RÉSUMÉ
Objective To explore the probability and associated factors of pulmonary fibrosis in 350 cases of elderly pneumonia. Methods Elderly patients who received diagnosis and treatment at Changzhi Medical College Affiliated Peace Hospital from January 2018 to December 2022 were selected, and 350 patients who met the criteria were included in the study. Analyze its clinical data, incidence of pulmonary fibrosis, and analyze the relationship between the two. Results The average age of 350 patients was (63.51 ± 5.74) years old; 219 cases were common type , 72 cases were severe type, and 59 cases were critically ill. At admission, the CT signs were: ground glass in 66 cases (18.86%) , paving stone in 37 cases (10.57%), consolidation in 73 cases (20.86%), nodules in 93 cases (26.57%) , fried egg sign in 20 cases (5.71%) , and mosaic sign in 61 cases (17.43%). At discharge, the lesion signs were as follows: 61 cases (17.43%) had no lesions, 207 cases (59.14%) maintained the original lesion signs, and 82 cases (23.43%) evolved into other signs. 76 cases of pulmonary fibrosis were discharged, with an incidence rate of 21.71%. There were significant differences in the incidence of pulmonary fibrosis among patients with different ages, lesion evolution during treatment, lesion signs at discharge, and clinical stages (all P<0.001). Pulmonary fibrosis is positively correlated with age (P=0.047), lesion signs at discharge (P=0.032), and clinical classification (P=0.010). The incidence of lesions presenting as paving stones (P=0.014) and fibrosis in critically ill patients (P=0.013) at discharge is higher. Age increase (P=0.047) , wide range of lesions at admission (P=0.042), evolution of lesions into other signs at discharge (P=0.016), and clinical classification as severe (P=0.008) or critically ill (P=0.021) are independent risk factors for the development of pulmonary fibrosis in elderly pneumonia patients. Conclusion The incidence of pulmonary fibrosis in elderly patients exceeds 20%. Increasing age, wide range of lesions upon admission, evolution of lesions into other signs upon discharge, and clinical classification as severe or critically ill are independent risk factors for the occurrence of pulmonary fibrosis in elderly pneumonia patients.
RÉSUMÉ
Objective To investigate the effects of Optimized New Shengmai Powder on myocardial fibrosis in rats with heart failure based on the β1-AR/cAMP/PKA/CREB signaling pathway.Methods Totally 50 SD rats were randomly divided into sham-operation group(10 rats)and operation group(40 rats).The left anterior descending coronary artery was ligated to establish a rat model of heart failure.The modeling rats were randomly divided into the model group,the captopril group,and TCM low-and high-dosage groups,with 8 rats in each group.The administration groups received relevant medicine for gavage for 4 weeks.LVEF and LVFS in rats were detected by echocardiography,and measurement of heart and lung mass and calculation of heart and lung organ coefficients were performed,myocardial fibrosis degree was observed by histopathology,serum NT-ProBNP and cAMP,Col Ⅰ,and Col Ⅲcontent in myocardial tissue were detected by ELISA,immunohistochemical was used to detect β1-AR,cAMP positive expression,and Western blot was used to detect the expression of β1-AR/cAMP/PKA/CREB signaling pathway related proteins.Results Compared with the sham-operation group,the LVEF and LVFS of the model group rats were significantly decreased(P<0.01),and the heart and lung organ coefficient significantly increased(P<0.01);the number of myocardial cells decreased,collagen volume fraction increased,and the proportion of type Ⅰ/Ⅲcollagen fibers increased(P<0.01),the contents of serum NT-ProBNP and myocardial tissue Col Ⅰ and Col Ⅲincreased significantly,while the cAMP content in myocardial tissue decreased significantly(P<0.01),the positive expressions of β1-AR and cAMP were significantly decreased(P<0.01),the expressions of β1-AR,AC1,cAMP,p-PKA,and p-CREB proteins were significantly decreased,while protein expressions of p-Smad2,Col Ⅰ,Col Ⅲ,and α-SMA significantly increased(P<0.05,P<0.01).Compared with the model group,the administration groups could increase LVEF and LVFS and decrease heart and lung organ coefficient to different degrees in rats;increase the number of myocardial cells,decrease collagen volume fraction and the proportion of type Ⅰ/Ⅲ collagen fibers,down-regulate serum NT-ProBNP and the content of Col Ⅰ and Col Ⅲ in myocardial tissue,up-regulate the content of cAMP,increase the positive expressions of β1-AR and cAMP in myocardial tissue,up-regulate β1-AR,AC1,cAMP,p-PKA,p-CREB protein expression,and inhibit p-Smad2,Col Ⅰ,Col Ⅲ,and α-SMA protein expression,in which the effects of the TCM high-dosage group and captopril group were more pronounced(P<0.01,P<0.05).Conclusion Optimized New Shengmai Powder can effectively reduce myocardial fibrosis in heart failure rats,improve myocardial hypertrophy and remodeling,and increase left ventricular contractility,and the mechanism may be related to the activation of the β1-AR/cAMP/PKA/CREB signaling pathway.
RÉSUMÉ
[Abstract ] Objective To investigate the growth and development of children after liver transplantation.Methods Seventy children who underwent liver transplantation in Beijing Friendship Hospital and Tianjin First Central Hospital from September 2006 to May 2014 were included in the study.Height Z-scores (ZH )and weight Z-scores (ZW )of each child were respectively calculated at transplantation and 6 months,1 year,2 years,3 years,4 years and 5 years after transplantation.The change trends of ZH and ZW at each time point were analyzed.Moreover,ZH and ZW at each time point were compared with the standardized mean of growth 0 (standardized mean ) formulated according to the survey data of children's physical development in nine provinces and municipalities in 2005.Children were divided into Z≥ -2 group and Z <-2 group according to ZH and ZW at transplantation.And the change trend of ZH and ZW of each group was compared.Results The mean of ZH and ZW at the time of liver transplantation was -1.63 ± 1.35 and-1.53 ±1.52 respectively.After liver transplantation,ZH and ZW increased gradually.ZH and ZW of children before transplantation and 6 months after transplantation were significantly lower than standardized mean (all in P <0.01).ZH and ZW in other postoperative periods had no statistical significance with standardized mean (all in P >0.05).There were significant difference between ZH≥ -2 group and ZH <-2 group at transplantation and 6 months and 1 year after transplantation (both in P <0.05).Zw of Zw≥ -2 group and Zw <-2 group at transplantation and 6 months,1 year and 2 years after transplantation had difference with statistical significance (all in P <0.05).Conclusions The growth and development of children with liver transplantation recover gradually and increase significantly at 1 year after transplantation.
RÉSUMÉ
Objective To investigate the clinical characteristics,prevention and treatment strategy of de novo hepatitis B virus (HBV)infection after pediatric living liver transplantation.Methods In total,106 pediatric recipients undergoing living liver transplantation in Organ Transplantation Center of Affiliated Beijing Friendship Hospital of Capital Medical University and Organ Transplantation Center of Tianjin First Center Hospital from July 2010 to July 2014 were enrolled in this study.All surgeries were performed by the same surgical team.According to preoperative test outcomes of donor HBV serological markers,all recipients were divided into the positive (n =45)and negative (n =61)antibody to hepatitis B core antigen (anti-HBc)donor liver groups (positive group and negative group),and the prevalence of de novo HBV infection was compared between two groups.The risk factors of de novo HBV infection in the positive group were analyzed to elucidate the clinical characteristics of de novo HBV infection in affected children.Results The incidences of de novo HBV infection in positive and negative group were 18% (8 /45 )and 2% (1 /61 )respectively.The risk factors of de novo HBV infection in recipients with positive anti-HBc were negative anti-HBs before transplantation and absence of antiviral therapy post-transplantation in recipients (both in P <0.05 ).The median interval between time of onset and time of liver transplantation was 12 months (8-48 months).Seven cases were treated with lamivudine and the remaining two cases were left untreated.All nine recipients survived.Conclusions Application of positive anti-HBc donor liver have a risk of HBV infection in recipients after pediatric liver transplantation.Absence of postoperative nucleoside analogue therapy and negative anti-HBs before transplantation acts as risk factors of de novo HBV infection in the recipients with positive anti-HBc donor liver.After liver transplantation,nucleoside analogue therapy is recommended for the pediatric recipients with positive anti-HBc donor liver to prevent the incidence of de novo HBV infection.Besides,hepatitis B vaccine should be administered prior to liver transplantation.