Résumé
ObjectiveTo observe the clinical efficacy and safety of Tinglu Yixin prescription in the treatment of patients with heart failure with preserved ejection fraction （HFpEF） combined with diabetes （syndromes of Qi and Yin deficiency and water retention and blood stasis） from taste-based compatibility and descending adverse Qi with bitter and pungent medicinals. MethodA total of 108 HFpEF patients with diabetes （syndromes of Qi and Yin deficiency and water retention and blood stasis） treated in the Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from May 2022 to March 2023 were enrolled in this study and randomized into an observation group （54 patients） and a control group （54 patients）. Both groups received conventional Western medicine treatment according to the guide recommendations for chronic heart failure and diabetes， and the observation group additionally received Tinglu Yixin prescription. The treatment course for both groups was 12 weeks. The New York Heart Association （NYHA） grading of cardiac function， left ventricular end diastolic diameter （LVEDD）， left atrium diameter （LAD）， the ratio of early diastolic maximum mitral flow velocity （E） to early diastolic mitral annular motion velocity （e'） （E/e'）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， hemoglobin A1c （HbA1c）， 6-minute walking test （6MWT）， Minnesota Living with Heart Failure Questionnaire， traditional Chinese medicine （TCM） syndrome scores， and safety indicators were determined before and after treatment. ResultFinally， 104 patients were included for analysis， including 52 patients in the observation group and 52 patients in the control group. After treatment， 35 and 47 patients in the control and observation groups showed improved cardiac function， which indicated the total response rates of 67.3% and 90.4%， respectively. The total response rate regarding the cardiac function in the observation group was higher than that in the control group （χ2=2.754， P<0.05）. The observation group outperformed the control group in reducing LVEDD and LAD （P<0.05）， decreasing the E/e' ratio （P<0.05）， lowering the NT-proBNP and HbA1c levels （P<0.05）， and recovering the 6MWT and Minnesota quality of life score TCM syndrome scores （P<0.05）. None of the safety indicators in the two groups showed abnormal values before and after treatment， and no serious adverse reaction was observed. ConclusionTinglu Yixin prescription can improve the heart function， exercise tolerance， and quality of life， lower the HbA1c level， and alleviate the TCM syndrome in the patients with HFpEF combined with diabetes （syndrome of qi and yin deficiency and water stagnation and blood stasis）.
Résumé
BACKGROUND:MXene nanoparticles have considerable application prospects as effective functional components of skin wound dressings due to their unique properties of conductivity,hydrophilicity,antibacterial activity,and biocompatibility. OBJECTIVE:To review the synthesis methods,functional properties,and application of MXene nanoparticles in skin injury repair. METHODS:"MXene,nanoparticles,nanomaterials,bioactive nanoparticles","wound dressing,wound dressing,wound repair materials","wound repair,wound healing,wound surface"were used as Chinese search terms to search Wanfang and CNKI databases."MXene,nanoparticles,nano-materials,bioactive nanoparticles","wound dressing,wound healing material","wound healing,wound repair,wound"were used as English search terms to search the PubMed database.Finally,88 articles were included for review analysis. RESULTS AND CONCLUSION:(1)MXene synthesis can be divided into two methods:bottom-up synthesis and top-down synthesis.The synthesized MXene can be further modified to enhance biocompatibility for better application in biomedicine.(2)MXene has a series of excellent properties such as hydrophilicity,antibacterial,photothermal properties,electrical conductivity,and good biocompatibility,all of which make it the basis for excellent skin repair materials.(3)At present,many scholars have developed new composite materials for wound dressings.Currently,these composite materials are based on MXene nanomaterials and make full use of its excellent characteristics as mentioned above,which play a role in local skin wound sterilization,drug delivery,and sustained release,active regulation of cytokines,and can integrate the advantages of other biologically active agents.It plays a better role in wound healing,especially in the treatment of complex chronic wounds.(4)Various composite materials such as MXene@PVA hydrogel and MXene@CH sponge developed based on various properties of MXene have shown good effects on improving tissue repair performance and repairing skin damage as drug carriers.It shows that MXenes nanoparticles are in the initial stage of development and have great prospects in the field of promoting skin repair.The characteristics and surface modification of MXenes nanoparticles have been well studied,but the molecular mechanism of dose-dependent biotoxicity is relatively incomplete.
Résumé
ObjectiveTo observe the fine structure of the trunk kidney in zebrafish, and to identify its secreted exosomes. MethodsThe microstructure and ultrastructure of the trunk kidney in zebrafish were observed by light microscopy and electron microscopy, and the particle size of exosomes was detected by nanoparticle tracking analysis (NTA). ResultsThe trunk kidney was close and parallel to the spine in adult zebrafish. The nephron consisted of renal tubules and renal corpuscles. The renal tubules could be further divided into three types: proximal convoluted tubules, distal convoluted tubules, and cervical segments. The renal corpuscles were composed of glomerulus and renal capsules. The periodic acid-Schiff (PAS) staining results revealed that there were abundant glycogen granules in the proximal convoluted tubules, with brush-like outline in the apical surface of epithelial cells. Under transmission electron microscopy (TEM), there were exosomes distributed in the lumen of renal tubules, with numerous late endosomes and few number of multivesicular bodies (MVBs) in the cytoplasm of the epithelial cells concentrating on the apical side. Meanwhile, MVBs were also distributed in the apical regions of the renal tubules and the podocytes of the renal glomeruli. Immunohistochemical staining results showed that CD9, CD63 and TSG101 were strongly expressed in the lumen surface of the renal tubules, but weakly expressed in the corpuscles and lumen. NTA and TEM results showed that the exosomes isolated from zebrafish trunk kidney were saucer-like outline, and the particle size mode was 144.4 nm, which was consistent with the characteristics of morphological futures of exosome. ConclusionThe zebrafish somatic kidney has the typical structure of the mammalian kidney and is the urinary organ in the body. The renal tubules have the ability to secrete exosomes, and their formation is a process of releasing poly-vesicles to the free surface of epithelial cells into the extracellular space. This study laid a morphological foundation for further study of exosomes in urinary function in aquatic experimental animals as well as the development and application of related models.
Résumé
Objective@#The aim of this study was to establish a comprehensive concise health index (CHI) for evaluating adolescents, so as to provide a basis for determining the overall health status of adolescents in China.@*Methods@#On the basis of a literature review and consensus among core researchers, adolescent CHI indicators in the following five dimensions were assessed:physical growth, physical fitness, common diseases, mental health and behavioral health. A total of 24 experts used an analysis hierarcgy process (AHP) to calculate the indicators subjective weights. In addition, from October to December of 2021, two regions, A and B were selected to conduct empirical research, and the CRITIC method was used to calculate the objective weights of the indicators. Finally, the weight coefficients were determined through the AHP-CRITIC combination weight method, and comprehensive evaluation was performed with the TOPSIS method.@*Results@#Across academic period and genders, the combined weighted coefficients of the health indicators were as follows:BMI, 0.081-0.095; waist circumference, 0.070-0.081; relative grip strength, 0.101-0.108; myopia, 0.110-0.128; dental caries, 0.055-0.070; psychological symptoms, 0.240-0.262; physical exercise, 0.085-0.115; screen time, 0.097-0.111; and sleep duration, 0.086-0.103. The health index of middle school students in city A (0.626±0.065) was significantly higher than that in city B(0.613±0.066)( t=6.34, P <0.01).@*Conclusion@#The comprehensive adolescent CHI evaluation method has good consistency and application value, and may serve as a reference for adolescent health monitoring.
Résumé
Objective:To investigate the medicinal retention of different concentrations of melatonin in the bone tissue of type 2 diabetic osteoporosis (T2DOP) rats and explore to efficacy of improvement of the bone microstructure of T2DOP rats.Methods:A total of 95 SD rats were selected, 60 of which had intraperitoneal in jection of high-fat diet combined with low-dose streptozotocin establishing a T2DOP rat model. Two months later, 45 rats' model was determined to be successful by detecting blood glucose and insulin sensitivity index. 30 successful modelling and 30 normal SD rats were randomly selected for melatonin distribution experiment, and were divided into four groups according to the injected melatonin concentration, including modeling rat high concentration group (50 mg/kg), modeling rat low concentration group (10 mg/kg), normal rat high concentration group (50 mg/kg) and normal rat low concentration (10 mg/kg), and there were15 rats in each group. Each group was divided into 5 sub-groups according to the time point of sampling (5, 15, 30, 60, 120 min), 3 animals per group. The bone tissue of each group was pretreated, and then the melatonin drug distribution in the bone tissue was detected by high performance liquid chromatography (HPLC). Another 15 rats were successfully modeled, and were divided into T2DOP group, high melatonin group (50 mg/kg) and low melatonin group (10 mg/kg), 5 rats in each group. 5 normal SD rats were taken as controls (control group), and Micro-CT was used to detect changes in bone microstructure after 8 weeks of treatment with melatonin.Results:The results of the drug distribution experiment showed that after melatonin was injected intraperitoneally, there were drugs remaining in the bone tissues of the rats in each group. The drug concentration reached the highest after 30 min of administration, and significantly decreased after 120 min. Compared with the normal rat low concentration group, there was no significant difference in the drug concentration between the two groups at 5 time points. However, the drug concentration at the four time points of 5, 15, 30, and 60 min in the modeling rat high concentration group were 7.613±2.568 ng/ml, 13.983±2.262 ng/ml, 18.816±1.291 ng/ml, 6.172±1.962 ng/ml, 1.112±0.566 ng/ml, which were significantly different compared with normal rat high group. Micro-CT results showed that after 8 weeks of melatonin treatment, the bone density of the high concentration group was (205.72±28.41 g/cm 3) significantly lower than that in the low concentration group (223.63±35.41 g/cm 3), but both groups were significantly higher than the normal rat group (158.31±31.86 g/cm 3). Conclusion:Exogenous melatonin is distributed in bone tissue, and the drug absorption rate of T2DOP rats is higher. Meanwhile, there is no difference in the distribution of melatonin in bone tissue with different concentrations, and these two concentrations of melatonincan canimprove the bone microstructure of T2DOP rats.
Résumé
Objective To observe the effect of Qi-strengthening and blood-activating Chinese patent medicine Qigui Ershen Granules on the carotid intima-media thickness(IMT ) , atheromatous plaque scores, serum fibroblast growth factor 23 (FGF23) and Klotho protein levels, and oxidation- and inflammation-associated indicators in carotid atherosclerosis patients. Methods Fifty-two carotid atherosclerosis patients were randomized into Chinese medicine group and western medicine group, 26 cases in each group. Chinese medicine group was treated with Qigui Ershen Granules orally, and western medicine group was treated with Atorvastatin Calcium Tablets orally. The mediation for the two groups lasted for 24 continuous weeks. Carotid ultrasonography was performed before and after treatment for the examination of carotid IMT and plaque Crouse scores. Double antibody sandwich enzyme-linked immunosorbent assay(ELISA) was applied for the detection of serum Klotho, FGF23, interleukin 1(IL-1) and tumor necrosis factorα(TNF-α) levels, and radio-immuno-precitation method was used for the assay of serum reactive oxygen species (ROS), malondialdehyde (MDA) and superoxide dismutase (SOD) levels. The clinical efficacy of the two groups was evaluated by the scores of Qi deficiency syndrome and blood stasis syndrome before and after treatment. Results (1) In western medicine group, 5 cases dropped out and were excluded, and a total of 21 cases completed the trial; in Chinese medicine group, 3 cases dropped out and were excluded, and a total of 23 cases completed the trial.(2) After treatment for 24 continuous weeks, IMT and Crouse scores of the plaque in the two groups were obviously reduced(P 0.05). (3) Serum Klotho protein level was increased while FGF23 was decreased in Chinese medicine group after treatment (P 0.05). The effects of Chinese medicine on increasing Klotho protein level and decreasing FGF23 level were superior to those of western medicine (P 0.05).(5) The scores of Qi deficiency syndrome and blood stasis syndrome in Chinese medicine were decreased after treatment (P 0.05). Chinese medicine group had better effect on improving the scores of Qi deficiency syndrome and blood stasis syndrome than western medicine group(P < 0.01).(6) After treatment, the total effective rate for improving Qi deficiency syndrome and blood stasis syndrome in Chinese medicine group was 82.61%, 78.26%, and that in western medicine group was 28.57%, 14.28%respectively, the difference being significant (P<0.01). Conclusion Qi-strengthening and blood-activating Qigui Ershen Granules have certain effects on counteracting atherosclerosis, inflammatory aging and oxidation.
Résumé
Objective To explore the features of subarachnoid hemorrhage (SAH) manifested as crescentshaped high density changes on brain CT.Methods The clinical data of 32 eases of tSAH similar to acute subdural hematoma ASDH were retrospectively analyzed.Results 2 cases of 3 receiving operation procedure were cured and 1 was slightly disabled.28 cases of 29 receiving non-operation treatment were cured and l was slightly disabled. Conclusion Because sometimes tSAH is featured as crescent-shaped high density image on brain CT,which will have a better effect through non.operation,so it is easily misdiagnosed as ASDH.
Résumé
Objective To investigate the causes and time distribution of trauma in prehospital patients. Methods The data of 2 055 trauma patients of our department admitted from January 2003 to March 2005 were analyzed. Results ① The mortality was 1.9%. ②723 patients (35.2%) were common trauma,and 32 had falling injuries (4.4%) with 18 dead including 12 at scene and 6 in emergency room. ③1 332 were Traffic accidents (64.8%) including 13 dead associated with bike , electric bicycle and motorbike. At the same time, there were 566 patients from 18:00 to 24:00 including 298 patients(52.7%) for the drivers after drinking. Conclusion Falling injuries and traffic accidents were the most important cause for death, especially in building spot . So we should enhance the security education for workers in these companies and limit the speed of electric bicycle for the increasing injury and mortality in traffic accidents . Driving after drinking at night should be prohibited too.