Reliability of 4D flow cardiac MRI for measuring hemodynamic parameters of left ventricle / 中国医学影像技术

Objective To observe the reliability of regional 4D flow and whole heart 4D flow cardiac MRI(CMRI)for measuring hemodynamic parameters of left ventricle.Methods Heart ultrasonography and CMRI were prospectively obtained in 31 healthy subjects.Hemodynamic parameters of left ventricle were measured using heart ultrasound,3-chamber 4D flow CMRI(based on inflow and outflow channel of left ventricle)and whole heart 4D flow CMRI,respectively.Intra-class correlation coefficient(ICC)was performed to evaluate the consistencies of the measured left ventricle hemodynamic parameters among the above 3 methods.Results Good consistencies of peak systolic velocity in aortic supravalvular/subvalvular,E peak diastolic velocity of mitral valve,supravalvular/subvalvular aortic pressure and aortic valve pressure gradient(all ICC＞0.75),while moderate consistency of A peak diastolic velocity of mitral valve(ICC=0.718)were found between heart ultrasound and 3-chamber 4D flow CMRI.Good consistencies of peak systolic velocity in aortic supravalvular/subvalvular,A peak diastolic velocity of mitral valve and supravalvular/subvalvular aortic pressure(all ICC＞0.75),while moderate consistencies of E peak diastolic velocity of mitral valve and aortic valve pressure gradient(ICC=0.600,0.628)were found between heart ultrasound and whole heart 4D flow CMRI.Meanwhile,good consistencies of the above parameters were found between 3-chamber 4D flow CMRI and whole heart 4D flow CMRI(all ICC＞0.75).Conclusion Measuring left ventricular hemodynamic parameters using local regional 4D flow and whole heart 4D flow CMRI were reliable,with good consistency with cardiac ultrasound.

Clinical study of Tiaogan Lifei Decoction on improving the level of symptom control in asthmatic patients with moderate and high dose glucocorticoid inhalation / 国际中医中药杂志

Objective:To investigate the effects of Tiaogan Lifei Decoction on the level of symptom control in patients with bronchial asthma (asthma) treated with moderate and high dosage inhaled glucocorticoids (ICS).Methods:Randomized double-blind placebo controlled prospective study was used. Totally 90 patients with asthma (liver lung disharmony, wind phlegm blocking collateral syndrome) using moderate and high dosage ICS who met the inclusion criteria from January 2020 to December 2021 in Chaoyang District Hospital of Traditional Chinese Medicine in Beijing were divided into two groups according to random number table method, with 45 cases in each group. On the basis of using the original dosage of ICS, the treatment group used Tiaogan Lifei Decoction, while the control group used Tiaogan Lifei Decoction simulant. The course of treatment was 12 weeks. TCM symptom score of both group before and after the treatment was detected; asthma control test (ACT) was used to assess the effects of asthma on the patients; St George's Hospital Respiratory Questionnaire (SGRQ) was used to assess patients' quality of life; the peak expiratory flow rate (PEF) was measured with a peak expiratory flow meter. 2 ml of venous blood was collected for eosinophil (EOS) detection, and the serum allergen specific IgE level was determined by ELISA. The adverse reactions were observed during the treatment and the clinical efficacy was evaluated.Results:During the test, 3 cases and 2 cases in the treatment group and control group lost prevention respectively. 3 cases in the treatment group and 6 cases in the control group withdrew from the trial because of the aggravation of symptoms and the need to increase the dosage of ICS. The total effective rate in the treatment group was 78.6% (33/42), and that in the control group was 55.8% (24/43), with statistical significance ( χ2=4.98, P=0.026). After treatment, the scores of daily activities, early awakening, control and total scores in the treatment group were higher than those in the control group ( t values were 1.76, 1.99, 2.00, 2.69, respectively, P<0.01 or P<0.05); after treatment, the scores of cough, chest tightness, active wheezing, upset, pharyngeal itch and total score in the treatment group were lower than those in the control group ( t values were -5.89, -6.01, -5.66, -4.27, -6.67, -9.05, respectively, P<0.01); SGRQ score in the treatment group was lower than that of the control group ( t=-7.19, P<0.01). No serious adverse reactions occurred during treatment in the two groups. Conclusion:Tiaogan Lifei Decoction is helpful to improve the symptom control level of asthma patients who are using ICS, and effectively improve the quality of life of patients with asthma of liver lung disharmony and wind phlegm obstructing collaterals syndrome.

Phenotype and genotype analysis of a pedigree affected with Joubert syndrome due to variant of TMEM237 gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the pathogenesis of two siblings (including a fetus) from a pedigree affected with Joubert syndrome.@*METHODS@#Peripheral blood samples of the proband and his parents as well as amniotic fluid and abortion tissues of the fetus were collected. Part of the samples were used for the extraction of DNA, and whole exome sequencing (WES) was carried out to screen potential variants in the proband and his parents. Suspected variants were subjected to bioinformatics analysis with consideration of the clinical phenotype, and were verified by Sanger sequencing of the proband, fetus and their parents.The remainders were used for the extraction of RNA, and the mechanism of splicing variant was validated by reverse transcription-PCR (RT-PCR).@*RESULTS@#WES showed that both patients have carried c.175C>T (p.R59X) and c.553+1G>A compound heterozygous variants of the TMEM237 gene. Among these, c.175C>T was a nonsense mutation inherited from the asymptomatic mother, while c.553+1G>A was an alternative splicing mutation inherited from the asymptomatic father. RT-PCR showed that this variant has resulted in aberrant splicing by exon skipping.@*CONCLUSION@#The compound heterozygous variants of the TMEM237 gene probably underlay the etiology of Joubert syndrome in this pedigree. Above finding has enriched the phenotype and variant spectrum of the TMEM237 gene, and facilitated genetic counseling and prenatal diagnosis for the family.

Application effect of primary trauma treatment teaching mode in cardiopulmonary resuscitation training of special occupation in mountainous area of Southern Ningxia / 中华危重病急救医学

Objective:To explore the application value of primary trauma treatment (PTC) teaching mode in special professional cardiopulmonary resuscitation (CPR) guide training.Methods:Cluster sampling method was adopted, and the residents' committee selected special occupation population from every town/sub-district office in the southern mountainous area of Ningxia Hui Autonomous Region for CPR training. A monthly session was held from January to December 2019, with personnel trained by traditional operation teaching and individual practice method from January to June 2019 as the control group and personnel trained by PTC teaching mode from July to December 2019 as the observation group. The two groups of trainers, training objectives and assessment standards were consistent. Questionnaire survey was conducted at the beginning and end of each training period, including the degree of mastery of first-aid knowledge and skills and the level of self-efficacy, etc., to evaluate the training effect.Results:There were 503 trainees in each group, and there was no significant difference in gender, age, education and occupation distribution between the two groups. There was no significant difference in the first aid principles, CPR skill level and self-efficacy between the two groups before the training. The first aid principle, CPR skills level and self-efficacy of the two groups after training were all improved, and the principle of first aid and CPR skills level in the observation group was obviously higher than that in the control group (first aid related concepts: 4.39±0.76 vs. 3.87±0.89, gold life-saving time: 5.71±0.49 vs. 4.53±0.62, the meaning of the first witnesses: 5.33±0.82 vs. 4.18±0.78, cardiac, respiratory cardiac arrest in the judgment: 5.12±0.73 vs. 4.07±0.73, CPR skills: 5.29±0.64 vs. 4.15±0.71, all P < 0.05). The self-efficacy score of the observation group was significantly higher than that of the control group (emergency attitude: 18.17±1.24 vs. 17.35±1.25, self-efficacy: 13.56±1.54 vs. 11.35±1.26, behavioral intention: 9.56±0.84 vs. 8.92±0.95, all P < 0.05). Conclusion:The application of PTC teaching mode in the training of CPR guidelines for special professions has significant effects, which can effectively help special professions to master CPR knowledge and skills, and has promotion value.

Analysis of Wu Weiping's medication rules on treating the onset of bronchial asthma based on data mining / 国际中医中药杂志

Objective To analyze Professor Wu Weiping's medication rules on treating the onset of bronchial asthma based on data mining.Methods The patients'records and prescriptions of Professor Wu Weiping on treating the onset of bronchial asthma were collected and collated,and the frequency and regularity of drug combinations were researched by using the association rules of TCM inheritance support system to analyze the medication experience of Professor Wu Weiping.Results By analyzing the 249 prescriptions of 61 patients,drug properties of the prescription:cold (45.6％),warm (42.6％),bitter(37.9％),pungent (27.5％).Channel tropism:lung,spleen,liver,stomach.The top 10 herbal medicine are Qingbanxia,Chaihu,Fangfeng,Huangqin,Mahuang,Wuweizi,Wumei,Qianhu,Chishao,Kuxingren.The top 3 treatment principle is reducing phlegm,expelling wind evil and regulating qi.Xiaochaihu decoction and Guomin decoction were showed in the article.Conclusions Data dining could help to discover the rules of Professor Wu Weiping's treatment of the onset of bronchial asthma.The cold and warm drugs,acrid and bitter drugs were used together frequently,while the drugs belonging to the lung,spleen,liver and stomach meridians were used commonly.The evil of phlegm,qi and wind were paid attention to eliminate pathogen.

A meta-analysis of Yupingfeng powder in conjunction of western medicine on cough variant asthma / 国际中医中药杂志

Objective@#To evaluate the efficacy and safety of Yupingfeng powder in conjunction treatment of western medicine on cough variant asthma (CVA).@*Methods@#We searched CNKI, Wanfang database, VIP database and PubMed through computer from the database building to October 31st 2017. The randomized controlled trails (RCT) with the comparison in the treatment of CVA with Yupingfeng powder and western medicinal were identified and included. The quality of RCTs was assessed by Jadad scores, and meta-analyses were performed by Review Manager 5.3 software.@*Results@#Totally 15 RCTs involving 1 318 patients were included into the study, which all belonged to the low methodological quality. The meta-analysis results showed that compared with the western medicine alone, the treatment in conjunction of Yupingfeng powder can significantly improve the clinical effective rate [OR=3.45, 95% CI (2.38-5.02), P<0.01], reduce the recurrence rate [OR=0.25, 95% CI (0.16-0.38), P<0.01]. There were no statistical significant differences with untoward effect between above two treatment groups [OR=0.70, 95% CI (0.34-1.46), P=0.35].@*Conclusions@#The Yupingfeng powder combined with the routine therapy may improve the clinical effective rate, and reduce the recurrence rate for CVA patients. However, we need more high-quality RCTs to comfirm such results.

Clinical effect ofShumu-Yuntu-Zhike decoction with converntional treatment for the gastroesophageal feflux cough / 国际中医中药杂志

Objective To observe the clinical effect of Shumu-Yuntu-Zhike decoction with conventional treatment for the Gastroesophageal Reflux Cough (GERC).Methods A total of 64 patients with GERC were randomly divided into the conventional treatment group and the combined treatment group, 32 in each. The conventional treatment group took the Rabeprazole capsule and Mosapride Citrate Tablets, and the combined treatment group received the traditional prescription of Shumu-Yuntu-Zhike decoction on the basis of the conventional therapy. Two groups were treated for 8 weeks and evaluated the effect with the Visual analogue scale (VAS), Reflux diagnostic questionnaire (RDQ) and Chronic cough impact questionnaire (CCIQ) before and after 4 and 8 weeks' treatment.Results After 4 week treatment, the VAS (4.47 ± 1.32vs. 6.22 ± 1.34;t=-5.859,P<0.01), CCIQ (32.60 ± 5.83vs. 47.32 ± 5.56,t=-11.548,P<0.01) in the combined treatment group decreased significantly than the conventional group, but the RDQ (13.62 ± 2.89vs. 13.67 ± 2.77;t=-0.079, P=0.937) showed no significant difference between the two groups. After 8 weeks' treatment. After 8 week treatment, the VAS (2.57 ± 1.69vs. 4.55 ± 2.06;t=-4.676,P<0.01), CCIQ (12.47 ± 3.41vs. 23.47 ± 3.55;t=-14.126,P<0.01) in the combined treatment group decreased significantly, but the RDQ (9.18 ± 2.77vs. 9.3 ± 2.43,t=-0.202,P=0.841) showed no significant difference between the two groups. After the treatment, the total effective rate of combined treatment group was 90.6% (29/32), while the control group was 68.7% (22/32). There was significant difference between the two groups (χ2=4.730,P=0.030).Conclusions The therapy of Shumu-Yuntu-Zhike decoction combined with conventional therapy can relieve the symptom of gastroesophageal reflux cough.

The effect of metformin and pioglitazone on glucagon of patients with diabetes and metabolic syndrome / 中华临床营养杂志

Objective To observe and evaluate the effects of metformin and pioglitazone on blood glucose,insulin,glucagon,β-cell function and insulin resistance among patients with diabetes and metabolic syndrome,so as to discuss the role of pancreatic α cells in pathogenesis of type 2 diabetes mainly caused by insulin resistance and the change of α-cell function after treatment.Methods A total of 60 patients diagnosed with diabetes and metabolic syndrome were selected in Beijing Chaoyang District Diabetes Center from April 2012 to April 2013 and divided with random number table into metformin group (treated with metformin 0.5 g orally thrice a day for 1 year,n =30) and pioglitazone group (treated with pioglitazone 15 mg orally once a day for 1 year,n =30).30 normal healthy people who had physical examination at the Center during the same period were enrolled into the control group,matched in age and gender with the intervention groups.The general condition of the 3 groups,and blood levels of glucose,insulin,and glucagon,insulin sensitivity index (ISI)-Matsuda,homeostasis model assessment of insulin resistance (HOMA-IR),β-cell function index (HOMA-β),1-phase index,2-phase index,and insulin secretion sensitivity index (ISSI) at baseline in the 3 groups and after treatment in the metformin group and the pioglitazone group were measured and calculated.Results Compared with the control group before treatment,the intervention groups as a whole had significantly higher fasting glucagon level [(146.22 ±25.41) pmol/L vs.(21.31 ±7.85) pmol/L,P =0.002] and area under curve (AUC) of glucagon [(469.84 ±13.12) pmol/(L · h) vs.(100.94 ± 7.73) pmol/(L · h),P =0.006].Compared with the results before treatment,the metformin group exhibited significantly reduced fasting glucose [(6.46 ± 1.38) mmol/L vs.(7.54 ± 0.43) mmol/L,P=0.031],fasting insulin [(119.22 ± 69.01) pmol/L vs.(139.38 ±71.13) pmol/L,P =0.042],fasting glucagon [(91.69 ±22.11) pmol/L vs.(142.81 ±24.56) pmol/L,P=0.029],AUC of glucose [(25.19 ± 1.31) mmol/ (L · h) vs.(32.68 ± 1.12) mmol/ (L · h),P =0.043],AUC of insulin [(468.65 ±20.10) pmol/ (L· h) vs.(786.32±21.37) pmol/ (L· h),P=0.017],and AUC of glucagon [(280.60±8.26) pmol/ (L · h) vs.(487.14±14.31) pmol/ (L · h),P=0.032];while the pioglitazone group after treatment also showed significantly decreased fasting glucose [(6.58 ±2.21) mmol/L vs.(7.68±0.59) mmol/L,P=0.028],fastinginsulin [(107.92±17.81) pmol/L vs.(144.66±74.43) pmol/L,P =0.033],fasting glucagon [(76.07 ±20.57) pmol/L vs.(148.34 ±28.94) pmol/L,P=0.025],AUC of glucose [(25.58 ±1.22) mmol/(L·h) vs.(35.07 ±1.38) mmol/(L· h),P=0.038],AUC of insulin [(435.54±19.30) pmol/ (L· h) vs.(854.75 ±20.61) pmol/(L·h),P=0.013],andAUCofglucagon [(223.43 ±5.83) pmol/ (L·h) vs.(458.55 ±12.96) pmol/ (L·h),P =0.026].The before-after-treatment differences were significantly smaller in the metformin group than in the pioglitazone group in terms of fasting insulin [(20.16 ± 2.98) mmol/L vs.(36.74 ± 2.88) mmol/L,P =0.011],fasting glucagon [(51.12 ± 3.67) pmol/L vs.(72.27 ± 4.58) pmol/L,P =0.016],AUC of insulin [(317.67 ±13.45) pmol/(L · h) vs.(419.21 ±15.44) pmol/(L · h),P=0.031] and AUC of glucagon [(206.54±9.66) pmol/(L· h) vs.(235.12±10.29) pmol/(L· h),P=0.046].Conclusions Glucagon in patients with diabetes and metabolic syndrome is higher than that in normal individuals.Metformin and pioglitazone can decrease the level of glucagon in patients with metabolic syndrome and diabetes as well as improve the glucose control,β-cell function and insulin resistance,suggesting improving effect of these two drugs on α-cell function.Pioglitazone manifests a stronger effect than metformin does.

The impact of childhood maltreatment experience and MAOA-VNTR on female adolescent’s impulsivity trait / 中国神经精神疾病杂志

Objective To examine the impact on impulsivity trait by monoamine oxidase A variable nucleotide tan?dem repeat (MAOA-VNTR) genotype and children’s abuse experience. Methods The self-reported questionnaire of Bar?ratt Impulsiveness Scale (BIS), Childhood Trauma Questionnaire (CTQ) were conducted in 403 normal Han female adoles?cents from north-west of China. The DNA were extracted from their venous blood sample and were genotyped for the MAOA-VNTR polymorphism. A linear regression model was used to investigate the main effects of MAOA-VNTR and children's abuse, and their interaction effect on impulsivity. Results The main effect of Children’s maltreatment experi?ence on trait impulsivity was significant (P0.05). Conclusion The MAOA-VNTR genotype may not be involved in the female adolescents’impulsivity traits related to childhood maltreat?ment.