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Objective: To investigate the clinical and pathologic features and diagnosis of follicular lymphoma (FL) with a predominantly diffuse growth pattern (DFL) with 1p36 deletion. Methods: Eight cases of DFL with 1p36 deletion diagnosed at Department of Pathology, Beijing Friendship Hospital, Capital Medical University (n=5) and the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital (n=3) from January 2017 to January 2023 were included. Their clinicopathologic features and follow-up data were analyzed. Immunohistochemistry and fluorescence in situ hybridization (FISH) were performed. Results: There were five males and three females, with a median age of 67 years, and inguinal lymphadenopathy was found as the main symptom. Histologically, similar morphologic features were sheared among all cases, with effaced nodal structure and characterized by proliferation of centrocytes in a diffuse pattern, with or without follicular components. The germinal center-related markers such as CD10 and/or bcl-6 were expressed in the tumor cells, and 1p36 deletion but not bcl-2 translocation was appreciable in these cases. Conclusions: DFL with 1p36 deletion is a rare subtype of FL, with some overlaps with other types of FL or indolent B-cell lymphomas in their pathologic features. An accurate diagnosis requires comprehensive considerations based on their clinical, pathologic, immunohistochemical, and molecular features.
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Masculino , Feminino , Humanos , Idoso , Linfoma Folicular/patologia , Hibridização in Situ Fluorescente , Linfoma de Células B/patologia , Deleção Cromossômica , Proliferação de CélulasRESUMO
Objective To explore the clinical characteristics and treatment scheme of periprosthetic joint infection(PJI)caused by Cutibacterium avidum(C.avidum).Methods The diagnosis and treatment process of a patient with PJI caused by C.avidum was summarized,and relevant literatures in the database were retrieved for review.Results A 65-year-old female patient with body mass index(BMI)of 31.1 kg/m2 underwent left humeral head prosthesis replacement surgery following a left proximal humerus fracture.Ten months after the surgery,the pa-tient exhibited poor wound healing and oozing,along with limited movement of the left shoulder joint,and was diag-nosed infection following shoulder arthroplasty.Patient underwent debridement of the infected lesion and removal of the prosthesis.The tissue,bone cement and prosthesis were cultured for C.avidum.Four literatures were re-trieved and screened,a total of 30 patients with PJI(28 cases hip joint infection and 2 cases shoulder joint infection)caused by C.avidum were reported through literature retrieval,and 78.6%(n=22)total hip arthroplasty(THA)surgeries were performed using direct anterior approach(DAA).The positive rate of preoperative joint fluid culture was 71.4%,29 cases underwent surgical combined with sensitive antimicrobials treatment.Except for one patient who had repeated infection and underwent three surgeries,other patients had a good prognosis.Conclusion PJI caused by C.avidum is mostly seen in THA patients who are obese and undergo DAA,with a few cases reported after shoulder arthroplasty.The high sensitivity of preoperative joint fluid culture provides an important basis for the development of surgical strategies and anti-infection protocols.
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ObjectiveTo explore the association between daily executive function and core symptoms, the symptoms of attention deficit hyperactivity disorder (ADHD) in children with autism spectrum disorder (ASD), and the moderating effect of theory of mind and other cognitive abilities on this association. MethodsChildren aged 6-12 years with ASD were recruited, and 86 children were identified according to the inclusion and exclusion criteria. Wechsler Intelligence Test for Children, Fourth Edition (WISC-Ⅳ), Strange Story Test (SST) and Behavior Rating Inventory of Executive Function (BRIEF) were used to evaluate children's cognitive ability. Swanson Nolan and Pelham-Version Ⅳ Scale (SNAP-Ⅳ), Social Responsiveness Scale (SRS), and Repetitive Behavior Scale-Revise (RBS-R) were used to assess the severity of ADHD symptoms, social impairment, and repetitive stereotyped behavior. Multiple linear regression was used to explore the association between daily executive function and ADHD symptoms, social impairment, repetitive stereotyped behaviors. ResultsAfter controlling for the score of strange stories, verbal comprehension index (VCI) and other factors, the full scale score and each index of BRIEF were positively correlated with full scale score of SNAP (b = 0.619-0.741, b’ = 0.637-0.755), SRS (b = 0.928-1.200, b’ = 0.417-0.513) and RBS-R (b = 0.326-0.525, b’ = 0.339-0.520) in children with ASD (P< 0.05), and the SNAP total score was more strongly correlated with the full scale BRIEF score and each index score (b’ = 0.637-0.755,P< 0.01). In addition to daily executive function, strange stories score (b = -2.218- -1.839) and age (b = 3.181-4.037) were also the important factors affecting the social function of children with ASD (P< 0.01). There were no moderating effects of strange stories score and age on the association between BRIEF score and full scale score of SNAP, SRS, and RBS-R(P> 0.05). ConclusionThe deficits of daily executive function in school-aged ASD children are significantly associated with core symptoms and ADHD symptoms, and the association is independent of other cognitive domains, such as theory of mind and verbal comprehension intelligence quotient.
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The paper summarizes professor ZHANG Wei-hua's clinical experience in treatment of insomnia with Zhenjing Anshen (calming-down the spirit) method. It is believed that insomnia results from the unstable spirit in pathogenesis of TCM. The basic therapeutic principle is regulating the spirit, in which, stabilizing the primary spirit and tranquilizing the heart spirit are emphasized. Main acupoints are Baihui (GV 20), Sishencong (EX-HN 1) and Yintang (GV 24+) to stabilize the primary spirit, located on the head; and Shenmen (HT 7) located on the wrist to calm-down the heart spirit, as well as Sanyinjiao (SP 6) and Yongquan (KI 1) in the lower extremities to benefit yin and balance yang, and then to house the spirit eventually. The needles are inserted in different depths and to various directions. The external application of herbal plaster is combined at Yongquan (KI 1) and the supplementary acupoints are selected in terms of syndrome differentiation. This therapy is simple in acupoint selection and very effective in treatment of insomnia.
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Humanos , Distúrbios do Início e da Manutenção do Sono/terapia , Pontos de Acupuntura , Emoções , Coração , Extremidade InferiorRESUMO
The paper summarizes professor ZHANG Wei-hua's clinical experience for the treatment of chronic somatic pain with zhidong needling techniques. In terms of the characteristics of chronic somatic pain, professor ZHANG has integrated zhidong needling with acupuncture kinetic therapy. The satisfactory therapeutic effects are obtained by selecting the painful points and regions as the treatment sites and the specific techniques of zhidong needling depending on the size of affected area, the depth of illness, the size and shape of the cord-like muscle, etc. Five techniques of zhidong needling are used accordingly with twirling, pulling, lifting and thrusting, surrounding needling methods involved, as well as with the manipulation speed, direction and frequency considered.
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Humanos , Procedimentos Cirúrgicos Vasculares , Dor Crônica , Dor Nociceptiva , Terapia por Acupuntura , MúsculosRESUMO
This paper summaries the Risk of Bias in Non-randomized Studies-of Environmental Exposure (ROBINS-E), a tool for evaluating risk of bias about non-randomized studies of exposures (NRSE), and introduces the application of ROBINS-E in a published NRSE. According to the characteristics of NRSE, evaluation fields and signaling questions were designed in ROBINS-E to provide essential information about risk of bias for NRSE included in systematic reviews and GRADE. ROBINS-E is the tool in assessment of risk of bias in observational studies and quasi-randomized studies. Although the tool has been used in practice to some extent, but it still needs further improvement. Attention should be paid to its update and progress.
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Humanos , Viés , Exposição Ambiental , Revisões Sistemáticas como AssuntoRESUMO
OBJECTIVES@#To study the clinical application effect of "kindergarten effect" in radiotherapy for children with tumor based on the psychology of preschool children aged 3-5 years.@*METHODS@#A total of 30 children, aged 3-5 years, who were admitted to the Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, from January 2020 to August 2021 were enrolled in this prospective study. The children were randomly divided into a control group and a test group, with 15 children in each group. The children in the test group were treated in "kindergarten mode", i.e., all children were treated together at a specified time and left together after all children completed treatment. Those in the control group were treated alternately with adult patients according to the treatment time based on the type of radiotherapy fixation device. The treatment compliance was evaluated for both groups, and the two groups were compared in terms of the setup errors in the superior-inferior (SI), left-right (LR), and anterior-posterior (AP) directions.@*RESULTS@#Compared with the control group, the test group showed a significantly shorter time for finishing the treatment (P<0.05) and a significantly lower proportion of children with treatment interruption (P<0.05). Compared with the control group, the test group showed smaller mean errors in the SI, LR and AP directions after image-guided radiotherapy, with significant differences in the mean errors in the SI and LR directions (P<0.05).@*CONCLUSIONS@#With the application of the "kindergarten effect", most children can actively cooperate in radiotherapy, and it can also improve the accuracy and repeatability of positioning and help to achieve the desired treatment outcome.
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Adulto , Humanos , Neoplasias/radioterapia , Estudos Prospectivos , Planejamento da Radioterapia Assistida por ComputadorRESUMO
Tenuifolin, a main component in Polygalae Radix, is frequently used as an important indicator for quality control of Polygalae Radix and its processed products. Dementia is a serious and persistent cognitive disorder, and the number of dementia patients is increasing worldwide, which brings great economic burden and mental pressure to families and society. At present, cholinesterase inhibitor and other drugs can only alleviate the symptoms of dementia, and there are some toxic and side effects. It has been found that tenuifolin can significantly improve cognitive disorder, learning and memory and is expected to be a potential drug for treating dementia. Tenuifolin exerts protective effects on amyloid-β (Aβ) deposition, acetylcholine reduction, neuroinflammation, cellular oxidative damage and nerve cell apoptosis caused by neurodegenerative diseases via multiple mechanisms, and can be applied to various types of dementia. In addition, it can be quickly absorbed into the blood, mainly distributed in liver and kidney, and can enter into the brain through the blood-brain barrier. However, because of its large molecular mass and poor fat solubility, tenuifolin can be rapidly eliminated, generating some problems such as low oral absoBrbability and permeability of blood-brain barrier. Therefore, the information of chemistry, pharmacology, pharmacokinetics and toxicology of tenuifolin was summarized in this paper to provide reference and ideas for further research and application.
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Damage to sperm DNA was proposed to play an important role in embryonic development. Previous studies focused on outcomes after fresh embryo transfer, whereas this study investigated the influence of sperm DNA fragmentation index (DFI) on laboratory and clinical outcomes after frozen embryo transfer (FET). This retrospective study examined 381 couples using cleavage-stage FET. Sperm used for intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF) underwent density gradient centrifugation and swim up processing. Sperm DFI had a negative correlation with sperm motility (r = -0.640, P < 0.01), sperm concentration (r = -0.289, P < 0.01), and fertilization rate of IVF cycles (r = -0.247, P < 0.01). Sperm DFI examined before and after density gradient centrifugation/swim up processing was markedly decreased after processing (17.1% vs 2.4%, P < 0.01; 65 randomly picked couples). Sperm progressive motility was significantly reduced in high DFI group compared with low DFI group for both IVF and ICSI (IVF: 46.9% ± 12.4% vs 38.5% ± 12.6%, respectively; ICSI: 37.6% ± 14.1% vs 22.3% ± 17.8%, respectively; both P < 0.01). The fertilization rate was significantly lower in high ( ≥25%) DFI group compared with low (<25%) DFI group using IVF (73.3% ± 23.9% vs 53.2% ± 33.6%, respectively; P < 0.01) but was equivalent in high and low DFI groups using ICSI. Embryonic development and clinical outcomes after FET were equivalent for low and high DFI groups using ICSI or IVF. In this study, sperm DFI did not provide sufficient information regarding embryo development or clinical outcomes for infertile couples using FET.
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Feminino , Humanos , Masculino , Gravidez , Fragmentação do DNA , Transferência Embrionária , Fertilização in vitro , Estudos Retrospectivos , Motilidade dos Espermatozoides , EspermatozoidesRESUMO
AIM: To investigate the influencing factors of disequilibrium refractive development in children aged 6-12 years old.METHODS: A total of 607 children with a mean age of 8.2±1.8 years old from two primary schools in Binhai New Area of Tianjin in December 2019 were selected by cluster sampling for optical biometry measurement(axial length and equivalent corneal power), cycloplegia refractive examination and questionnaire survey.RESULTS: The childrens'spherical equivalent was -0.11±1.63D, binocular spherical equivalent difference was -0.08±0.64D and absolute value of spherical equivalent difference was 0.41±0.49D. There were 56 children with anisometropia and 551 children without anisometropia. There was no difference in the absolute value of binocular corneal power difference between anisometropia and non-anisometropia group(0.30±0.34D vs 0.27±0.24D, P=0.430). But the absolute value of axial difference was significantly different(0.67±0.39mm vs 0.13±0.13mm, P=0.005). Multivariate linear regression analysis showed that weekly usage time of phones/computers, weekly close work hours, weekly visual fatigue times and habitual reading distance were the influencing factors of refractive imbalance development(the absolute value of binocular spherical equivalent difference). Habitual reading distance and handedness in writing are the influencing factors of the developmental bias of refractive imbalance(binocular spherical equivalent difference).CONCLUSION: Children aged 6-12 years old who spend more time on phones/computers, and have prolonged close work, more times of visual fatigue and close habitual reading distance may increase the degree of refractive imbalance. Children with right-handed handwriting and severe left or right head deviation have a deeper degree of myopia in the right eye than in the left eye.
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BACKGROUND@#The global pandemic coronavirus disease 2019 (COVID-19) has become a major public health problem and presents an unprecedented challenge. However, no specific drugs were currently proven. This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.@*METHODS@#Medline, Embase, the Cochrane Library, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/SARS-CoV. Random-effects network meta-analysis within the Bayesian framework was performed, followed by the Grading of Recommendations Assessment, Development, and Evaluation system assessing the quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion, and overall adverse events (OAEs). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.@*RESULTS@#Sixty-six RCTs with 19,095 patients were included, involving standard of care (SOC), eight different antiviral agents, six different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids (COR), and other treatments. Compared with SOC, a significant reduction of mortality was observed for TCM (OR = 0.34, 95% CI: 0.20-0.56, moderate quality) and COR (OR = 0.84, 95% CI: 0.75-0.96, low quality) with improved cure rate (OR = 2.16, 95% CI: 1.60-2.91, low quality for TCM; OR = 1.17, 95% CI: 1.05-1.30, low quality for COR). However, an increased risk of mortality was found for CQ_HD vs. SOC (OR = 3.20, 95% CI: 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR = 0.52, 95% CI: 0.38-0.70, very low quality) but CQ_HD (OR = 2.51, 95% CI: 1.20-5.24) and interferons (IFN) (OR = 2.69, 95% CI: 1.02-7.08) vs. SOC with very low quality were associated with an increased risk.@*CONCLUSIONS@#COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN, and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low-quality and further high-quality trials are needed.
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Humanos , COVID-19 , Medicina Tradicional Chinesa , Metanálise em Rede , Pandemias , SARS-CoV-2RESUMO
OBJECTIVE@#To compare the clinical efficacy between open and arthroscopic Latarjet procedure in the treatment of anterior shoulder instability by using Meta-analysis.@*METHODS@#Search PubMed, Medline, Embase, Cochrane, China National Knowledge Infrastructure(CNKI), Wanfang database, China Biological Literature system(CBM) and VIP database. Review all retrospective or prospective cohort studies and randomized controlled trials on open and arthroscopic Latarjet procedure for anterior shoulder instability. Binary variables (postoperative recurrence rate, incidence of intraoperative and postoperative complications) and continuousvariables [shoulder external rotation range of motion, Walch-Duplay score, Rowe score, WOSI score, postoperative visual analogue scale (VAS), postoperative anxiety degree and operation time] were selected for analysis. NOS bias risk assessment criteria (recommended by Cochrane collaboration Network) were used to evaluate the literature quality of retrospective or prospective cohort studies, and modified Jadad scale was used to evaluate the quality of randomized controlled trials. Literature screening, literature quality evaluation and data extraction were carried out independently by two observers. RevMan 5.3 software was used for Meta analysis.@*RESULTS@#(1)A total of 9 studies were included, including 8 retrospective cohort studies and 1 prospective cohort study. A total of 956 patients were included in this study, including open Latarjet procedure(@*CONCLUSION@#The arthroscopic Latarjet stabilisation shows satisfactory and comparable results to open procedure, and the postoperative recurrence and complication rates are low in both group. Both open and arthroscopic Latarjet procedure are reliable surgical procedures in the treatment of anteriorly shoulder instability. Arthroscopic procedure has longer learning curve than open procedure, the doctors may either choose arthroscopic or open Latarjet procedure based on personal skills and preference, as well as the patient's condition. However, all the literatures included in this study are cohort studies with low level of evidence. The research lack randomized controlled trials, and small sample size is small. In the future, randomized controlled studies with large sample size and high level of evidence are still needed to determine the efficacy difference between the two.
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Humanos , Artroscopia , China , Instabilidade Articular , Estudos Prospectivos , Recidiva , Estudos Retrospectivos , Ombro , Luxação do Ombro , Articulação do OmbroRESUMO
Objective:To analyze the gene variants in patients with primary distal renal tubular acidosis (dRTA), and explore the correlation between the genotype and phenotype.Methods:The Sanger direct sequencing or whole-exome sequencing was used to identify causal variants and the variation pathogenicity was evaluated according to 2015 American College of Medical Genetics and Genomics (ACMG) standards and guidelines in 44 dRTA patients (37 families) diagnosed in the Affiliated Qingdao Municipal Hospital of Qingdao University and the Affiliated Hospital of Qingdao University from April 2010 to September 2020. The clinical features of the patients were summarized, and the correlation between the genotype and phenotype was investigated.Results:Seven variants of SLC4A1 gene, 17 variants of ATP6V0A4 gene, and 15 variants of ATP6V1B1 gene were identified in 44 patients with dRTA, and of which 11 variants were new ones. According to ACMG guidelines, the pathogenic, likely pathogenic, benign variants among the 39 variants were 22, 16 and 1, respectively. Nine patients were autosomal dominant hereditary dRTA caused by SLC4A1 gene mutation, 4 patients with autosomal recessive hereditary dRTA complicated with Southeast Asian ovalocytosis and anemia were caused by SLC4A1 gene mutation, and 14 patients caused by ATP6V0A4 gene mutation and 8 patients caused by ATP6V1B1 gene mutation were autosomal recessive hereditary dRTA; Two children with dRTA were found to carry one monoallelic defect in ATP6V1B1, and no causal gene mutation was identified in 7 patients. One patient showed incomplete dRTA, and the other 43 patients showed complete dRTA. The prevalence of sensory neural hearing loss caused by ATP6V0A4 and ATP6V1B1 mutation were 2/14 and 6/10 respectively. The frequency of chronic kidney disease in adults, children and infants were 4/4, 2/4, and 1/36, separately. After the drug treatment based on potassium citrate and sodium citrate, the growth and development (28/40) and electrolyte disturbance (41/44) of most patients were significantly improved. Conclusions:The present study has identified 39 variants of SLC4A1, ATP6V0A4 and ATP6V1B1 genes in 44 patients with dRTA, including 11 novel ones. There is a close relationship between genotype and phenotype in dRTA patients and most patients' conditions were improved after proper treatment. This study enriches the human gene mutation database and provides valuable references for diagnosis, treatment and genetic counseling in patients with dRTA.
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The aim of the present study was to investigate the protective effect of propofol on the experimental myocardial infarction in rats. The myocardial infarction model was established by ligating the anterior descending branch of left coronary artery in rats. Model rats were treated with propofol. Cardiac function was evaluated by echocardiography. Cardiac hemodynamic changes were detected by multiconductor biorecorder. Pathological changes in the infarcted myocardia were detected by HE staining. The expression levels of cardiac hypertrophy marker genes and fibrosis marker proteins were analyzed by real-time quantitative PCR and Western blot. The results showed that, compared with the sham surgery group, the model group exhibited larger infarct size (> 40%), impaired heart function, and significantly increased left ventricular end-diastolic pressure (LVEDP). Propofol reduced cardiac function impairment and decreased LVEDP in the model group. Propofol significantly reduced lung weight/body weight ratio, heart weight/body weight ratio, left ventricular weight/body weight ratio and left atrial weight/body weight ratio in the model group. Furthermore, after myocardial infarction, the administration of propofol significantly improved the diastolic strain rate, down-regulated the mRNA expression levels of myocardial hypertrophy markers, atrial natriuretic peptide and β-myosin heavy chain, and reversed the up-regulation of matrix metalloproteinase 2 (MMP2), MMP9 and tissue inhibitor of metalloproteinase-2 (TIMP-2) induced by myocardial infarction. These results suggest propofol can reduce adverse ventricular remodeling, cardiac dysfunction, myocardial hypertrophy and fibrosis after myocardial infarction, and has protective effect against the experimental myocardial infarction induced by coronary artery ligation in rats.
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Animais , Ratos , Cardiotônicos/farmacologia , Metaloproteinase 2 da Matriz , Metaloproteinase 9 da Matriz , Infarto do Miocárdio/tratamento farmacológico , Miocárdio , Propofol/farmacologia , Inibidor Tecidual de Metaloproteinase-2/genética , Remodelação VentricularRESUMO
OBJECTIVE@#To evaluate the clinical efficacy of acupuncture at different timings in acute stage for limb dysfunction in patients with cerebral infarction.@*METHODS@#A total of 101 patients with cerebral infarction limb dysfunction were divided into an early exposure group (@*RESULTS@#Compared before treatment, the mRS grade at 30 and 60 days after onset in the early exposure group was improved (@*CONCLUSION@#The timing of acupuncture is an independent factor affecting the disability status and limb motor dysfunction in patients with cerebral infarction, and the effect of early intervention may be better than late intervention.
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Humanos , Pontos de Acupuntura , Terapia por Acupuntura , Infarto Cerebral/terapia , Projetos Piloto , Estudos Prospectivos , Acidente Vascular Cerebral , Resultado do TratamentoRESUMO
Background Myelodysplastic syndromes (MDS) mainly occur in the elderly but can rarely affect younger individuals too. The correct diagnosis relies on careful morphologic evaluation, cytogenetic/molecular results, and excluding reactive conditions mimicking MDS. We present the clinical, pathologic, cytogenetic, and molecular features of a case of MDS with excess blasts-2 (MDS-EB-2) in a 30-year-old male who was found to have pancytopenia during his hospitalization for coronavirus disease 2019 (COVID-19) and discuss the diagnostic challenges of MDS in patients with COVID-19. Case presentation A 30-year-old man presented to an outside hospital with fever, chills, weakness, coughing spells, dizziness and shortness of breath and was diagnosed with bilateral pneumonia due to COVID-19. At the outside hospital, he was found to be pancytopenic, and a subsequent bone marrow aspiration and biopsy raised concern for a COVID-19 induced hemophagocytic lymphohistiocytosis. In addition, MDS could not be ruled out. The patient was thus referred to our institute for further management. The patient's peripheral blood showed pancytopenia with occasional dysplastic neutrophils and a few teardrop cells. Given the diagnostic uncertainty, a bone marrow aspiration and a biopsy were repeated revealing a hypercellular bone marrow with erythroid hyperplasia, megakaryocytic hyperplasia, trilineage dysplasia, increased blasts (13%), many ring sideroblasts, and mild to moderate myelofibrosis, consistent with MDS-EB-2. Chromosomal analysis revealed isochromosome 14. Next generation sequencing demonstrated SF3B1 K700E mutation. Discussion and conclusion The diagnosis of MDS can be challenging, particularly in young patients. Cytopenia and myelodysplastic features have been reported in COVID-19 patients, making the diagnosis of MDS more elusive. A careful pathologic examination of the bone marrow with ancillary studies including flow cytometry, immunohistochemistry, and cytogenetic and molecular studies in combination with a thorough clinical evaluation, leads to the accurate diagnosis.
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Humanos , Masculino , Adulto , Síndromes Mielodisplásicas/patologia , Medula Óssea , Citogenética , COVID-19RESUMO
With the widespread application of modern information technologies such as the Internet of Things, cloud computing, block chain, and artificial intelligence, the integration of multidisciplinary key technologies and health big data will vigorously promote the development of health causes and health industries. To construct a new comprehensive health care model of all staff, all area, whole process and full-time service according to the real needs of retired military cadres, we integrated several information technologies such as the Internet of Things, cloud computing, block chain and artificial intelligence, and strengthened the collection, mining, analysis and utilization of big data technology in the all-dimensional health care model. Four kinds of health care models and their corresponding operating mechanisms were constructed. With better practicability and promotion value, our new models can effectively improve the quality of prevention, medical treatment and health care in primary health institutions.
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Guizhi Decoction is a resolving agent,which is a classic prescription for traditional Chinese medicine. It is effective in the treatment of sepsis in clinical practice. However,due to the complexity of the prescription,its anti-sepsis mechanism is difficult to be clarified. The " Cinnamomi Ramulus-Paeoniae Radix Alba" drug pair,as the classic compatibility for medicinal and medicinal herbs,is the core of Guizhi Decoction. In this study,Cinnamomi Ramulus-Paeoniae Radix Alba drug pair was used as the research object and the molecular mechanism of its treatment of sepsis was investigated by analyzing the chemical compositions with integrative pharmacology platform( TCMIP,http://www.tcmip.cn/),predicting disease target,analyzing gene function and pathway of " Cinnamomi Ramulus-Paeoniae Radix Alba" in treatment of sepsis,and establishing a multi-dimensional network relationship of " Chinese medicine-chemical components-core targets-key pathways". The prediction results of " Cinnamomi Ramulus-Paeoniae Radix Alba" drug pair showed that its anti-sepsis effect was associated with 45 active components,and the active components played an anti-sepsis role through multiple targets and pathways,involving inflammatory targets such as PF4,MyD88,TLR4,BDKRB2,CD14,and NOS3. The sepsis was relieved mainly by regulating Toll like signaling pathway,Fox O signaling pathway,chemokines signaling pathway,thyroid and insulin endocrine signaling pathways and biological processes. This study provides a scientific basis for further development of Cinnamomi Ramulus-Paeoniae Radix Alba drug pair and Guizhi Decoction against sepsis.
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Humanos , Cinnamomum , Química , Medicamentos de Ervas Chinesas , Farmacologia , Medicina Tradicional Chinesa , Paeonia , Química , Plantas Medicinais , Química , Sepse , Tratamento FarmacológicoRESUMO
OBJECTIVE@#To investigate the mechanism of high glucose affecting the apoptosis of schwann cells through Nox4 NADPH oxidase.@*METHODS@#The schwann cells of newborn Wistar rats were cultured in vitro. The cultured cells were divided into four groups: control group, high-glucose group, NOX4 siRNA group and control siRNA group (n=10). The WST-1 method was used to detect the cell vitality, and the DCFH-DA method was used to detect the contents of intracellular reactive oxygen free radicals (ROS). Nox4 and Caspase3 mRNA expressions were detected by real-time fluorescence quantitative RT-PCR. Nox4 and Caspase3 protein expressions were determined by Western blot.@*RESULTS@#High glucose culture up-regulated Nox4 mRNA and protein expressions of schwann cells, decreased activity of schwann cells, increased intracellular ROS content, and promoted apoptosis by increasing Caspase3 mRNA and protein expressions. NOX4 siRNA blocked the accumulation of ROS in the high glucose cultured schwann cells, and reduced the damage of glucose on cell viability, by inhibiting NOX4 gene expression. NOX4 siRNA also reduced cell apoptosis by down-regulating Caspase3 mRNA and protein expressions.@*CONCLUSION@#Nox4 was involved in the hyperglycemic-induced apoptosis of schwann cells through ROS. The regulation of Nox4 expression or function might be a new way to treat diabetic peripheral neuropathy.
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Animais , Ratos , Apoptose , Caspase 3 , Metabolismo , Células Cultivadas , Meios de Cultura , Glucose , NADPH Oxidase 4 , Metabolismo , Ratos Wistar , Espécies Reativas de Oxigênio , Metabolismo , Células de Schwann , Biologia Celular , MetabolismoRESUMO
Objective To evaluate the clinical efficacy of intravitreal ranibizumab injection and panretinal photocoagulation for neovascular glaucoma.Methods Totally 8 patients (40 eyes) with neovascular glaucoma in the First Affiliated Hospital of Zhengzhou university from January 2016 to October 2016 were collected in this study,and the patients were randomly divided into two groups according to the different treatments:trabeculectomy group (18 eyes),in which the patients were treated with intravitreal injection of ranibizumab + trabeculectomy + panretinal photocoagulation,and cyclophotocoagulation group (22 eyes),subjects undergoing cyclophotocoagulation + panretinal photocoagulation.All patients were followed up for 6 months.And there was no significant difference in the general data of the two groups (all P > 0.05).Finally,variables including iris neovascularization,the best corrected visual acuity (BCVA),the preoperative and postoperative 1 month,3 months and 6 months intraocular pressure,the operation successful rate and complications in both groups were evaluated and compared.Results In the trabeculectomy group,1 week after treatment,neovascularization in all patients was disappeared,and 6 months of follow-up,a small amount of neovascular recurrence occurred;in the cyclophotocoagulation group,2 weeks after treatment,neovascularization disappeared in 18 eyes,decreased in 3 eyes,and did not change in 1 eye;additionally,6 months of follow-up,some eyes presented neovascularization recurrence.The postoperative BCVA in the trabeculectomy group was significantly higher than that before operation,and the difference was statistically significant (P =0.026),But there was no significant difference between preoperative and postoperative BCVA in the cyclophotocoagulation group (P =0.438).Preoperative BCVA in the trabecuiectomy group was significantly higher than that in the cyclophotocoagulation group,and the difference was statistically significant (P =O.039).The intraocular pressures of the both groups were decreased at 1 month,3 months and 6 months after operation,and the differences were statistically significant (all P < 0.05).There was significant difference in the success rate of operation between the two groups (P =0.047).The efficacy of the trabeculectomy group was better than that of the cyclophotocoagulation group.The incidence of complications in the trabeculectomy group was lower than that in the cyclophotocoagulation group,and the difference was statistically significant (P =O.024).Conclusion It is safe and effective for intravitreal ranibizumab injection + trabeculectomy + panretinal photocoagulation in the treatment of iris neovascularization,of which the clinical efficacy is better than cyclophotocoagulation + pamretinal photocoagulation.