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Alzheimer's disease （AD） is a neurodegenerative disease often characterized by cognitive impairment in clinical practice. The main pathogenesis includes β amyloid protein （Aβ） excessive deposition， neuroinflammatory response， Tau protein hyperphosphorylation， and other factors， and currently only a few chemical drugs have been approved for clinical treatment of AD. The mechanism of action is relatively single， so it is imperative to find new treatment strategies. Traditional Chinese medicine theory believes that the loss of nourishment in the brain and marrow， as well as the loss of vital energy， is the internal mechanisms underlying the occurrence and development of AD， which runs through the entire treatment process. The pathogenesis of AD is closely related to the inflammasome signaling pathway of nucleotide binding oligomerization domain-like receptor protein 3 （NLRP3）. Activating the NLRP3 signaling pathway increases neuroinflammatory response， intervenes in microglial polarization， and regulates Aβ sedimentation， cellular autophagy， brain homeostasis， etc. This article takes the NLRP3 signaling pathway as the starting point to sort out and summarize the upstream and downstream targets under the AD mechanism in the past five years， as well as the research on the NLRP3 signal pathway targets with the participation of the relevant traditional Chinese medicine compounds， such as Danggui Shaoyaosan， modified Shuyu Wan， Qingxin Kaiqiao prescription， Kaixin San， Jiedu Yizhi prescription， and modified Buwang San， traditional Chinese medicine monomer extracts， such as silibinin， Lycium barbarum polysaccharides， liquiritigenin， salidroside， baicalin， cinnamaldehyde， betaine， acacetin， and Hericium erinaceus， and acupuncture and moxibustion. It also reviews the latest achievements in the prevention and treatment of AD. This study provides ideas and directions for in-depth research on the prevention and treatment of cognitive dysfunction related diseases with traditional Chinese medicine.
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RNA editing, an essential post-transcriptional reaction occurring in double-stranded RNA (dsRNA), generates informational diversity in the transcriptome and proteome. In mammals, the main type of RNA editing is the conversion of adenosine to inosine (A-to-I), processed by adenosine deaminases acting on the RNAs (ADARs) family, and interpreted as guanosine during nucleotide base-pairing. It has been reported that millions of nucleotide sites in human transcriptome undergo A-to-I editing events, catalyzed by the primarily responsible enzyme, ADAR1. In hematological malignancies including myeloid/lymphocytic leukemia and multiple myeloma, dysregulation of ADAR1 directly impacts the A-to-I editing states occurring in coding regions, non-coding regions, and immature miRNA precursors. Subsequently, aberrant A-to-I editing states result in altered molecular events, such as protein-coding sequence changes, intron retention, alternative splicing, and miRNA biogenesis inhibition. As a vital factor of the generation and stemness maintenance in leukemia stem cells (LSCs), disordered RNA editing drives the chaos of molecular regulatory network and ultimately promotes the cell proliferation, apoptosis inhibition and drug resistance. At present, novel drugs designed to target RNA editing(e.g., rebecsinib) are under development and have achieved outstanding results in animal experiments. Compared with traditional antitumor drugs, epigenetic antitumor drugs are expected to overcome the shackle of drug resistance and recurrence in hematological malignancies, and provide new treatment options for patients. This review summarized the recent advances in the regulation mechanism of ADAR1-mediated RNA editing events in hematologic malignancies, and further discussed the medical potential and clinical application of ADAR1.
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The modernization of traditional Chinese medicine （TCM） theories is not only a prerequisite for the modernization of TCM but also a way to deal with the external environment and the difficulties of its development. The modernization of TCM is based on the premise of maintaining its own characteristics and advantages， and along with the progress of modern science and technology， the entire TCM has undergone new changes and improvements from theory to practice， and has become a scientific system with modern scientific level that adapts to the needs of the times. In the context of the unprecedented profound changes in contemporary TCM academics， this paper puts forward the definition of modernization of TCM theory and argues that the modernized theoretical system of TCM should maintain originality to build the foundation of TCM inheritance， clarify the frontier of the discipline and establish the conceptual system， form an open network to be compatible with multi-disciplinary interaction， incorporate the falsification and establish self-renewal system， creatively transform and innovatively develop， and modernize the interpretation and update the discourse system.
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On-site supervision is a risk-based regulatory system that requires the scientific development of supervision plans for quality risks and hidden dangers in pharmaceutical enterprises， the rational allocation of supervision resources based on their risk levels， and the implementation of classified supervision measures. In this study， the quality risk monitoring business support system is set up for pharmaceutical enterprises by establishing the quality risk expert database and quality risk monitoring index system for pharmaceutical enterprises based on the difficulty analysis of on-site drug supervision. Based on this support system， the quality risk classification method， the differentiated spot check strategy and business auxiliary visualization system are established. This support system is used to learn the risk level of pharmaceutical enterprises， so as to innovate supervision methods and optimize monitoring strategies. Taking Jiangxi Province as an example， it is verified that the support system can guide the risk assessment of sample enterprises， can improve the targeting of on-site drug supervision in the process of technical review， scheme editing， on-site implementation and comprehensive evaluation， and can effectively improve the quality and efficiency of supervision.
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Decoction is the most commonly used dosage form in the clinical treatment of traditional Chinese medicine (TCM). During boiling, the violent movement of various active ingredients in TCM creates molecular forces such as hydrogen bonding, π-π stacking, hydrophobic interactions and electrostatic interactions, which results in the formation of self-assembled aggregates in decoction (SADs), including particles, gels, fibers, etc. It was found that SADs widely existed in decoction with biological activities superior to both effective monomers and their physical mixtures, providing a new idea to reveal the pharmacodynamic material basis of Chinese herbal medicine from the perspective of component interactions-phase structure. Recently, SADs have become a novel focus of research in TCM. This paper reviewed their relevant studies in recent years and found some issues to be concerned in the research, such as the polydispersity of decoction system, instability of active ingredient interactions during boiling, uncertainty of the aggregates self-assembly rules, and stability, purity, yield of the products. In this regard, some solutions and new ideas were presented for the integrated development and clinical application of SADs.
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Nonalcoholic fatty liver disease （NAFLD） has gradually become the main reason affecting human liver health， and many factors are involved in the development and progression of NAFLD. Mitochondria， as the “energy factory” of cells， plays an important role in maintaining normal physiological functions. Studies have shown that hepatic mitochondrial dysfunction promotes the development and progression of NAFLD. This article briefly introduces the latest research advances in the basic characteristics and physiological function of liver mitochondria and reviews new research findings in the association of mitochondrial dysfunction with obesity， simple fatty liver disease， and nonalcoholic steatohepatitis， in order to provide new ideas for the research on targeted mitochondrial therapy for NAFLD.
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Alzheimer's disease （AD） is a neurodegenerative disease with progressive losses of memory and cognitive function as the main clinical manifestations. It is difficult to be cured because of the complex pathogenesis. Histone acetylation regulates gene transcription and chromosome structure remodeling without changing the coding sequences of genes， participating in the pathological process of AD via modulating the amyloid beta-protein （Aβ） deposition， Tau phosphorylation， neuron growth， and synaptic plasticity. Traditional Chinese medicine can prevent and control AS via multiple targets and pathways from a holistic view. Animal and cell experiments have proven that traditional Chinese medicine can attenuate AD by regulating histone acetylation. Focusing on the key role of histone acetylation in AD， this study reviews the relevant studies in the last five years from the aspects of active ingredients of traditional Chinese medicine and traditional Chinese medicine compound prescriptions. The available studies suggest that the main mechanisms involve antagonizing apoptosis， inhibiting oxidative stress， ameliorating Tau and Aβ deposition， maintaining synaptic function， nourishing neurons， and repairing myelin sheath. The treatment methods include invigorating kidney and tranquilizing mind， tonifying spleen and harmonizing middle energizer， and opening orifices and resolving phlegm. The commonly used herbal medicines in compound prescriptions include Poria， Glycyrrhizae Radix et Rhizoma， Chuanxiong Rhizoma， Acori Tatarinowii Rhizoma， and Paeoniae Radix Alba. The findings indicate that traditional Chinese medicine demonstrates great potential in the prevention and treatment of AD， providing a theoretical basis for the clinical treatment and research of AD.
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The current interdisciplinary research on traditional Chinese medicine （TCM） often comes from the simple combination of TCM application needs and mature engineering technology. Actually， higher goal of cross-disciplinary research should be the win-win development of TCM and interdisciplinary majors. In detail， to enhance the innovative development of original thinking mode of TCM， meanwhile， to stimulate the innovation of interdisciplinary majors with medical tasks. Previously， we successfully performed the research on the objective representation of pre-disease and disease state of dyslipidemia in population with phlegm-dampness constitution. Taking this project as an example， this paper discusses the methodology on scientific issue positioning， key medical tasks selection， interdisciplinary theory， and technology exploration， to expounds the research design and ideas which could be generalized in other cross-disciplinary research of TCM.
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ObjectiveTo establish the categories and structure of physical activity in children with autism spectrum disorder (ASD), and systematically evaluate the long-term effect of physical activity on the executive function of children with ASD, based on the theoretical and methodological framework of the International Classification of Functioning, Disability, and Health-Children and Youth version (ICF-CY). MethodsA search was conducted in databases such as Wanfang data, CNKI, PubMed, Web of Science and ProQuest, to collect literatures about long-term physical activity for executive function of children with ASD published from 2014 to 2023. The literatures were reviewed based on inclusion and exclusion criteria, following PRISMA guidelines for systematic review, and the quality of the included literatures were assessed with the Physiotherapy Evidence Database (PEDro) scale. ResultsTotally, ten articles were included, consisting of nine randomized controlled trials (RCTs) and one non-randomized controlled trial, with a total of 351 children diagnosed as ASD, aged three to 18 years, came from Italy, Canada, South Korea, China and the United States, published mainly after 2016. Physical activity primarily included sports activities (such as baseball, basketball, table tennis and equine-assisted activities), skill-based activities (such as cycling, cognitive-motor training and active gaming), physical fitness activities (SPARK), as well as combat-related activities (martial arts and karate); 30 to 70 minutes a time (mainly 45 minutes), one to five times a week (mainly twice a week), for two to 24 weeks (mainly twelve weeks). Long-term physical activities had been found to improve inhibitory control and cognitive flexibility in children with ASD, although the effect on working memory was inconsistent. ConclusionLong-term physical activity may positively impact on executive function in children with ASD, especially inhibitory control and cognitive flexibility. However, the effect on working memory need more researches.
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Background/Aims@#Metabolic dysfunction-associated steatohepatitis (MASH) is an unmet clinical challenge due to the rapid increased occurrence but lacking approved drugs. Autophagy-related protein 16-like 1 (ATG16L1) plays an important role in the process of autophagy, which is indispensable for proper biogenesis of the autophagosome, but its role in modulating macrophage-related inflammation and metabolism during MASH has not been documented. Here, we aimed to elucidate the role of ATG16L1 in the progression of MASH. @*Methods@#Expression analysis was performed with liver samples from human and mice. MASH models were induced in myeloid-specific Atg16l1-deficient and myeloid-specific Atg16l1-overexpressed mice by high-fat and high-cholesterol diet or methionine- and choline-deficient diet to explore the function and mechanism of macrophage ATG16L1 in MASH. @*Results@#Macrophage-specific Atg16l1 knockout exacerbated MASH and inhibited energy expenditure, whereas macrophage-specific Atg16l1 transgenic overexpression attenuated MASH and promotes energy expenditure. Mechanistically, Atg16l1 knockout inhibited macrophage lipophagy, thereby suppressing macrophage β-oxidation and decreasing the production of 4-hydroxynonenal, which further inhibited stimulator of interferon genes(STING) carbonylation. STING palmitoylation was enhanced, STING trafficking from the endoplasmic reticulum to the Golgi was promoted, and downstream STING signaling was activated, promoting proinflammatory and profibrotic cytokines secretion, resulting in hepatic steatosis and hepatic stellate cells activation. Moreover, Atg16l1-deficiency enhanced macrophage phagosome ability but inhibited lysosome formation, engulfing mtDNA released by pyroptotic hepatocytes. Increased mtDNA promoted cGAS/STING signaling activation. Moreover, pharmacological promotion of ATG16L1 substantially blocked MASH progression. @*Conclusions@#ATG16L1 suppresses MASH progression by maintaining macrophage lipophagy, restraining liver inflammation, and may be a promising therapeutic target for MASH management.
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OBJECTIVE@#Based on metabonomics technology of high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) and hydrogen nuclear magnetic resonance spectroscopy (1H NMR), the pharmacokinetic characteristics and therapeutic mechanism of Rhei Radix et Rhizoma (RhRR, Dahuang in Chinese), Eupolyphaga Steleophaga (EuS, Tubiechong in Chinese) combined with RhRR acting on acute liver injury were explored.@*METHODS@#Models of acute liver injury were established, and the pharmacokinetic methods of five components of RhRR-EuS in rats were found by HPLC-MS/MS. The liver tissues of different groups of mice were analyzed by 1H NMR spectroscopy combined with multivariate statistical analysis to investigate the metabolomics of RhRR-EuS and RhRR.@*RESULTS@#Pharmacokinetic results showed there were different levels of bimodal phenomenon in different groups, and the absorption of free anthraquinone in RhRR increased after compatibility with EuS. In addition, the pathological state of acute liver injury in rats can selectively promote the absorption of emodin, chrysophanol, physcion and aloe emodin. Through 15 differential metabolites in the liver tissue of acute liver injury mice, it was revealed that RhRR-EuS and RhRR could protect the liver injury by regulating the metabolism of glutamine and glutamic acid, alanine, aspartic acid and glutamic acid, and phosphoinositide. However, the regulation of RhRR was weaker than that of RhRR-EuS.@*CONCLUSION@#For the first time, we studied the pharmacokinetics and metabolomics differences of RhRR-EuS and RhRR in rats and mice with acute liver injury, in order to provide theoretical reference for clinical treatment of liver disease by DHZCP.
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PURPOSE@#To identify the potential target genes of blast lung injury (BLI) for the diagnosis and treatment.@*METHODS@#This is an experimental study. The BLI models in rats and goats were established by conducting a fuel-air explosive power test in an unobstructed environment, which was subsequently validated through hematoxylin-eosin staining. Transcriptome sequencing was performed on lung tissues from both goats and rats. Differentially expressed genes were identified using the criteria of q ≤ 0.05 and |log2 fold change| ≥ 1. Following that, enrichment analyses were conducted for gene ontology and the Kyoto Encyclopedia of Genes and Genomes pathways. The potential target genes were further confirmed through quantitative real-time polymerase chain reaction and enzyme linked immunosorbent assay.@*RESULTS@#Observations through microscopy unveiled the presence of reddish edema fluid, erythrocytes, and instances of focal or patchy bleeding within the alveolar cavity. Transcriptome sequencing analysis identified a total of 83 differentially expressed genes in both rats and goats. Notably, 49 genes exhibited a consistent expression pattern, with 38 genes displaying up-regulation and 11 genes demonstrating down-regulation. Enrichment analysis highlighted the potential involvement of the interleukin-17 signaling pathway and vascular smooth muscle contraction pathway in the underlying mechanism of BLI. Furthermore, the experimental findings in both goats and rats demonstrated a strong association between BLI and several key genes, including anterior gradient 2, ankyrin repeat domain 65, bactericidal/permeability-increasing fold containing family A member 1, bactericidal/permeability-increasing fold containing family B member 1, and keratin 4, which exhibited up-regulation.@*CONCLUSIONS@#Anterior gradient 2, ankyrin repeat domain 65, bactericidal/permeability-increasing fold containing family A member 1, bactericidal/permeability-increasing fold containing family B member 1, and keratin 4 hold potential as target genes for the prognosis, diagnosis, and treatment of BLI.
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Rats , Animaux , Lésion pulmonaire/génétique , Capra/génétique , Kératine-4 , Analyse de profil d'expression de gènes , Expression des gènesRésumé
Objective:To quantitatively evaluate the guidelines for hypertensive disorders of pregnancy (HDP) at home and abroad, and to provide a reference for the development of related guidelines in the future.Methods:Guidelines related to HDP published at home and abroad from 1 January 2018 to 31 December 2022 were retrieved from several databases, including CNKI, Wanfang Database, Yiigle, VIP Database, PubMed, Embase, and Web of Science with the terms of "hypertension in pregnancy", "hypertensive disorders of pregnancy", "pre-eclampsia", "eclampsia", and "guidelines". The retrieved guidelines were evaluated with the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) and Scientific, Transparent and Applicable Rankings (STAR) tool. According to the manual of AGREE Ⅱ two researchers graded the retrieved guidelines from six domains: scope and purpose, participants, rigor, clarity, applicability, and independence. Mean standardized score of each domain and the overall score were obtained. STAR tool was used to grade the guidelines by two researchers and one methodologist from 11 domains: registration, protocol, funding, working groups, conflicts of interest, clinical issues, evidence, consensus methods, recommendations, accessibility, and others.Results:A total of 19 related guidelines were included, covering six countries on three continents. The mean standardized scores of the 19 guidelines in the six domains of scope and purpose, participants, rigor, clarity, applicability, and independence using the AGREE II instrument were 73.98%, 63.16%, 59.98%, 66.37%, 56.36%, and 71.93%, respectively. Scores in the 11 domains of registration, protocol, funding, working groups, conflicts of interest, clinical issues, evidence, consensus methods, recommendations, accessibility, and others using the STAR tool were 0.00%, 0.00%, 76.15%, 39.87%, 58.92%, 65.19%, 60.80%, 49.78%, 78.95%, 30.89%, and 42.11%, respectively. According to the overall evaluation results, 12 guidelines were recommended and seven needed further modifications. It was found that most guidelines were unanimous in their recommendations on the prevention of preeclampsia with aspirin, medications for patients with severe hypertension, and the timing of pregnancy termination in preeclampsia patients, with the consensus rates of 10/13, 9/13, and 9/13, respectively. Besides, these recommendations were supported by substantial evidence.Conclusions:The overall quality of guidelines related to HDP at home and abroad is high, but there is still room for improvement. When developing relevant guidelines in the future, statisticians and methodologists should be included in the working groups to improve the evidence-based quality, and much attention should be paid to the disclosure of conflicts of interest guidelines. Registration and protocol are needed before publishing a guideline. The development of multiple versions for different users will conduce to improving the management of HDP.
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@#The treatment of patients with advanced lung cancer has been revolutionized with the advent of immunotherapy. However, not all patients can benefit equally from immunotherapy. In recent years, the relationship between intestinal flora and the efficacy of immunotherapy has gradually attracted scholars' attention. During the treatment of immune checkpoint inhibitors, the use of antibiotics, proton pump inhibitors and other drugs will affect the patient's intestinal flora, thus affecting the efficacy of immune checkpoint inhibitors, leading to poor prognosis of patients. This review will discuss that antibiotics and proton pump inhibitors reduce the efficacy of immunotherapy by affecting the diversity of intestinal flora, in order to facilitate the rational use of related drugs in clinical practice and improve the patient's outcomes.
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A polymethionine(p-Met)-modified laser-induced graphene(LIG)electrode was constructed and integrated with portable electrochemical workstations and handheld computer to achieve on-site,simultaneous detection of azo dyes sunset yellow(SY)and tartrazine(Tz)in environmental water.Firstly,the sensor interface with the best electrical conductivity was obtained by optimizing the laser processing parameters,and then the electrochemical responses of SY and Tz were improved by electropolymerization of methionine on the surface of LIG.Finally,a portable electrochemical sensor platform was built by connecting p-Met/LIG,a small electrochemical workstation and a handheld computer application program.Differential pulse voltammetry(DPV)was used to determine these two dyes.SY showed a good linear relationship in the concentration range of 0.2-20 μmol/L and 20-100 μmol/L,the detection limit was as low as 0.001 μmol/L.Tz showed a good linear relationship in concentration range of 0.3-40 μmol/L and 40-100 μmol/L,and the detection limits was as low as 0.005 μmol/L.p-Met/LIG also had excellent anti-interference performance and reproducibility.The portable electrochemical platform was applied to real-time detection of real water samples,and the results showed that the platform was expected to be applied in field detection of SY and Tz in real environmental water bodies.
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Objective:To evaluate the effect of ultrasound and CT three-dimensional reconstruction in open reduction and internal fixation of fractured ribs.Methods:A retrospective case-control study was conducted to analyze the clinical data of 112 patients with chest trauma and rib fractures admitted to Yan′an People′s Hospital from January 2021 to September 2023. According to the different preoperative positioning methods used, the reconstruction group was divided into a reconstruction group ( n=61) and a combined group ( n=51). The reconstruction group positioned the surgical incision position based on conventional CT three-dimensional reconstruction, while the combined group positioned the rib fracture end based on CT three-dimensional reconstruction combined with ultrasound. Record clinical data of two groups of patients and compare their preoperative positioning accuracy, average incision length, exposure time of fracture ends, fracture healing time, incision infection rate, surgical related indicators, visual analogue pain score (VAS) at one month after surgery, and surgical incision healing levels. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter group comparison; Comparison of count data between groups using chi-square test; The comparison of grade data were conducted using Mann-Whitney U test. Results:The preoperative localization accuracy, postoperative VAS at one month, and surgical incision healing grade A of the combined group patients were 94.4%, (2.26±0.48) points, 96.1%, respectively, the reconstruction group were 84.1%, (4.52±1.34) points, 72.1%, the combined group was better than the reconstructed group, the difference between the two groups was statistically significant ( P<0.05); The average incision length, fracture exposure time, fracture healing time, surgical time, and thoracic tube retention time of the combined group were (7.32±2.44) cm, (18.06±4.78) min, (48.16±4.58) d, (55.46±7.48) min, and (3.57±1.28) min, respectively. The reconstruction group were (10.16±2.86) cm, (29.45±5.65) min, (55.36±4.45) d, (64.36±7.52) min, and (7.49±1.52) min, respectively, the difference between the two groups was statistically significant ( P<0.05). Conclusion:Application of ultrasound combined with CT three-dimensional reconstruction in open reduction and internal fixation of fractured ribs can increase the preoperative positioning accuracy, which can guide the surgical incision, thus alleviating postoperative pain, facilitating postoperative healing, minimizing surgical trauma, and improving the patient′s prognosis.
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Objective To investigate the effect of cisplatin treatment on the transcriptional level of human liver cancer cells by conducting transcriptome sequencing analysis after treating human liver cancer cell lines with differ-ent concentrations of cisplatin(CDDP).Methods Liver cancer cell lines HepG2 and Huh7 were incubated with cisplatin at different final concentrations of 0,20,50,100 and 200 μmol/L.After 12 hours,cell viability,immuno-fluorescence and RNA-sequencing(RNA-seq)were performed.Differential gene expression analysis(DEG),KEGG pathway analysis,and protein-protein interaction network analysis were conducted.Results Cisplatin de-creased cell viability and increased DNA damage in HepG2,Huh7 cells.Among the genes regulated after cisplatin treatment at different concentrations,59 genes were commonly up-regulated in both HepG2 and Huh7 cells,while 81 genes were commonly down-regulated.The commonly upregulated genes were mainly enriched in cancer initiation and progression pathways.The 81 commonly down-regulated genes were mainly enriched in Rap1 signaling pathway,Ras signaling pathway,signaling pathways regulating pluripotency of stem cells,axon guidance,and cell adhesion-related pathways.Survival analysis of key nodes in the protein-protein interaction network of commonly up-regulated and downregulated genes revealed a significant correlation between high expression of Jun proto-oncogene,AP-1 transcription factor subunit(JUN)and prolonged patient survival and a significant correlation between low ex-pression of growth arrest and DNA damage inducible alpha(GADD45A)and prolonged patient survival.Conclu-sions The study revealed common transcriptional changes in liver cancer cells under cisplatin treatment.Differential expression of JUN and GADD45A is a potential core mechanism to explain drug resistance.This conclusion provides some important prognostic indicators for clinical treatment.
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Age-related macular degeneration(AMD)is a serious threat to the visual health of the elderly,and the dysfunction of retinal pigment epithelial cells(RPE)is a significant etiology risk.Aging process leads to RPE repli-cation senescence,and some environment factors like light exposure and cigarette exposure may lead to RPE stress premature aging,and the decreased lysosomal digestion ability of senescent RPE cells may lead to the accumulation of lipofuscin,triggering the occurrence of early AMD.A series of homeostatic imbalances in aging retina,such as cell senescence-renewal imbalance,oxidative stress-antioxidant imbalance,chronic inflammatory-anti-inflammatory imbalance,intestinal barrier and intestinal microbiota imbalance and pro-angiogenesis-antiangiogenic imbalance all contribute to the development of AMD.
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Objective To compare the clinical efficacy of DSA-guided pyloric balloon dilation with that of conservative medical treatment for postsurgical gastroparesis syndrome(PGS).Methods The clinical data of 41 patients with PGS,who were admitted to the Department of Interventional Radiology,Affiliated Third Hospital of Suzhou University of China to receive DSA-guided pyloric balloon dilation(study group,n=21)or conservative medical treatment(control group,n=20)between January 2012 and February 2021,were retrospectively analyzed.The median follow-up period in the control group and the study group was 626 days and 588 days respectively.The average length of stay(ALOS)was compared between the two groups.Results In the study group,all the 21 patients returned to normal food intake within 2 days after successful DSA-guided pyloric balloon dilation treatment,and they were all discharged within one week after treatment.The ALOS in the study group was(10.2±1.3)days,which was strikingly shorter than(34.5±14.2)days in the control group,the difference between the two groups was statistically significant(P＜0.001).Conclusion For the treatment of PGS,DSA-guided pyloric balloon dilation carries better clinical efficacy when compared with conservative medical treatment,therefore,it can be used as the preferred treatment for patients with PGS.Further studies are need to be conducted before its therapeutic mechanism can be clarified.
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Objective To investigate the etiology and outcome of elderly patients with new-onset status epilepticus(NOSE).Methods According to the electronic medical record,the keywords"Epilepsy"and"Status epilepticus"were searched for elderly patients with status epilepticus admitted to Sichuan Provincial People's Hospital between January 2018 and June 2023.Elderly patients with NOSE were strictly screened according to inclusion and exclusion criteria,and etiology were analyzed according to medical history and ancillary examinations,and factors related to prognosis of epilepsy were analyzed by Logistic regression.Results There were 63 elderly NOSE patients,including 38 males and 25 females,with an average age of(72.71±7.45)years old.Cerebrovascular disease(21%)was determined as the major cause of NOSE in elderly patients,followed by central nervous system infection(17%).Logistic regression analysis of prognostic factors showed that co-infection(OR = 11.67,95%CI:1.391-97.850,P =0.024)and renal insufficiency(OR =18.90,95%CI:3.522-101.43,P = 0.001)were associated with poor patient prognosis.Conclusions Cerebrovascular disease is the main known cause of NOSE in elderly patients.Prevention of infection and improvement of renal function may improve prognosis.