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OBJECTIVES@#To understand the growth and development status and differences between small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants during corrected ages 0-24 months, and to provide a basis for early health interventions for preterm infants.@*METHODS@#A retrospective study was conducted, selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022, including 144 SGA and 680 AGA infants. The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared.@*RESULTS@#The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months (P<0.05), while there were no significant differences between the two groups at corrected age 24 months (P>0.05). At corrected age 24 months, 85% (34/40) of SGA and 79% (74/94) of AGA preterm infants achieved catch-up growth. Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age <34 weeks and the AGA subgroups with gestational age <34 weeks and 34 weeks (P<0.05). In addition, the weight and length of the SGA subgroup with gestational age 34 weeks showed significant differences compared to the AGA subgroups with gestational age <34 weeks and 34 weeks at corrected ages 0-18 months and corrected ages 0-12 months, respectively (P<0.05). Catch-up growth for SGA infants with gestational age <34 weeks and 34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months, respectively.@*CONCLUSIONS@#SGA infants exhibit delayed early-life physical growth compared to AGA infants, but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants. Catch-up growth can be achieved earlier in SGA infants with a gestational age of <34 weeks compared to those with 34 weeks.
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Nouveau-né , Enfant , Nourrisson , Femelle , Humains , Enfant d'âge préscolaire , Prématuré , Âge gestationnel , Études longitudinales , Études rétrospectives , Nourrisson petit pour son âge gestationnelRésumé
ObjectiveTo establish a qualitative and quantitative analysis method for chemical constituents in Liu Junzitang(LJZT), and to clarify its material basis. MethodThe chemical constituents in LJZT were analyzed by ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS), and the resulting compounds were identified by using databases, such as MassBank, PubChem, ChemSpider, Traditional Chinese Medicine Systems Pharmacology Database and Analytical Platform(TCMSP), and by combining with relevant literature. UPLC was used to establish a quantitative method for analysis of 9 compounds in LJZT, including liquiritin, hesperidin, lobetyolin, liquiritigenin, glycyrrhizic acid, nobiletin, tangeretin, atractylenolide Ⅱ and Ⅰ. ResultBy combining the relevant literature, database and MS information, a total of 79 compounds were identified from LJZT, including 31 flavonoids, 15 terpenoids, 14 nitrogen-containing compounds, 6 phenylpropanoids, 6 organic acids and 7 other compounds. The established quantitative analytical method for the nine representative components showed good linearity within their respective linear ranges, and the precision, stability, reproducibility and recovery were in accordance with the requirements. The quantitative results showed that the contents of liquiritin, hesperidin, lobetyolin, liquiritigenin, glycyrrhizic acid, nobiletin, tangeretin, atractylenolide Ⅱ and Ⅰ in LJZT were 0.376 5, 2.602 1, 0.082 6, 0.128 1, 1.778 6, 0.015 7, 0.006 7, 0.030 4, 0.003 2 mg·g-1, respectively. ConclusionThe established method can quickly, sensitively and accurately analyze the chemical constituents in LJZT, clarify that the material basis of LJZT is mainly flavonoids, terpenoids and nitrogen-containing compounds, and simultaneously determine the contents of the 9 components, which can lay a foundation for the research on quality control, mechanism and clinical application of LJZT.
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Objective: To analyze the clinical characteristics and risk factors of protein energy wasting (PEW) in children with chronic kidney disease (CKD). Methods: Clinical data of 231 children with chronic kidney disease hospitalized in Beijing Children's Hospital affiliated to Capital Medical University from January 2018 to January 2023 were retrospectively analyzed to explore the incidence of PEW. According to the diagnostic criteria of CKDPEW, they were divided into a CKDPEW group and a non PEW group. The comparison between the groups was performed by independent-sample t test and Chi-squared test, and the risk factors were analyzed by multivariate Logistic regression. Results: Among the 231 children, there were 138 males and 93 females, with a visiting age of 9.9 (7.9, 16.0) years; 6 cases were in stage 1, 14 cases in stage 2, 51 cases in stage 3, 36 cases in stage 4, and 124 cases in stage 5. A total of 30 children (13.0%) with CKD PEW were diagnosed at the age of 7. 1 (3.8, 13.2) years, including 1 case in stage 1, 1 case in stage 2, 5 cases in stage 3, 5 cases in stage 4, and 18 cases in stage 5. There were a total of 201 cases (87.0%) in the non PEW group, diagnosed at the age of 11.8 (8.5, 12.2) years, including 5 cases in stage 1, 13 cases in stage 2, 46 cases in stage 3, 31 cases in stage 4, and 106 cases in stage 5. The Chi-squared test and t test showed that the systolic blood pressure, diastolic blood pressure, birth weight and carbon dioxide binding capacity of the CKD PEW group were lower than those of the non PEW group ((109±22) vs. (120±20) mmHg (1 mmHg=0.133 kPa), (72±19) vs. (79±16) mmHg, (2.9±0.5) vs. (3.2±0.6) kg, (17±4) vs. (19±4) mmol/L,t=2.85, 2.14, 0.67, 2.63, all P<0.05). Multivariate logistic regression analysis showed that carbon dioxide binding capacity and birth weight were independent protective factors of CKDPEW in children (OR=0.81 and 0.36, 95%CI=0.73-0.90 and 0.17-0.77, respectively; both P<0.01); the risk of PEW in CKD children decreased by 0.187 times for every 1 mmol/L increment in carbon dioxide binding capacity, and 0.638 times for every 1 kg increment in birth weight. Conclusions: The incidence of protein energy expenditure in children with chronic kidney disease is lower than that in the previous researches. PEW can appear in CKD 1-2 stage, and attention should be paid to it in the early stage of CKD in clinical practice. Low birth weight CKD children are susceptible to PEW, and actively correcting metabolic acidosis can reduce the risk of CKDPEW.
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Humains , Enfant , Adolescent , Mâle , Femelle , Insuffisance rénale chronique/épidémiologie , Métabolisme énergétique , Malnutrition protéinocalorique/épidémiologie , Facteurs de risque , Protéines/métabolisme , Chine/épidémiologieRésumé
OBJECTIVE@#To investigate the effects of the pre-shock state on the mortality of patients with sepsis.@*METHODS@#We enrolled patients with sepsis admitted to the medical intensive care unit of a tertiary care university hospital. These patients were then classified into three groups: sepsis, pre-shock state, and septic shock. The primary outcome was the 28-day mortality rate. The secondary outcomes were the 90-day, 180-day, and 1-year mortality rates.@*RESULTS@#A total of 303 patients (groups: sepsis 135 [44.6%]), pre-shock state (93 [30.7%]), and septic shock (75 [24.8%]) completed the 1-year follow-up. The mortality rates at 28 days, 90 days, and 180 days and 1 year were significantly higher in the pre-shock state group than those of the sepsis group, but significantly lower than those in the septic shock group, especially among older patients. When compared with the pre-shock state group, the sepsis group had significantly lower mortality risks at 28 days, 90 days, and 180 days and 1 year, whereas the sepsis shock group had higher mortality risks at these time points.@*CONCLUSION@#The mortality rates of patients in the pre-shock state were notably different from those of patients with sepsis or septic shock. The introduction of a modified sepsis severity classification, which includes sepsis, pre-shock state, and septic shock, could offer valuable additional prognostic information.
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Humains , Choc septique , Études rétrospectives , Sepsie , Hospitalisation , UniversitésRésumé
Objective: To explore the family rehabilitation model for children with scar contracture after hand burns and observe its efficacy. Methods: A retrospective non-randomized controlled study was conducted. From March 2020 to March 2021, 30 children with scar contracture after deep partial-thickness to full-thickness burns of hands, who met the inclusion criteria, were hospitalized in the Burn Center of PLA of the First Affiliated Hospital of Air Force Medical University. According to the rehabilitation model adopted, 18 children (23 affected hands) were included in a group mainly treated by family rehabilitation (hereinafter referred to as family rehabilitation group), and 12 children (15 affected hands) were included in another group mainly treated by hospital rehabilitation (hereinafter referred to as hospital rehabilitation group). In the former group, there were 11 males and 7 females, aged (4.8±2.1) years, who began rehabilitation treatment (3.1±0.8) d after wound healing; in the latter group, there were 7 males and 5 females, aged (4.6±2.1) years, who began rehabilitation treatment (2.8±0.7) d after wound healing. The children in hospital rehabilitation group mainly received active and passive rehabilitation training in the hospital, supplemented by independent rehabilitation training after returning home; after 1-2 weeks of active and passive rehabilitation training in the hospital, the children in family rehabilitation group received active and passive rehabilitation training at home under the guidance of rehabilitation therapists through WeChat platform. Both groups of children were treated for 6 months. During the treatment, they wore pressure gloves and used hand flexion training belts and finger splitting braces. Before treatment and after 6 months of treatment, the modified Vancouver scar scale, the total active movement of the hand method, and Carroll quantitative test of upper extremity function were used to score/rate the scar of the affected hand (with the difference of scar score between before treatment and after treatment being calculated), the joint range of motion (with excellent and good ratio being calculated), and the function of the affected limb, respectively. Data were statistically analyzed with independent sample t test, equivalence test, Fisher's exact probability test, and Mann-Whitney U test. Results: The differences of scar scores of the affected hands of children in family rehabilitation group and hospital rehabilitation group between after 6 months of treatment and those before treatment were 3.0 (2.0, 7.0) and 3.0 (2.0, 8.0) respectively (with 95% confidence interval of 2.37-5.38 and 1.95-5.91). The 95% confidence interval of the difference between the differences of the two groups was -2.43-2.21, which was within the equivalent boundary value of -3-3 (P<0.05). The excellent and good ratios of joint range of motion of the affected hand of children in family rehabilitation group and hospital rehabilitation group were 3/23 and 2/15 respectively before treatment, and 15/23 and 12/15 respectively after 6 months of treatment. The ratings of joint range of motion of the affected hand of children in family rehabilitation group and hospital rehabilitation group after 6 months of treatment were significantly higher than those before treatment (with Z values of 3.58 and 2.30, respectively, P<0.05), but the ratings of joint range of motion of the affected hand between the two groups were similar before treatment and after 6 months of treatment (with Z values of 0.39 and 0.55, respectively, P>0.05). The functional ratings of the affected limbs of children in family rehabilitation group and hospital rehabilitation group after 6 months of treatment were significantly higher than those before treatment (with Z values of 3.98 and 3.51, respectively, P<0.05), but the functional ratings of the affected limbs between the two groups were similar before treatment and after 6 months of treatment (with Z values of 1.27 and 0.38, respectively, P>0.05). Conclusions: The WeChat platform assisted rehabilitation treatment with mainly family rehabilitation, combined with hand flexion and extension brace can effectively reduce the scarring after children's hand burns, improve the joint range of motion of the affected hands, and promote the recovery of affected limb function. The effect is similar to that of hospital-based rehabilitation providing an optional rehabilitation, treatment method for children who cannot continue to receive treatment in hospital.
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Mâle , Femelle , Humains , Enfant , Cicatrice/thérapie , Études rétrospectives , Résultat thérapeutique , Cicatrisation de plaie , Blessures de la main/rééducation et réadaptation , Traumatismes du poignet , Contracture/étiologie , Brûlures/complicationsRésumé
OBJECTIVE@#To evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) versus systemic thrombolysis (ST) in the treatment of pulmonary embolism (PE).@*METHODS@#The Cochrane Library, PubMed, and Embase databases were searched to collect the literature on the comparison of the results of CDT and ST in the treatment of PE from the beginning of their records to May 2020, and meta-analysis was performed by STATA software (version 15.1). Using standardized data-collection forms, the authors screened the studies and independently extracted data, and assessed the quality of the studies using the Newcastle-Ottawa Scale for cohort studies. Cohort studies that examined the following results were included in the current study: in-hospital mortality, all-cause bleeding rate, gastrointestinal bleeding rate, intracranial hemorrhage rate, the incidence of shock, and hospital length of stay.@*RESULTS@#A total of eight articles, with 13,242 participants, involving 3962 participants in the CDT group and 9280 participants in the ST group were included. CDT compared with ST in the treatment of PE can significantly affect in-hospital mortality rate [odds ratio (OR) = 0.41, 95% CI: 0.30-0.56, P < 0.05], all-cause bleeding rate (OR = 1.20, 95% CI: 1.04-1.39, P = 0.012), gastrointestinal bleeding rate (OR = 1.43, 95% CI: 1.13-1.81, P = 0.003), the incidence of shock (OR = 0.46, 95% CI: 0.37-0.57, P < 0.05), and hospital length of stay [standard mean difference (SMD) = 0.16, 95% CI: 0.07-0.25, P < 0.05]. However, there was no significant effect on intracranial hemorrhage rate in patients with PE (OR = 0.70, 95% CI: 0.47-1.03, P = 0.070).@*CONCLUSIONS@#CDT is a viable alternative to ST in the treatment of PE, as it can significantly reduce in-hospital mortality rate, all-cause bleeding rate, gastrointestinal bleeding rate, and incidence of shock. However, CDT may prolong hospital length of stay to a certain extent. Further research is needed to evaluate the safety and efficacy of CDT and ST in the treatment of acute PE and other clinical outcomes.
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Objective:To explore the risk factors for lower extremity deep vein thrombosis (DVT) in patients with a spinal cord injury (SCI).Methods:The medical records of 276 hospitalized SCI patients were analyzed retrospectively. They were divided into a DVT group ( n=63) and a no-DVT group ( n=213). Gender, age, blood type, smoking history, surgical history, the time from SCI to admission, cause of SCI, fracture, SCI segments, American Spinal Cord Injury Association grade and complications were compared between the two groups. Binomial logistic regression was used to isolate the risk factors for lower extremity DVT among such patients. Results:Among 84% of the 63 with a lower extremity DVT, it was a calf muscle venous thrombosis. Anemia, hyponatremia and time from SCI to admission (which ranged from 74 to 195 days) were the most serious DVT risk factors.Conclusions:SCI patients are of high risk for DVT, with anemia and hyponatremia being independent risk factors.
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Objective:To explore the risk factors for urinary tract infection (UTI) after a spinal cord injury (SCI).Methods:The medical records of 403 SCI patients were analyzed retrospectively. They were divided into UTI group and no-UTI group according to whether they had a UTI at admission. Gender, age, cause of injury, injury level of the spinal cord, voluntary anal contraction, time from injury to admission, American Spinal Injury Association (ASIA) grade, axillary temperature at admission, complications at admission (diabetes, hypertension, fracture of the pelvis, pressure sores or anemia), white blood cell count and urinary bacteria were compared between the two groups. Binary logistic regression was used to highlight the risk factors for a UTI after an SCI.Results:Of the 354 patients included in the final analysis, 62 (17.51%) had a UTI at admission. The regression showed that UTI after an SCI was closely related to an inability to voluntarily contract the anus, anemia, elevated white blood cell count and a high level of bacteria in the urine.Conclusions:Inability to contract the anus, fever, anemia and an elevated white blood cell count are independent indicators of a UTI after an SCI. A temperature ≥37.3°C is a simple indicator of a concentration of bacteria in the urine ≥1266/μL.
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Tibet orbivirus (TIBOV) was identified as a novel orbivirus in 2014. Antibodies against TIBOV were detected in cattle, Asian buffalo, and goats, while all the sequenced TIBOV strains were isolated from mosquitos and Culicoides. The known TIBOV strains have been classified into four putative serotypes. In this study, two TIBOV strains isolated from Culicoides spp. in Shizong County of Yunnan Province, China, were fully sequenced. The phylogenetic analysis of outer capsid protein 2 (VP2) indicated that these two viral strains belong to two novel putative serotypes of TIBOV. The updated putative serotypes may help in an investigation of the distribution and virulence of TIBOV.
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Malignant mesothelioma is a highly malignant disease that most often occurs in the pleural cavity, followed by the peritoneum and pericardium. Malignant peritoneal mesothelioma (MPM) accounts for 10%-15% of all mesothelioma. The most important risk factor for MPM is exposure to asbestos. MPM has no specific clinical symptoms, imaging and histopathology are critical for the diagnosis. There are currently no generally accepted guidelines for curative treatment of MPM. The patient mainly presented with abdominal pain, abdominal distension and discomfort. Due to extensive omentum metastasis, no further surgical treatment was performed. Pemetrexed combined with cisplatin chemotherapy was given for 2 cycles, and the patient is still alive.
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Humains , Mésothéliome malin/traitement médicamenteux , Mésothéliome/diagnostic , Pémétrexed/usage thérapeutique , Cisplatine/usage thérapeutique , Tumeurs du péritoine/diagnostic , Tumeurs de la plèvre , Tumeurs du poumon/traitement médicamenteuxRésumé
This paper was aimed to clarify the effect of high-intensity interval training (HIIT) on depression. Animal running platforms were used to establish HIIT exercise models, depression models were prepared by chronic unpredictable mild stress (CUMS), and depression-related behaviors were detected by behavioral experiments. The results showed that HIIT exercise improved depression-related behavior in CUMS model mice. Western blot and ELISA results showed that in the hippocampus, medial prefrontal cortex (mPFC) and amygdala of the CUMS model mice, glucocorticoid receptor (GR) protein expression was down-regulated, and the content of tumor necrosis factor α (TNF-α) was increased, compared with those in the control group, whereas HIIT exercise could effectively reverse these changes in CUMS model mice. These results suggest that HIIT exercise can exert antidepressant effect, which brings new ideas and means for the clinical treatment of depressive diseases.
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Animaux , Souris , Antidépresseurs/pharmacologie , Comportement animal , Dépression/traitement médicamenteux , Modèles animaux de maladie humaine , Hippocampe/métabolisme , Stress psychologique/traitement médicamenteuxRésumé
Objective: Functional near-infrared spectroscopy (fNIRS) was used to study the effect of aging on the neuroimaging characteristics of cerebral cortex in the process of speech perception. Method: Thirty-four adults with normal hearing were recruited from March 2021 to June 2021, including 17 in the young group, with 6 males, 11 females, age (32.1±5.0) years, age range 20-39 years. and 17 in the elderly group, with 6 males, 11 females, age (63.2±2.8) years, age range 60-70 years. The test material was the sentence table of the Mandarin Hearing Test in Noise (MHINT). The task state block experiment design was adopted, and the temporal lobe, Broca's area, Wernicke's area, motor cortex were used as regions of interest. Objective brain imaging technology (fNIRS) combined with subjective psychophysical testing method was used to analyze the activation area and degree of cerebral cortex related to auditory speech perception in the elderly and young people under different listening conditions (quiet, signal-to-noise ratio of 10 dB, 5 dB, 0 dB, -5 dB). SPSS 23 software was used for statistical analysis. Result: The activation area and degree of activation in the elderly group were lower than those in the young group under each task condition; The number of activation channels in the young group were significantly more than those in the old group, and the number of activation channels in the left hemisphere were more than those in the right hemisphere, but there was no difference in the number of activation channels. There were more channels affected by age in the left hemisphere than in the right hemisphere. The activation degree of the young group when the signal-to-noise ratio was 0 dB was significantly higher than that of other signal-to-noise ratio conditions (P<0.05), but there was no significant difference in the old group under the five conditions (P>0.05). The speech recognition score of the young group was higher than that of the old group under all conditions. When the quiet and signal-to-noise ratio was 10 dB, the correct score of the two groups was equal or close to 100%. With the gradual decrease of signal-to-noise ratio, there was a significant difference between the two groups when the signal-to-noise ratio was 5 dB. The speech recognition accuracy of the young group decreased significantly when the signal-to-noise ratio was 0 dB, while that of the old group decreased significantly when the signal-to-noise ratio was 5 dB. Conclusions: With the increase of age, the speech perception in noisy environment and the activity of cerebral cortex gradually deteriorate, and the speech dominance hemisphere (left hemisphere) will be significantly affected by aging. The overall activation area and activation degree of the elderly under different speech tasks are lower than those of the young.
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Adolescent , Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Stimulation acoustique/méthodes , Cortex auditif/physiologie , Spectroscopie proche infrarouge , Perception de la parole/physiologie , TechnologieRésumé
Objective:To investigate the safety and efficacy of ultrasound-guided transversus abdominis plane (TAP) combined with paracervical block in percutaneous microwave ablation(PMWA) of uterine fibroids.Methods:Twenty-four patients with uterine fibroids who underwent PMWA after ultrasound-guided TAP combined with paracervical block in Sichuan Cancer Hospital from October 2021 to January 2022 were retrospectively analyzed. The success rate and adverse reactions of TAP combined with paracervical block were recorded, and the types and doses of rescue analgesics used during and after operation were recorded. The pain degree of patients was recorded by NRS(numeric rating scales) during and 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours after operation, and the satisfaction of patients was recorded.Results:The success rate of TAP combined with paracervical block was 100%, and there were no adverse reactions during and after operation. During the operation, 5 patients(20.83%) had mild pain, which was tolerable and did not need intervention, 4 patients(16.67%) presented with moderate pain, and the NRS scores were 4, 4, 5 and 6 respectively, the symptoms were relieved after rescue analgesia. All patients completed one ablation, no ablation failure or secondary ablation. Some patients had mild pain after operation, which could be tolerated without intervention, and all were relieved naturally within 6 hours. All patients returned home on the day of ablation and were 100% satisfied with the analgesic effect.Conclusions:Ultrasound-guided TAP combined with paracervical block in PMWA of uterine fibroids is safe and effective, which is worthy of clinical promotion.
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Objective:To study the correlation between peripheral blood eosinophils levels and clinical characteristics of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:A retrospective study was conducted in 79 AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine of Peking University Third Hospital from January 2015 to December 2016. Peripheral blood EOS level 100/μl, 300/μl, 2%, 3%, and sputum EOS level 3% were the cut-off values. Patients were divided into EOS≥100/μl group ( n=33), EOS<100/μl group ( n=46); EOS≥300/μl group ( n=10), EOS<300/μl group ( n=69); EOS%≥2% group ( n=27), EOS<2% group ( n=52); blood EOS≥3% group ( n=16), blood EOS<3% group ( n=63); sputum EOS≥3% group ( n=7), sputum EOS<3% group ( n=15) respectively. The study analyzed the differences of clinical features between each two groups of patients; According to the blood EOS level in the acute phase and the recovery phase, ≥100/μl was high and<100/μl was low, they were divided into high EOS in both acute and recovery phase group ( n=21), high EOS in the acute phase and low EOS in the recovery phase group ( n=4), low EOS in the acute phase and high EOS in the recovery phase group ( n=20) and low EOS in both acute and recovery phase group ( n=12). The differences of clinical characteristics in each group were analyzed. Results:The median duration of COPD, proportion of patients with forced expiratory volume in the first second (FEV 1) percentage of predicted value (FEV 1% predicted value)<50%, proportion of complicated with respiratory failure, median level of procalcitonin, proportion of systemic glucocorticoid therapy and median length of stay in the EOS≥100/μl group were all significantly lower than EOS<100/μl group (5 vs 13 years, 48.0% vs 81.8%, 21.9% vs 50.0%, 0.04 vs 0.09 μg/L, 21.2% vs 56.5%, 11 vs 14 d, all P<0.05). The proportion of re-acute exacerbation in the EOS≥300/μl group was significantly higher than EOS<300/μl group (60.0% vs 23.2%), while the median fibrinogen level and median procalcitonin level were significantly lower than EOS<300/μl group (3.38 vs 3.85 g/L, 0.03 vs 0.07 μg/L, all P<0.05). The median duration of COPD, proportion of FEV 1% predicted value<50%, proportion of complicated with respiratory failure, the modified British Medical Research Council′s dyspnea scale (mMRC) score, median fibrinogen level, median C-reactive protein level, median procalcitonin level, proportion of systemic glucocorticoid therapy, proportion of non-invasive ventilation during hospitalization and median length of stay in the EOS≥2% group were all significantly lower than EOS<2% group [5 vs 13 years, 40.9% vs 83.3%, 12.0% vs 51.0%, 3 (2, 3) vs 3 (3, 4) points, 3.37 vs 3.97 g/L, 3.6 vs 16.8 mg/L, 0.04 vs 0.09 μg/L, 14.8% vs 55.8%, 0 vs 19.2%, 9 vs 14 d] (all P<0.05). The median duration of COPD, proportion of complicated with respiratory failure, median level of C-reactive protein and proportion of systemic glucocorticoid therapy in the blood EOS≥3% group were significantly lower than blood EOS<3% group (5 vs 10 years, 6.7% vs 45.8%, 4.4 vs 12.9 mg/L, 12.5% vs 49.2%) (all P<0.05). The median duration of COPD and median length of stay in the sputum EOS≥3% group were significantly shorter than sputum EOS<3% group (2 vs 15 years, 10 vs 21 d), while the median blood EOS count and median blood EOS ratio were significantly higher than sputum EOS<3% group (0.20 vs 0.01×10 9/L, 2.4% vs 0.1%) (all P<0.05). The proportion of complicated with respiratory failure and received systemic glucocorticoid therapy in the high EOS in both acute and recovery phase group were significantly lower than the low EOS in the acute phase and high EOS in the recovery phase group (14.3% vs 75.0%, 14.3% vs 55.0%) (all P<0.05). The proportion of FEV 1% predicted value <50% in the high EOS in the acute phase and low EOS in the recovery phase group was significantly lower than the low EOS in the acute phase and high EOS in the recovery phase group (0 vs 82.4%) ( P<0.05). The median FEV1% predicted value level in the high EOS in the acute phase and low EOS in the recovery phase group was significantly higher than the low EOS in both acute and recovery phase group (59.5% vs 36.0%) ( P<0.05). Conclusions:High EOS AECOPD patients have a shorter duration of disease and fewer days of hospitalization. The proportion of patients complicated with respiratory failure is lower. It is easier to distinguish the differences in clinical characteristics of AECOPD patients with a blood EOS count of 100/μl as a cut-off value. EOS levels in the acute phase and the recovery phase are helpful to distinguish the clinical characteristics of AECOPD patients.
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Objective To study the radioactive concentration of 131I in the air of workplaces where sodium iodide [131I] oral solution was administrated for patients with differentiated thyroid cancer (DTC) in the Department of Nuclear Medicine, and to estimate the internal radiation dose to the staff. Methods Workplaces of radioiodine 131I therapy for DTC patients in the Department of Nuclear Medicine of a hospital were investigated. Air samples in 131I administration areas and treatment wards were collected respectively and were measured by low-background gamma-ray spectrometry to calculate the activity concentration of 131I in the air and to further estimate the internal radiation dose to staffs. Results The activity concentration in the 131I administration area within the first 3 h of administration was 3~187 Bq/m3. During administration and within the first 3 h of administration, the staff exposed in the administration area for 5~30 min received an internal radiation dose of 0.08~0.50 μSv and 0.00~0.04 μSv, respectively. The highest activity concentration of 131I in the air of the ward was measured on the day of administration, reaching 3091 Bq/m3. After patients were discharged, the activity concentration in the ward gradually decreased to 10~242 Bq/m3 within 48 h. Within 48 h after patients were discharged, the staff exposed in the ward for 5~30 min received an internal radiation dose of 0.01~14.11 μSv. Conclusion A high activity concentration of 131I in the air was recorded during administration for DTC patients in radioiodine 131I therapy, and thus we recommend remote instructed administration or administration through a shielded window. We also recommend that non-treatment related personnel except medical staffs should not enter the ward during patients’ hospitalization at which the activity concentration of 131I in the ward was the highest. After patients were discharged, a delayed entry into the ward is recommended to reduce the internal radiation dose.
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Objective To compare the impact on 18F fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) image quality when block sequential regularized expectation maximization (BSREM) algorithm and ordered subset expectation maximization (OSEM) algorithm were used at various acquisition times (ATs), and to discuss the feasibility of AT optimization with BSREM algorithm. Methods In the phantom experiment, the NEMA/IEC PET phantom was adopted. In the clinical study, 66 pulmonary nodules with high uptake values from 61 patients who underwent a 18F-FDG PET-CT examination for pulmonary nodules from March to September 2020 were included. PET images were reconstructed according to BSREM algorithm and OSEM algorithm at various ATs in both the phantom experiment and the clinical study. Coefficient of variation, signal-to-noise ratio, contrast-to-noise ratio, and activity values (uptake value in the phantom experiment; standardized uptake value in the clinical study) were compared between the above sequence images for quality evaluation. Results The phantom experiment showed that the image quality of 120 s BSREM sequence was superior to that of 120 s OSEM sequence, and the image quality of 75 s BSREM sequence was similar to that of 120 s OSEM sequence. The clinical study showed that the image quality of 120 s BSREM sequence was superior to that of 120 s OSEM sequence, and the image quality of 75 s BSREM sequence was slightly better than that of 120 s OSEM sequence. Conclusion In the PET phantom experiment and the clinical study of pulmonary nodules with high uptake values, BSREM algorithm can significantly improve the image quality as compared to OSEM algorithm, and the image quality of 75 s BSREM sequence is slightly better than that of 120 s OSEM sequence.
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Inflammation and immune disorders are integral to the occurrence and progression of atherosclerosis (AS). With the role of regulatory T cells (Tregs) in immune regulation attracting attention, it has been widely accepted that Treg decrease and dysfunction are involved in AS pathogenesis. Chinese medicine (CM) has the advantages of being dual-directional, multi-targeted, and having minimal side effects in immune regulation. The anti-atherosclerosis effects of CM via Treg modulation have been revealed in clinical and animal studies. Therefore, this article reviews existing research on Tregs, the relationship between Tregs and AS, and the progress of CM for treating and prevention of atherosclerotic cardio-cerebrovascular diseases by regulating Tregs. Although the underlying mechanisms remain to be elucidated, CM treatment targeting Treg cells might provide a promising and novel future approach for prevention and treatment of AS.
Sujets)
Animaux , Athérosclérose/traitement médicamenteux , Inflammation , Médecine traditionnelle chinoise , Lymphocytes T régulateursRésumé
@#Extracorporeal cardiopulmonary resuscitation (ECPR) is a salvage therapy for patients suffering cardiac arrest refractory to conventional resuscitation, and provides circulatory support in patients who fail to achieve a sustained return of spontaneous circulation. ECPR serves as a bridge therapy that maintains organ perfusion whilst the underlying etiology of the cardiac arrest is determined and treated. Increasing recognition of the survival benefit associated with ECPR has led to increased use of ECPR during the past decade. Commonly used indications for ECPR are: age<70 years, initial rhythm of ventricular fibrillation or ventricular tachycardia, witnessed arrest, bystander cardiopulmonary resuscitation within 5 min, failure to achieve sustained return of spontaneous circulation within 15 min of beginning cardiopulmonary resuscitation. This review provides an overview of ECPR utilization, recent outcomes, risk factors, and complications of ECPR. Identifying ECPR indications, rapid deployment of extracorporeal life support equipment, and high-quality ECPR management strategies are of paramount importance to improve survival.
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This study aims at the critical role of P-glycoprotein (P-gp) in tumor drug resistance, taking advantage of the adenosine triphosphate (ATP) dependence of P-gp mediated drug transport and efflux across the cell membrane. Mitochondrial targeted calcium arsenite/doxorubicin (DOX) lipid nanoparticles were constructed via hydrothermal method and thin-film dispersion method for reversing tumor drug resistance. The results showed that the lipid nanoparticles were uniform in size and well dispersed with a mean particle size of (261 ± 7) nm, zeta potential of (-9.6 ± 1.3) mV. The DOX loading efficiency and encapsulation efficiency were 22.6% and 84.0%. The in vitro drug release profile was pH-dependent; the drug accumulation at mitochondria was significantly increased, which then caused overload of calcium and inhibition of P-gp and ATP, thereby reversing tumor drug resistance. The simultaneously released arsenite ion and DOX could synergistically kill the tumor cells. In summary, the lipid nanoparticles prepared in this study have uniform particle size, high drug loading efficiency and encapsulation efficiency, excellent colloidal stability, pH responsiveness, and impressive ability to reverse tumor drug resistance, which may hold great potential in further clinical applications.
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To compare the effect of hot or warm property of Chinese medicine(CM) on the skin toxicity of essential oils(EOs) as penetration enhancer in vitro and in vivo, and explore the mechanism. EOs were extracted from WIM of Bichengqie(Litseae Fructus), Dingxiang(Flos Syzygii Aromatici), Huajiao(Pericarpium Zanthoxyli Bungeani), and Xiaohuixiang(Fructus Foeniculi) with warm property, and Ganjiang(Rhizoma Zingiberis), Gaoliangjiang(Rhizoma Alpiniae Officinari), Hujiao(Fructus Piperis), and Wuzhuyu(Fructus Evodiae Rutaecarpae) with hot property, respectively. Then the in vitro toxicity was evaluated by human keratinocyte cytotoxicity. In vivo skin irritation potency was also evaluated through pathological observation after topical administration. The components, especially those located in stratum corneum, were analyzed by GC-MS. The main components, namely monoterpenes and sesquiterpenes, of EOs extracted from CM with hot property,were detected for the interaction with keratino-lipid ceramide 3 by molecular simulation technology; and the interaction energy value was calculated based on the optimal conformation. It was found that the skin cell toxicity of EOs from CM with hot property was significantly higher than that of EOs from CM with warm property. However, there was no significant difference between them by in vivo skin irritation evaluation. Whether from CM with hot property or warm property, EOs showed a significant reduced toxicity compared with azone. Sesquiterpenes(33.56%±19.38%) were found to be one of the main components in EOs from CM with hot property, while almost no sesquiterpenes was found in EOs from CM with warm property. After topical administration of EOs from CM with hot property, sesquiterpenes were demonstrated to be prone to locate in stratum corneum. The results of molecular simulation also revealed that the interaction between sesquiterpenes and ceramide 3 was significantly stronger than that of monoterpenes(P<0.01). In conclusion, the location of sesquiterpenes in stratum corneum resulted in the significant difference between in vitro skin cell toxicity and in vivo skin irritation potency. The EOs from CM with hot property shall be taken into account for further development of potent penetration enhancer.