases (RTKs) in cancer cells to activate oncogenic signaling, especially the PI-3K/Akt pathway and Src kinase. Elevated expression of HER3 has been observed in a wide variety of human cancers and associates with a worse survival in cancer patients with solid tumors. Studies on the underlying mechanism implicate HER3 expression as a major cause of treatment failure in cancer therapy. Activation of HER3 signaling has also been shown to promote cancer metastasis. These data strongly support the notion that therapeutic inactivation of HER3 and/or its downstream signaling is required to overcome treatment resistance and improve the outcomes of cancer patients.
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Objective To analyze the problems and mechanism obstacles existing in the allocation of health human resources in medical institutions in poverty-stricken counties of Hubei province, and propose targeted policy recommendations. Methods The stratified random sampling method was used in an on-site investigation conducted at 5 county-level hospitals and 9 township hospitals in 3 poverty-stricken counties of Hubei province. Results The allocation of human resources in such counties showed an overall trend of improvement year by year. However, some of the counties still faced such problems as inadequate health workforce, unreasonable structure of health manpower, and great gaps of health manpower structure within the county. In most of the hospitals, the proportion of health technicians with bachelor's degree or above fell below 50% . In county hospitals, the proportion of personnel expenditure was generally less than 15% from 2013 to 2016. Conclusions The allocation of health human resources in poverty-stricken areas is facing such mechanism obstacles as limited financial input, restrictions of staffing quota, and lack of cooperative motivation by medical institutions. It is necessary to clarify the responsibility of the government and guarantee the fiscal support of personnel expenditure. It is also imperative to promote the reform of the personnel practice in the health system, strengthen the construction of the health talents guarantee mechanism at the primary level, optimize the vertical cooperation mechanism of medical institutions and promote the integrated health management of counties-township-villages.
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Objective To investigate the disease types incurring poverty, patient population layout, and cost burden by poor households due to illness. Methods During the time August 17-24,2017, App questionnaires were used onsite for data survey at 2 824 poor hourseholds in Nanyang city of Henan province, in order to learn the impacts of the poverty-causing diseases on the labor capacity of the patients and the cost burdens. Such methods as descriptive analysis, rank sum test and correlation analysis were used for data analysis. Results The survey found that 61.79 percent(1 745 households) of the poor households turned poor by illness, most of them aged 40 to 60 years old. The ten disease categories, namely cerebrovascular diseases, malignant tumor, ischemic heart diseases and mental diseases, constitute top disease causes of poverty. These diseases significantly damage their labor capacity, up to 37.67% of them totally disabled. The self-paid expenses of the patients per year accounted for 57.22% of the total annual expenses. Conclusions Medical insurance policies need to elevate the scope and efforts of medical compensation;public health services need to improve health promotion and health education; government supervision needs to be enhanced to keep minimizing patients′disease burdens.