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Objective To analyze the consistency between computer tomography angiography(CTA)and digital subtraction angiography(DSA)in evaluating the global limb anatomic staging system(GLASS)stage of patients with chronic limb-threatening ischemia(CLTI).Methods The clinical data of patients with CLTI,who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University of China to receive treatment between January 2017 and December 2020,were retrospectively analyzed.Taking the DSA assessment as the gold standard,the consistency of CTA and DSA in evaluating the GLASS stage of patients with CLTI was analyzed.Results In the assessment of GLASS stage of CLTI,CTA showed strong agreement with DSA.The weighted Kappa coefficient of CTA and DSA for the staging of femoropopliteal segment was 0.798(95%CI=0.722-0.873,P<0.01),and the weighted Kappa coefficient of CTA and DSA for the staging of infrapopliteal artery segment was 0.785(95% CI=0.725-0.845,P<0.0l).For the overall staging of GLASS,the weighted Kappa coefficient of CTA and DSA was 0.832(95% CI=0.752-0.91 1,P<0.01).All the above results indicated that a very strong consistency existed between CTA and DSA in evaluating the GLASS stage of patients with CLTI.Conclusion CTA examination of lower limb can accurately evaluate GLASS score and stage of CLTI patient's target lesions,which is helpful in diagnosing lower extremity arteriosclerosis occlusion disease as well as in assessing the technical difficulty degree of its revascularization operation.(J Intervent Radiol,2024,33:300-303)
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Objective:To study the incidence and risk factors of central vein stenosis (CVS) in chronic kidney disease (CKD) patients who received arteriovenous fistula (AVF) creation for the first time, as well as effects of CVS on patency of ipsilateral AVF.Methods:It was a retrospective study. The CKD patients who received AVF creation for the first time in the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2020, with central vein digital subtraction angiography (DSA) results prior to angioplasty were selected as the study subjects. The differences of incidence of CVS in CKD patients with/without a history of cervical catheterization and primary patency rates of AVF between CVS and non-CVS groups were compared. Logistic regression analysis method was applied to analyze the influencing factors of CVS in CKD patients. Kaplan-Meier method was used to analyze the primary patency rate of AVF. Cox regression analysis method was used to analyze the effect of CVS on the primary patency of ipsilateral AVF.Results:A total of 283 CKD patients aged (50.45±14.76) years were enrolled in the study, including 165 males (58.3%). The dialysis age was 0.5 (0, 7.0) months. There were 55 patients (19.4%) diagnosed with CVS before AVF, including 39 patients with stenosis <50% and 16 patients with stenosis ≥50%. The incidence of CVS in patients with history of right internal jugular vein central venous catheter insertion was significantly higher than that in those without this history [60.5% (26/43) vs. 9.9% (15/151), χ2=51.274, P<0.001]. Multivariate logistic regression analysis results showed that hemodialysis catheters indwelling time ≥3 months elevated the risk of CVS ( OR=4.345, 95% CI 1.540-12.263, P=0.006). A subset of 268 patients who had AVF creation ipsilateral to CVS were analyzed to determine the effects of CVS on patency of AVF. The median follow-up time was 34 months. The primary patency rate of AVF in the moderate to severe CVS group was significantly lower than that in the non-CVS group (5/7 vs. 58/228, χ2=7.720, P=0.005). The primary patency rates of AVF in the subclavian vein stenosis group and superior vena cava stenosis group were significantly lower than those in the brachiocephalic vein stenosis group (4/5 vs. 8/27, χ 2=6.974, P=0.008; 6/8 vs. 8/27, χ 2=6.908, P=0.009, respectively). Moderate to severe CVS and combined diabetes were independent influencing factors of primary patency of AVF ( HR=4.362, 95% CI 1.644-11.574, P=0.003; HR=2.682, 95% CI 1.624-4.431, P<0.001, respectively). Conclusions:The incidence of CVS is higher in CKD patients who establish an arteriovenous fistula for the first time. Hemodialysis catheter indwelling time ≥3 months is an independent risk factor of CVS. The moderate to severe CVS is an independent risk factor of primary patency of AVF.
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Objective:To investigate the clinical outcomes of hemodialysis (HD) patients with stent grafts for arteriovenous access complications in real-world.Methods:It was a retrospective cohort study. Clinical data of HD patients treated with stent grafts for arteriovenous access complications from August 1, 2018 to December 31, 2021 in the First Affiliated Hospital of Zhengzhou University was collected to analyze target lesion primary patency (TLPP), target lesion primary assisted patency (TLPAP), and access circuit primary patency (ACPP) using the Kaplan-Meier survival analysis and Log-rank test, and to compare TLPP and mean annual intervention times between pre-stent grafts and post-stent grafts placement.Results:A total of 77 stent grafts in 71 patients were included according to the inclusion criteria, of which 46 (59.7%) were arteriovenous fistula (AVF) and 31 (40.3%) were arteriovenous graft (AVG), with a median follow-up time of 22.4 months. At 6, 12, 24, and 36 months after stent grafts deployment, TLPP was 89.3%, 66.5%, 48.3% and 42.5%, respectively. TLPAP was 94.8%, 90.4%, 78.7% and 75.4%, respectively. And ACPP was 77.2%, 54.3%, 35.2% and 29.0%, respectively. At subgroup analysis, there was no difference in TLPP at the three different sites of central vein, cephalic arch, and AVG venous anastomosis or outflow tract ( χ2=0.086, P=0.808). TLPP was better in the stenosis group than thrombosis or occlusion group, but was not statistically significant ( χ2=2.551, P=0.110). Compared with pre-stent grafts, TLPP improved significantly ( χ2=7.484, P=0.006), the median patency time increased from 16.6 months to 23.2 months, and the mean annual intervention times decreased from 0.99 (0.10, 1.83) to 0.50 (0, 1.45) ( Z=-2.841, P=0.004) after stent grafts placement Conclusion:The TLPP of HD patients with stent grafts for arteriovenous access complications improves significantly, and the mean annual intervention times reduce significantly.
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Objective:To investigate the impacts of hierarchical management based on medical alliance on the patency of arteriovenous graft (AVG),and provide a basis for further exploration of optimal AVG management.Methods:In this retrospective cohort study, clinical and follow-up data of patients with AVG established in the First Affiliated Hospital of Zhengzhou University from January 1, 2018 to December 31, 2021 were analyzed. Patients were divided into medical alliance group and non-medical alliance group according to whether they were under hierarchical management model, and the patency rate of AVGs and the incidence of clinical events were compared between the two groups.Results:A total of 328 AVGs were included in this study, which were from 151 hemodialysis centers, including 189 AVGs (57.6%) from 72 centers in medical alliance group, and 139 AVGs (42.4%) from 79 centers in non-medical alliance group. The age of the patients was (55.57±11.80) years, among whom 130 (39.6%) were males and 126 (38.4%) were diabetic. The follow-up time of AVGs in this cohort was 15.5 (9.5, 26.2) months, with 15.4 (9.8, 25.2) months in medical alliance group and 15.5 (9.2, 27.3) months in non-medical alliance group. The incidence of thrombosis or occlusion (0.328 times/patient-year), graft dissection (0.007 times/patient-year), graft infection (0.030 times/patient-year), and catheter utilization (0.043 times/patient-year) in the medical alliance group were lower than those in the non-medical alliance group (0.589 times/patient-year, 0.040 times/patient-year, 0.054 times/patient-year and 0.147 times/patient-year, respectively), and there was no significant difference in clinic follow-up rates between the two group (1.91 times/patient-year vs. 1.94 times/patient-year). The median primary patency time was 17.4 (95% CI 11.3-23.5) months, the median primary assisted patency time was 32.6 (95% CI 25.0-40.2) months, and the median secondary patency time was 47.9 (95% CI 40.0-55.8) months in the medical alliance group, compared with 12.3 (95% CI 9.4-15.2) months, 19.4 (95% CI 14.3-24.5) months, and 34.6 (95% CI 29.3-39.9) months in the non-medical alliance group, respectively. Primary patency were significantly higher in the medical alliance group (77.4%, 62.2%, 39.9%, and 26.6%) than those in the non-medical alliance group (71.1%, 50.1%, 30.6%, and 13.4%) at 6, 12, 24, and 36 months (Log-rank test, χ2=4.504, P=0.034). Primary assisted patency were significantly higher in the medical alliance group (90.9%, 84.3%, 67.1%, and 46.1%) than those in the non-medical alliance group (89.2%, 75.7%, 42.0%, and 16.6%) at 6, 12, 24, and 36 months (Log-rank test, χ2=10.655, P=0.001). Secondary patency were significantly higher in the medical alliance group (96.8%, 91.8%, 84.2%, and 74.0%) than those in the non-medical alliance group (89.9%, 85.8%, 69.3%, and 47.5%) at 6, 12, 24, and 36 months (Log-rank test, χ2=11.634, P=0.001). Multivariate Cox regression analysis showed that it was a protective factor for primary patency ( HR=0.708, 95% CI 0.512-0.980, P=0.037), primary assisted patency ( HR=0.506, 95% CI 0.342-0.749, P=0.001) and secondary patency ( HR=0.432, 95% CI 0.261-0.716, P=0.001) under the medical alliance model. Conclusion:The hierarchical management based on medical alliances can improve the patency of AVGs and reduce the incidence of clinical events.
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Bile acids(BAs)are synthesized by the liver from cholesterol through several complementary pathways and aberrant cholesterol metabolism plays pivotal roles in the pathogeneses of cholesterol gallbladder polyps(CGP)and cholesterol gallstones(CGS).To date,there is neither systematic study on BAs profile of CGP or CGS,nor the relationship between them.To explore the metabolomics profile of plasma BAs in healthy volunteers,CGP and CGS patients,an ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)method was developed and validated for simultaneous determination of 42 free and conjugated BAs in human plasma.The developed method was sensitive and reproducible to be applied for the quantification of BAs in the investigation of plasma samples.The results show that,compared to healthy volunteers,CGP and CGS were both characterized by the significant decrease in plasma BAs pool size,furthermore CGP and CGS shared aberrant BAs metabolic characteristics.Cheno-deoxycholic acid,glycochenodeoxycholic acid,λ-muricholic acid,deoxycholic acid,and 7-ketolithocholic acid were shared potential markers of these two cholesterol gallbladder diseases.Subsequent analysis showed that clinical characteristics including cysteine,ornithine and body mass index might be closely related to metabolisms of certain BA modules.This work provides metabolomic information for the study of gallbladder diseases and analytical methodologies for clinical target analysis and efficacy evaluation related to BAs in medical institutions.
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Objective:To investigate the risk factors for catheter-related bloodstream infection (CRBSI) in hemodialysis (HD) patients with tunnel-cuffed catheter (TCC) and construct a risk prediction model for the prevention and treatment of catheter infection.Methods:It was a retrospective study. Patients who had their TCC removed in Hemodialysis Access Center of the First Affiliated Hospital of Zhengzhou University from July to December 2020 were randomly divided into a training set (for model building) and a validation set (for model validation) in the ratio of 7∶3. The training set was divided into CRBSI group and non-CRBSI group with reference to the 2019 Kidney Disease Outcomes Quality Initiative clinical practice guidelines for vascular access, and the risk factors for the occurrence of CRBSI were analyzed. The odds ratio ( OR) values of the variables in the multivariate logistic regression analysis were applied to construct a risk prediction model, and the assessment ability of the model was validated in the validation set. Results:A total of 254 HD patients were included. The training set consisted of 179 patients with male-to-female ratio of 1.36∶1, age of (55.81±15.95) years old, median dialysis age of 18(8, 27) months, median TCC retention time of 15(5, 24) months, and 40 patients with confirmed CRBSI. Logistic regression analysis showed that, combined diabetes ( OR=2.711, 95% CI 1.174-6.258, P=0.019), history of catheter-related infection within 3 months ( OR=3.674, 95% CI 1.541-8.760, P=0.003), more than 4 times nursing interventions within 1 month ( OR=3.128, 95% CI 1.343-7.283, P=0.008), and central venous disease ( OR=2.572, 95% CI 1.130-5.854, P=0.024) were the independent influencing factors for CRBSI occurrence in HD patients with TCC. The OR values of the variables in the multivariate logistic regression were rounded to the assigned scores of the risk prediction model. The corresponding scores of each factor were summed in the training set to obtain the risk score. The receiver operating characteristic (ROC) curve was plotted, with area under the curve ( AUC) of 0.761(0.683-0.839) and maximum Youden index of 0.461, at which time the corresponding cut-off value was 6, with sensitivity of 90.0% and specificity of 56.1%. The model was validated in the validation set with AUC of 0.794(0.674-0.914) and cut-off value of 6, with sensitivity of 61.6% and specificity of 82.5%. Conclusions:Combined diabetes, history of catheter-related infection within 3 months, more than 4 times nursing interventions within 1 month, and central venous disease are the independent risk factors for CRBSI, and the prediction model based on the above factors has good efficacy in predicting the risk of CRBSI and can provide guidance for the prevention and treatment of CRBSI in HD patients.
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Objective:To investigate the patency rates and risk factors of arteriovenous graft (AVG), and provide a clinical guidance for further optimization of vascular access selection and improvement of dialysis quality.Methods:This was a retrospective study. The clinical and follow-up data of patients who received AVG in the Blood Purification Center, First Affiliated Hospital of Zhengzhou University from January 1, 2017 to December 31, 2021 were selected. Kaplan-Meier curve and Cox regression model were used to analyze the patency rates and risk factors of AVG.Results:A total of 381 cases with AVG were included, with 154 cases (40.4%) of males, age of (55.5±11.8) years old, and 140 cases (36.7%) of diabetes. The median time of primary patency was 377.00(95% CI 314.26-439.74) days, and the primary patency rates at 1, 2, and 3 years were 51.0%, 30.7%, and 15.4%, respectively. The median time of primary assisted patency was 839.00(95% CI 668.89-1 009.11) days, and the primary assisted patency rates at 1, 2, and 3 years were 78.3%, 56.4%, and 39.1%, respectively. The secondary patency rates at 1, 2, and 3 years were 96.7%, 90.1%, and 78.5%, respectively. Multivariate Cox regression analysis results showed that anastomotic vein types of basilic vein and cephalic vein (median cubital vein as a reference, HR=1.869, 95% CI 1.124-3.107, P=0.016; HR=2.110, 95% CI 1.176-3.786, P=0.012) and the diameter of anastomotic vein<3.5 mm ( HR=1.411, 95% CI 1.020-1.952, P=0.037) were the independent influencing factors for abnormal primary patency of AVG. Males ( HR=1.680, 95% CI 1.127-2.503, P=0.011), mean arterial pressure<70 mmHg ( HR=3.228, 95% CI 1.109-9.394, P=0.032), Acuseal graft type (Intering as a reference, HR=1.884, 95% CI 1.185-2.994, P=0.007), anastomotic vein type of cephalic vein (median cubital vein as a reference, HR=2.817, 95% CI 1.328-5.977, P=0.007), the diameter of anastomotic vein<3.5 mm ( HR=1.555, 95% CI 1.048-2.306, P=0.028), serum phosphorus ≤1.78 mmol/L (1.13-1.78 mmol/L />1.78 mmol/L, HR=1.737, 95% CI 1.111-2.716, P=0.015;<1.13 mmol/L />1.78 mmol/L, HR=2.162, 95% CI 1.072- 4.362, P=0.031), and ferritin<200 μg/L ( HR=1.850, 95% CI 1.231-2.780, P=0.003) were the independent influencing factors for abnormal primary assisted patency of AVG. Serum albumin<40 g/L ( HR=2.165, 95% CI 1.096-4.275, P=0.026) was an independent influencing factor for abnormal secondary patency of AVG. Conclusions:The primary patency rates of AVG at 1, 2, and 3 years were 51.0%, 30.7%, and 15.4%, respectively. The secondary patency rates of AVG at 1, 2, and 3 years were 96.7%, 90.1%, and 78.5%, respectively. Anastomotic vein types of cephalic vein and basilic vein, and internal diameter<3.5 mm are the independent risk factors for abnormal primary patency of AVG. Anastomotic vein type of cephalic vein and internal diameter<3.5 mm are the independent risk factors for abnormal assisted primary patency of AVG. Serum albumin<40 g/L is an independent risk factor for abnormal secondary patency of AVG. It is suggested that systematic preoperative evaluation and good nutritional status of patients are important to maintain long-term patency of the AVG.
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Objective@#To investigate the effect of long-term exposure of nitrogen dioxide on the incidence of hypertension.@*Methods@#From March to December 2009, 37 386 eligible residents from four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) were enrolled in a follow-up study by using the random cluster sampling method. Demographic characteristics, lifestyle, history of diseases, and self-report situation of hypertension were collected by using questionnaire. Based on the average annual concentration of NO2 during the period from the cohort to the onset of hypertension as an estimate of exposure, the effect of NO2 exposure on hypertension was analyzed by employing Cox proportional hazards model. The interactions between NO2 exposure and different characteristics (age, sex, body mass index, smoking, alcohol consumption, education, economy, exercise, and fruit intake) were also examined.@*Results@#The baseline age of residents was (43.74±13.78) years, and the body mass index (BMI) was (22.56±2.92) kg/m2. During an average follow-up time of 11.40 years, 2 619 (7.0%) new cases of hypertension were reported. The overall mean environmental pollution levels during the study period for the entire cohort was (40.74±17.07) μg/m3. After adjusting for age, sex, BMI, family history of hypertension, socio-economic information, and lifestyle, the hazard ratio (HR) of incident hypertension with a 10 μg/m3 increase of NO2 was 1.21 (95%CI: 1.18-1.25). Compared with residents aged 60 years and over (HR=1.19, 95%CI: 1.14-1.26), former and current smoking (HR=1.20, 95%CI: 1.14-1.25), and high-frequency fruit consumption (HR=1.17, 95%CI: 1.13-1.21), residents younger than 60 years (HR=1.28, 95%CI: 1.25-1.32), non-smoker (HR=1.23, 95%CI: 1.19-1.27), and low-frequency fruit consumption (HR=1.27, 95%CI: 1.20-1.35) had stronger interaction effect with NO2 (all P values for interaction<0.05).@*Conclusion@#NO2 exposure may lead to the onset of hypertension, which has a stronger effect on people younger than 60 years old, without smoking history and with low-frequency fruit consumption.
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OBJECTIVE: To investigate the effects of Enalapril maleate folic acid tablets on carotid atherosclerosis in H type hypertension patients with type 2 diabetes mellitus (T2DM) and its potential mechanism.METHODS: In prospective control study, 182 H type hypertension patients with T2DM were selected from Chongqing People's Hospital during Jan. 2014-Jan. 2016, and then randomly divided into observation group and control group, with 91 cases in each group. All patients received basic or hypoglycemic treatment of premixed insulin; observation group was additionally given Enalapril maleate folic acid tablets (containing enalapril maleate 10 mg, folic acid 0. 8 mg in each tablet) orally, one tablet, qd; control group was additionally given Enalapril maleate tablets (containing enalapril maleate 10 mg in each tablet) orally, one tablet, qd. Treatment course lasted for 12 months. The levels of blood pressure, plasma homocysteine (Hcy), fasting blood glucose (FBG), C-reactive protein (CRP) and carotid plaque score were detected in 2 groups before treatment, 12 months after treatment. RESULTS: Compared to before treatment, SBP and DBP of 2 groups were decreased significantly in 2 groups after 12 months of treatment (P<0. 05); there was no statistical significance between 2 groups (P>0. 05). The levels of plasma Hcy, FBG and CRP, carotid intima-media thickness and carotid plaque integral in observation group were significantly lower than control group (P<0. 05). CONCLUSIONS: Enalapril maleate folic acid tablets can relieve inflammation by reducing plasma Hcy, FBG and CRP so as to treat carotid atherosclerosis in H type hypertension patients with T2DM.
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OBJECTIVE:To compare clinical efficacy and safety of intravenous dripping of methotrexate and uterine arterial perfusion embolization combined with complete curettage of uterine cavity (CCUC) in the treatment of cesarean scar pregnancy (CSP).METHODS:A total of 90 CSP patients were randomly divided into group A and B,with 45 cases in each group.Group A was given Methotrexate (MTX) injection 50 mg/m2 intravenously before CCUC.Group B received Seldinger catheterization in supine position before CCUC,and was given sequential infusion of MTX injection 50 mg/m2 and gelatin sponge particles into the uterine artery;the catheter was removed after satisfactory embolization by imaging examination.The levels of β-HCG of 2 groups were reexamined every 24 h,and CCUC was performed when serum β-HCG level was below 1 000 mU/mL.Perioperative bleeding volume,postoperative bleeding volume,the time of blood β-HCG returning to normal,the time of menstruation returning to normal,hospitalization time as well as the lesion diameters,the levels of blood β-HCG,the occurrence of compliance and ADR before and after treatment were compared between 2 groups.RESULTS:The intraoperative bleeding amount and postoperative bleeding amount of group B were significantly lower than those of group A,while the time of blood β-HCG returning to normal,the time of menstruation returning to normal and hospitalization time were significantly shorter than group A,and the incidence of total compliance was significantly lower than group A,with statistical significance (P<0.05).Before medication,there was no statistical significance in lesion diameters between 2 groups (P>0.05).Before CCUA,the lesion diameters of 2 groups were significantly smaller than before medication,and the group B was significantly smaller than group A,with statistical significance (P<0.05).Before medication,there was no statistical significance in blood β-HCG levels between 2 groups (P>0.05).Before and after CCUC,blood ββHCG levels of 2 groups were significantly lower than before medication,and the group B was significantly lower than group A,with statistical significance (P<0.05).There was no statistical significance in the incidence of ADR between 2 groups (P>0.05).CONCLUSIONS:Compared with methotrexate by intravenous drip,methotrexat by uterine artery embolization combined with CCUC for CSP can effectively reduce intraoperative bleeding amount,promote the decrease of blood β-HCG and menstrual recovery,and contribute to the reduction of complication risk with good safety.
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To study the chemical constituents from the bark of Myrica rubra, fourteen compounds were isolated from the methanolic extract using various chromatographic techniques, including silica gel, Sephadex LH-20 and preparative HPLC. Their structures were identified on the basis of chemical properties and spectroscopic data, as 3, 5-dimethoxy-4-hydroxymyricanol (1), myricanol (2), myricanone (3), myricanol 11-sulfate (4), myricitrin (5), quercetin (6), quercetin-3-rhamnoside (7), tamarixol (8), uvaol (9), ursolic acid (10), taraxerol (11), myricadiol (12), β-sitosterol (13) and β-daucosterol (14). Among them, compound 1 is a new compound, named as 3, 5-dimethoxy-4-hydroxymyricanol, compounds 8, 9 were isolated from the genus Myrica for the first time.
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OBJECTIVE@#To explore the imaging characteristics of cerebral stenosis and peripheral vascular stenosis in patients with ischemic stroke. @*METHODS@#The data collected from 1 060 patients with ischemic stroke, who were examined by cerebral angiography and abdominal angiography, were retrospectively analyzed. All relevant parameters for atherosclerosis were recorded. Then the correlation of cerebrovascular stenosis with peripheral vascular stenosis was analyzed, and the risk factors of multi-artery stenosis and ulcerative plaque were examined. @*RESULTS@#Peripheral vascular stenosis was closely correlated to cerebrovascular stenosis (r=0.236, P<0.01). The stenosis degree and quantity of cerebrovascular were positively correlated with peripheral vascular stenosis (r=0.228, P<0.01; r=0.231, P<0.01). The age (OR=1.059, 95% CI: 1.015-1.117; P<0.05), smoking (OR=3.423, 95% CI: 1.524-7.780; P<0.01) and diabetes (OR=3.651, 95% CI: 1.536-8.425; P<0.01) were risk factors for the occurrence of multi-artery stenosis. But the risk factor of ulcerative plaque was not found by single factor analysis. @*CONCLUSION@#The cerebral angiography combined abdominal angiography is an effective method to identify cerebrovascular and peripheral vascular stenosis in the patients with stroke. Age, smoking and diabetes are independent risk factors for multi-artery stenosis in patients with ischemic stroke.
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Humains , Athérosclérose , Anatomopathologie , Angiographie cérébrale , Sténose pathologique , Facteurs de risque , Accident vasculaire cérébral , DiagnosticRésumé
@#As one of the first-line antipsychotic drugs, olanzapine(OLA)inducing insulin resistance and metabolic disorder has become a serious clinical concern. This study aimed at investigating the effect of OLA on white adipose tissue(WAT)beiging as a potential mechanism behind its metabolism-disturbing effects. C57BL6/J mice were orally administered with low and high-dose OLA(4, 8 mg/kg, once daily)for 28 consecutive days; body weight and food intake were recorded every other day. Mice were subjected to glucose-tolerance test(GTT)and a cohort from each group was challenged with cold stress for 36 h before sacrifice. The perirenal, epididymal and inguinal WAT were carefully dissected, weighed and processed separately for hematoxylin-eosin staining, UCP-1 immunohistochemical and Western blot analysis. The results showed that OLA induced significant impairment in basal heat generation and glucose regulation. There were fewer beige adipocytes in the inguinal WAT after OLA treatment. The beiging of inguinal WAT in response to cold stress was significantly inhibited in OLA-treated mice. Mechanistically, OLA induced the activation of mTOR-Notch pathway, as evidenced by a significant increase in phosphorylated mammalian target of rapamycin(p-mTOR)and intracellular domain of Notch1(N1ICD)expression. Together, our study reveals that the inhibitory effects on WAT beiging may explain the propensity of OLA to induce metabolic disturbance, and mTOR-Notch pathway activation could play key roles in this effect. Future validation and elucidation of these novel findings are expected to provide novel insights into the metabolic risks of OLA and related second generation antipsychotics, which may lead to innovative intervention strategies in the clinic.
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Objective To observe the variation of the levels of γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis before and after treatment.Methods A total of 159 patients with brucellosis were enrolled from the Second People's Hospital of Tianjin between September 2009 and August 2014,of which 122 were with acute phase and 37 with subacute stage.γδT cells,CD4+ and CD8+ T lymphocytes in peripheral blood of all patients before and after treatment were detected by flow cytometry.Thirty healthy controls were also enrolled.Measurement data were analyzed using t test and nonparametric Kruskal-Wallis test.Results The medians of γδT cells,CD4+ and CD8+ T lymphocyte counts of brucellosis patients with acute stage before treatment were 84.0/μL,780.5/μL and 774.0/μL,respectively,and those with subacute stage were 76.0/μL,887.0/μL and 890.0/μL,respectively.Those in control group were 49.0/μL,772.5/μL and 592.5/μL,respectively.γδT cells (U=114.5,P =0.001) and CD8+ T lymphocyte counts (U=1 185.5,P =0.003) in acute phase group were elevated than control group.γδT cells (U=359.0,P=0.013),CD4+ T lymphocyte counts (U=325.5,P=0.004) and CD8+ T lymphocyte counts (U=316.5,P=0.003) in subacute phase group were increased than control group.CD4+ T lymphocyte counts in subacute phase group were elevated than acute phase group (U=1 619.0,P=0.009).There were 31 patients with acute phase and 30 patients with subacute phase who completed 6-week treatment.γδT cells ([120.7 ± 104.9]/μL vs [82.2 ±85.3]/μL;t=3.568,P=0.001),CD4+ T lymphocyte ([802.1±300.6]/μL vs [663.0±280.6]/μL;t=2.904,P=0.007) and CD8+ T lymphocytes counts ([908.1±422.7]/μL vs [651.1±241.7]/μL;t=3.885,P=0.001) of brucellosis patients with acute stage before and after treatment were significantly different.γδT cells ([67.1± 38.4]/μL vs [48.4±32.1]/μL;t=2.695,P=0.012),CD4+ T lymphocytes ([817.1± 147.4]/μL vs [650.8± 196.5]/μL;t=5.301,P<0.01) and CD8+ T lymphocytes counts ([703.7±191.5]/μL vs [537.4±186.0]/μL;t=5.152,P<0.01) of brucellosis patients with subacute stage after treatment were significantly decreased compared with those of patients before treatment.Conclusions γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis are all in a state of immune activation.The levels of activation are highly correlated with disease progression.And detection of the variation of these cells contributes to understand the immune state of the acute and subacute brucellosis.
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Objective To promote the idea and practice of truthful conduct of research among fellow researchers by creating a research integrity training mode for Chinese postgraduates.Methods Based on the RCR (Responsible Conduct of Research) training module,a common research education initiative adopted by many American research institutes,and through literature review and social science study,this paper explored the idea of develop a research integrity training mode for Chinese postgraduates.Results A thorough explanation and analysis was given to the five major aspect of research integrity training mode,including theoretical basis,training objectives,operational procedure,neces sary conditions for application and training evaluation.Conclusion Research integrity training is one of the most important contents of graduate education,and a well designed training mode is the first and foremost step of developing a responsible and credible environment in academia of China.
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Depending on the performance,Type of management of medical scientific research managers is divided into four basic management types of positive push type,upload issued type,passive type,the individual barrier type.In addition,factors of management,management performance and the quality of recruits are resolved corresponding to the management type,and have proposed the corresponding practice and management recommendations from two angles of medical research managers and the upper decision makers.
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Atherosclerosis is a chronic inflammatory disease.Atherosclerotic plaque rupture and thrombosis may result in cardio-cerebrovascular events.Inflammatory mediator CD40L widely exists in cells associated with atherosclerosis.They participate in plaque inflammatory response,release proinflammatory cytokines,degrade extracellular matrix,improve procoagulant activity,and promote the progression of atherosclerosis and plaque vulnerability.Intervening CD40/CD40L signaling system may become an effective treatment strategy to slow the progress of atherosclerosis and stabilize atherosclerotic plaques.
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Cathepsin S is one of the cathepsins that distributes generally at lysosomes of histiocyte in humans body.It has variety of actions when it is unbalancing,including promote inflammation,atherosclerosis,diabetes and obesity,etc.Studies in recent years have demonstrated that there are certain correlations of adiponectin with vascular risk factor and cerebrovascular disease.
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ObjectiveTo observe the virological and immunological items in peripheral blood of Chinese-origin Rhesus macaques infected with SIVmac251.The normal levels of WBC and CD4+T cell ratio for healthy Chinese-origin Rhesus macaques that suitable for simian AIDS modeling also investigated.MethodsThirty-six Chinese-origin Rhesus macaques were intravenously infected with SIVmac251.Blood samples were collected at 10 time points respectively include 1 day before SIV infection,every week within 1-8th week and then in tenth week post infection.Blood routine,peripheral blood T lymphocyte subsets,plasma viral load were tested.ResultsThe most significant changes of the tested items were appeared in 1 or 2 weeks post SIV infection,while the WBC counts didn't show marked changes in all the time points tested.WBC counts ranged from 4×106/ml to 10×106/ml and the CD4+T cells ratio high than 25% are the suitable levels for simian AIDS modeling.ConclusionThis research provides necessary and beneficial informations to the usage of Chinese-origin Rhesus macaques in AIDS research.
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This paper based on overall design and research framework of national major science and technology program's selection and outputs in population and health Field,further proposed basic principles,specific content and selected basis.Then several problems had been discussed on.It can play a role to improve the science and technology program' s selection and outputs evaluation and management hopefully.