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Objective To investigate the role and regulatory mechanism of stress-inducing protein 1(SESN1)in liver gluconeogenesis of fasting mice.Methods RT-qPCR was used to detect mRNA expression of SESN1 in liver tissues of C57BL/6J mice and primary mouse hepatocytes treated with forskolin(Fsk)and dexamethasone(Dex).HepG2 cells were transfected with plasmids and the effects of SESN1 overexpression on mRNA expression of gluconeogenesis related genes PGC-1α,PEPCK and G6Pase was detected by RT-qPCR.The effect of SESN1 on the promoter activity of PGC-1α in HepG2 cells was studied using a dual luciferase reporter system.The effect of SESN1 on PGC-1α deacetylation was detected by overexpression of SESN1 and inhibition of SIRT1 expression.By knocking down SIRT1 expression,we detected whether it mediated the changes in mRNA levels of SESN1 in-duced gluconeogenesis related genes.Results The mRNA expression of SESN1 was significantly increased in liver tissues of starved C57BL/6J mice and in primary hepatocytes treated with Fsk and Dex(P<0.001).Over-expression of SESN1 in HepG2 cells promoted mRNA expression of PGC-1α,PEPCK and G6Pase(P<0.001)and promoter activity of PGC-1α(P<0.001).Over-expression of SESN1 decreased the acetylation level of PGC-1α in primary hepatocytes.Sirt family inhibitors NAM and shRNA adenovirus interfered with SIRT1 expression respective-ly,and antagonized the deacetylation effect of SESN1 on PGC-1α.The expression of PGC-1α,PEPCK and G6Pase induced by SIRT1 was also significantly impaired(P<0.000 1).Conclusions SESN1 regulates liver gluconeogene-sis in mice with a SIRT1-dependent mechanism.
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Objective To investigate the effect of Nutlin-3a,a mouse double minute 2 homolog(MDM2)inhibitor,on lipid metabolism of mouse adipose.Methods High-fat diet-induced obesity(DIO)C57BL/6J mice were randomly divided into a control group injected with DMSO and an experimental group injected with Nutlin-3a.Then we conducted glucose tolerance(GTT)and insulin tolerance(ITT)tests.The epididymal white adipose tissue(eWAT),inguinal white adipose tissue(iWAT)and brown adipose tissue(BAT)of animals were isolated and microscopy of WATs with hematoxylin-eosin(HE)staining was performed to observe the morphological changes of adipocytes.The expression of lipid metabolism related gene cell death-inducing DFF45-like effector C(CIDEC)in eWAT were detected by qPCR and Western blot.Results Compared with the control group,Nutlin-3a was found to promote the body weight(P<0.001),but no effect on glucose tolerance and insulin sensitivity in DIO mice.Nutlin-3a treatment decreased the size of adipocytes and fat deposition in adipose tissue and downregulated the mRNA and protein levels of CIDEC in eWAT.Conclusions Nutlin-3a inhibits the formation of lipid droplets by downregulating expression of CIDEC in white adipose tissue.
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Objective:To explore the abnormally low expression of regulatory T cells (Tregs) in the peripheral blood of patients with keloids, its correlation with the formation and evolution of keloids.Methods:A total of 50 peripheral blood samples of patients diagnosed with keloids were collected in the first diagnosis of Changzhi City People′s Hospital from January 2019 to January 2021 as keloid group, including 22 males and 28 females, with an age range of 18-55 years and an average age of 32.13 years; the control group was normal healthy beauty seekers in the outpatient department of Changzhi People′s Hospital during the same period, and finally 25 peripheral blood samples were also collected, including 15 males and 10 females, with an age range of 18-55 years and an average age of 32.96 years. All patients had 2 ml of venous blood drawn on an empty stomach early in the morning before admission for treatment, and placed in an ethylene diamine tetraacetic acid (EDTA) potassium anticoagulation tube. Fresh peripheral blood samples were generated and sent for examination immediately. Flow cytometry was used to detect the CD4 + , CD25 + , CD127 + cells and low Tregs ratio in peripheral blood of keloid patients ( n=50) and normal healthy people ( n=25); the fluorescence intensity was analyzed, the light scattering data were saved, and Cell Quest Plot was used on the computer after the test. The point diagram and the group square diagram were analyzed by SPSS 24.0 for statistical software analysis; peripheral blood Tregs ratio was expressed as the mean ± standard deviation ( ±s), and the mean comparison between the two groups was conducted by using independent sample t test; multiple groups One-way analysis of variance was used for the comparison of the averages, and the difference was statistically significant at P<0.05. The keloid questionnaire and clinical grading were utilized to deeply analyze the relationship between the Tregs ratio in peripheral blood of keloid patients and the severity of keloid. Results:Compared with the normal control group, the peripheral blood Tregs ratio of the keloid group was significantly reduced [(4.39±1.31)% vs. (6.64±1.83)%, P<0.001]; according to the Sawada score scale, keloids were classified as mild, moderate and severe degrees; the Tregs ratio in peripheral blood of the moderate keloid group was significantly lower than that of the mild keloid group [(4.43±1.23)% vs. (5.37±1.12)%, P<0.05], while in the severe keloid group it was also significantly lower than the moderate keloid group [(3.55±0.97)% vs. (4.43±1.23)%, P<0.05]. Conclusions:The Tregs ratio of peripheral blood in patients with keloids is significantly decreased, suggesting that Tregs cell is one of the biomarkers to reflect the severity of keloids.
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Objective:To investigate the changes and clinical significance of multiple cytokine levels in exhaled breath condensate (EBC) in patients undergoing tracheotomy with severe inhalation injury.Methods:A prospective study was conducted. A total of 32 patients with severe burn combined with severe inhalation injury admitted to the department of burns and plastic surgery of Affiliated Suzhou Hospital of Nanjing Medical University from May 2021 to August 2022 were enrolled. Twenty healthy volunteers from the same period were served as controls. EBC of patients at 12 hours after burn and the samples of healthy controls were collected. The levels of 27 cytokines in EBC, including tumor necrosis factor-α (TNF-α) and interleukins (IL-1β, IL-6, IL-8, IL-10, and IL-17), were determined by liquid phase chip technology. Meanwhile, plasma of patients at 12 hours after burn and the plasma of volunteers were collected, and the levels of inflammatory cytokines were detected by liquid chip technology, and the differences between the levels in plasma and those in EBC were analyzed. Plasma and EBC of patients with aspiration injury were collected at 12 hours and 3, 7, 14 and 21 days after burn, and TNF-α levels were determined by enzyme-linked immunosorbent assay (ELISA).Results:Finally, 32 patients were enrolled, and the total burned area was (40±16)% of total body surface area (TBSA). The time of admission was (4.2±2.3) hours after injury. ① Twenty-seven cytokines in EBC: 18 kinds of cytokines including macrophage inflammatory protein-1β (MIP-1β), IL-6, IL-5, IL-2, IL-1β, IL-8, IL-10, IL-15, IL-9, interferon-γ (IFN-γ), IL-1 receptor antagonist (IL-1ra), TNF-α, chemotactic factor for eosinophil (Eotaxin), basic fibroblast growth factor (bFGF), platelet derived growth factor-BB (PDGF-BB), interferon-inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), granulocyte colony-stimulating factor (G-CSF) were significantly increased in patients with severe aspiration injury compared with health controls. Eotaxin was not detected in EBC of healthy controls. Five cytokines, granulocyte-macrophage colony-stimulating factor (GM-CSF), chemokine ligand 5 (CCL5/RANTES), IL-13, IL-4 and MIP-1α, were not detected in EBC of severe inhalation injury patients and healthy controls. Vascular endothelial growth factor (VEGF) and IL-12 p70 in EBC of severe aspiration injury patients were slightly decreased as compared with healthy controls, while IL-7 and IL-17 were slightly increased, but the differences were not statistically significant. ② Six inflammatory cytokines in plasma: the levels of IL-6 and IL-8 in the severe aspiration injury group were significantly increased as compared with healthy controls [IL-6 (ng/L): 18.51 (10.87, 26.21) vs. 0.22 (0.10, 0.36), IL-8 (ng/L): 10.75 (8.58, 18.79) vs. 1.06 (0.81, 2.14), both P < 0.01]. The plasma levels of TNF-α, IL-1β and IL-10 were slightly increased in patients with severe aspiration injury as compared with healthy controls, and IL-17 was slightly decreased, but the difference was not statistically significant. In the EBC collected during the same period, five inflammatory cytokines, including TNF-α, IL-1β, IL-6, IL-8 and IL-10, in patients with severe inhalation injury were significantly increased as compared with healthy controls [TNF-α (ng/L): 16.42 (12.57, 19.21) vs. 7.34 (6.11, 8.69), IL-1β (ng/L): 15.57 (10.53, 20.25) vs. 0.99 (0.67, 1.41), IL-6 (ng/L): 13.36 (9.76, 16.54) vs. 0.70 (0.42, 0.85), IL-8 (ng/L): 1 059.29 (906.91, 1 462.37) vs. 10.36 (8.40, 12.37), IL-10 (ng/L): 2.69 (1.54, 3.33) vs. 1.54 (1.18, 2.06), all P < 0.05]. ③ Dynamic changes of TNF-α in plasma and EBC: the level of TNF-α in EBC of patients with severe aspiration injury was lower than that in plasma. Plasma TNF-α level was increased gradually with the extension of time after injury, and was significantly higher than that of healthy controls on day 3 [ng/L: 30.38 (24.32, 39.19) vs. 22.94 (17.15, 30.74), P < 0.05], and reached the peak on day 14, then fell back. The level of TNF-α in EBC at 12 hours after injury was significantly higher than that in healthy controls [ng/L: 15.34 (11.75, 18.14) vs. 6.99 (6.53, 7.84), P < 0.01], and reached the peak on 3 days after injury, and then gradually decreased. Conclusion:There are changes in the expression of multiple cytokines in EBC of patients with severe inhalation injury, and the changes of many inflammatory cytokines including TNF-α are more sensitive than those in plasma, which can be used to monitor and evaluate the condition of patients with inhalation injury.
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The mechanisms of radiotherapy (RT) in cancer treatment are both by immunity and non-immunity pathways. According to different absorbed doses, the immune modulating effect of RT comprises of tumor microenvironment modulating effect, immune-modulatory effect as well as immune-ablative effect. RT could improve the therapeutic efficacy of immunotherapy, while immunotherapy could enlarge the immunity activating effect induced by RT in turn. Therefore, RT is emerging as a valuable partner of cancer immunotherapy. RT regimens have a vital impact on immunity within tumor microenvironment. Stereotactic body RT (SBRT) has obvious advantages regarding interferon production and abscopal effect. At present, potentially sub-ablative RT regimen of 8 Gy plus 3 fractionations is the most widely used SBRT. Several novel RT regimens, such as hybrid fractionation, singular site irradiation and multisite irradiation, have been designed to maximize the immune induction effect and improve the combination efficacy with immunotherapy in metastatic malignancies. In this review, the latest advances in the immune effect of RT were discussed and novel SBRT regimens were proposed, aiming to provide reference for enhancing the efficacy of radio-immunotherapy or immuno-radiotherapy in clinical practice.
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Radiotherapy is an important treatment method for malignant tumors. Radiation resistance is the main obstacle to the therapeutic effect of radiotherapy. Cellular metabolic reprogramming is one of the main features of cancer, and it may have an important effect on the therapeutic effect of radiotherapy. Glutamine is closely related to tumor cell biosynthesis and growth. It affects radiotherapy sensitivity by producing antioxidants through decomposition. In addition, the expression patterns and functions of two isoenzymes of glutamine, namely, glutaminase (GLS) and glutaminase 2 (GLS2), are different and have an important influence on the sensitivity of radiotherapy. The utilization of glutamine metabolism in the tumor microenvironment has great research value to improve the efficacy of radiotherapy. This review describes the metabolic characteristics of glutamine in malignant tumors and the sensitization effect of glutamine inhibitors on the efficacy of radiotherapy.
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【Objective】 Coronary no-reflow during percutaneous conranary intervention (PCI) often results in the failure of ischemic myocardial reperfusion and major adverse cardiovascular events (MACE). The present study sought to evaluate whether the GRACE risk score can predict coronary no-reflow in STEMI patients undergoing PCI. 【Methods】 We consecutively recruited 1 118 patients with STEMI who were admitted to Gansu Provincial People’s Hospital and The First Affiliated Hospital of Xi’an Jiaotong University from January 2009 to December 2011. Main demographic data, cardiovascular risk factors, blood lipid and other biochemical indicators were recorded. Coronary angiography was performed by a radial artery approach using the standard Judkins technique. Coronary no-reflow was evaluated by at least two independent experienced cardiologists. The GRACE risk score was calculated with a computer program. All the cases were followed up by medical records, face-to-face interviews or telephone calls. Finally, we analyzed the predictive value of the GRACE risk score for coronary non-reflow and MACE in STEMI patients undergoing PCI. 【Results】 During a median period of 36 months, 58 of the 1 118 patients (5.2%) were lost to follow-up. Of the remaining 1 060 patients, 118 (11.1%) had no-reflow and 147 (13.9%) had MACE. The GRACE score was higher in patients with no-reflow than those without no-reflow. Multivariate logistic regression established that the GRACE score was an independent predictor for coronary no-reflow (OR=1.034; P=0.002). And multivariate Cox analysis showed the GRACE score was an independent predictor of MACE. The area under the ROC curve for coronary no-reflow and MACE was 0.719 and 0.697, respectively. Kaplan-Meier analysis showed that the probability of rehospitalization for heart failure, reinfarction, all-cause death and cumulative cardiovascular events increased with the increase of the GRACE risk score. 【Conclusion】 The GRACE risk score is a readily available predictive scoring system for coronary no-reflow and MACE in STEMI patients.
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Objective:To analyze the status of extracorporeal membrane oxygenation (ECMO) for poisoned patients in China, and prognosis, complications and risk factors for death in poisoned patients supported with ECMO.Methods:The data of adult poisoned patients registered in Chinese Society of Extracorporeal Life Support (CSECLS) database were collected. Patients were divided into the survival group and death group according to the conditions at discharge. The type of poisoning, patient prognosis, hemodynamic parameters and complications before and after ECMO were retrospectively analyzed.Results:A total of 96 poisoned patients supported with ECMO were included in the database from 2017 to 2022, including 77 adult patients. The use of ECMO for poisoning was more common in Henan Province (28 cases, 36%), Guangdong Province (11 cases, 14%) and Zhejiang Province (9 cases, 8%). The number of adult poisoned patients registered in the database increased over time from 2017 to 2022, but the survival rate showed no significant difference ( P = 0.794). Agricultural poisoning was the most common indication (43%). Veno-arterial (V-A) ECMO was used in 60 patients (78%) and venovenous (V-V) ECMO in 27 patients (22%). Thirty-two patients (42%) survived to hospital discharge. The mean duration of ECMO support was 57 (34, 123) h, the mean duration of mechanical ventilation was 88 (33, 211) h, the mean length of hospital stay was 10 (2, 21) days, and the mean length of ICU stay was 9 (2, 18) days. Multivariate analysis showed that 24-h lactic acid level was significantly associated with mortality ( OR = 0.378, 95% CI: 0.183-0.779, P = 0.008). Conclusions:ECMO can be used as a salvage strategy to treat various types of severe poisoning. Although the application of ECMO is expanded rapidly in China, it is still necessary to optimize intervention indications and treatment timing, and adopt standardized ECMO management and monitoring strategies to improve the prognosis of patients.
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Objective:To investigate the expression of miRNA-21 in serum of patients with multiple myeloma (MM) and its significance.Methods:The data of 55 MM patients and 20 healthy controls in the Second Hospital of Hebei Medical University from July 2019 to June 2020 were retrospectively analyzed. Among the MM patients, 20 cases were diagnosed without treatment, 15 cases were in complete remission (CR), and 20 cases were clinically relapsed. Blood samples were collected from all subjects, and the relative expression levels of miRNA-21 were detected by real-time quantitative polymerase chain reaction (qRT-PCR), and the correlation of miRNA-21 expression with β 2-macroglobulin (β 2-MG), creatinine, hemoglobin, albumin, t(4;14) mutation, 13q14 mutation and prognosis were analyzed. The MM cell line LP-1 was selected, and normal bone marrow CD138-positive plasma cells were sorted by immunomagnetic beads as control cells. The relative expression levels of miRNA-21 in the two groups of cells were detected by qRT-PCR. Results:The serum relative expression level of miRNA-21 in MM group was higher than that in healthy control group (1.50±0.10 vs. 1.03±0.06, t = 7.04, P = 0.002). The serum expressions of miRNA-21 in newly diagnosed untreated MM patients and relapsed/refractory MM patients were high (1.50±0.10 and 3.13±0.32), and compared with the healthy control group, the differences were statistically significant ( t values were 7.04 and 10.22, both P < 0.05). The relative expression level of miRNA-21 in MM patients with complete remission (CR) was 1.27±0.25, which had no significant difference compared with the healthy control group ( t = 1.76, P = 0.152). The serum expression level of miRNA-21 in MM patients with high β 2-MG, high creatinine, low hemoglobin, low albumin, t(4;14) mutation, 13q14 mutation, non-remission and recurrence was significantly increased (all P < 0.05). The relative expression level of miRNA-21 in LP-1 cell line was higher than that in control cells (1.56±0.05 vs. 1.00±0.06), and the difference was statistically significant ( t = 11.73, P < 0.01). Conclusions:The miRNA-21 may be a molecular marker to assist in the diagnosis and efficacy evaluation of MM.
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Objective:To summarize the clinical experience of treating patients with severe acute organic fluorine poisoning using extracorporeal membrane oxygenation (ECMO).Methods:In January 2021, an acute mass organic fluorine gas poisoning incident occurred in Quzhou, Zhejiang Province. The clinical data of 4 severe patients with acute poisoning of organic fluorine treated by ECMO in our hospital were retrospectively analyzed, and the epidemiological characteristics, clinical symptoms, signs, the abnormal laboratory studies/examinations, and treatments of this kind poisoning patients, especially, the treatment pattern, support time, complications, and outcomes of ECMO were collected and analyzed.Results:All the 4 patients were male, with an average age of (52±9) years, and all of them came to the emergency department complaining chest tightness, cough and pharyngeal discomfort 6 h after exposure by inhalation. The patient’s condition progressed rapidly with severe acute respiratory failure and circulatory failure as the prominent manifestations. The mechanical ventilations were performed (13.0±4.8) h after poisoning, and ECMO treatment was performed (15.5±5.3) h after poisoning. Among them, 2 patients were treated using venoarterial (VA) ECMO, and 2 patients using venovenous (VV) ECMO, but 1 patient was converted to VA-ECMO 8 h later. The duration of ECMO support for the patients was (8.8±3.6) d. The duration of mechanical ventilation was (23.0±28.7) d and stay in intensive care unit was (42.0±55.4) d. Among them, one patient was transferred to a specialized rehabilitation hospital after the amputation surgery due to lower limb necrosis after VA-ECMO support, and the remaining 3 patients were discharged after recovery.Conclusions:ECMO support might have the irreplaceable value in the treatment of patients with severe acute organic fluorine poisoning, and should be considered as one of the reserves of regional health care system in dealing with public health emergencies.
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AIM: To screen the active constituents in Taohong Siwu Decoction(THSWD) by Systems Pharmacology and to study its protective effect on myocardial injury through cell experiments. METHODS: The TCMSP database and Pharmmaper database were used to retrieve the constituents and active constituent targets of THSWD. The Genecards database was used to retrieve the myocardial injury related targets gene. Then construct and analyze the constituents-disease intersection target network and the contribution value of constituents, and screen out the main active constituents of THSWD acting on the myocardium. Furthermore, CoCl
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Objective This article takes a cosmetics factory in Yichang City as an example, uses a variety of methodologies to explore methods of health impact assessment and provides methodological references for future health evaluation of related public policies. Methods By analyzing the environmental assessment report of the cosmetic renovation project, an indicator system was established and expert consultation meetings were conducted to score the impact of the corresponding indicators on health. The impact of the renovation project of the factory on the factory workers, surrounding residents and the sustainable development of the environment was analyzed by means of the Kaiser model with the risk matrix and the Borda value. Results The risk values of the five influencing factors of industrial wastewater, domestic wastewater, industrial waste gas, industrial waste and noise were 5.11%, 5.43%, 10.6%, 6.71% and 7.02% respectively. All the influencing factors were in the green zone of the risk matrix. The Borda values of the five influencing factors of industrial waste water, domestic waste water, industrial waste gas, industrial waste residue and noise were 4, 5, 10, 7 and 5 respectively. Conclusion The multiple methodologies adopted in the factory renovation project are feasible, and can provide new ideas for the health impact assessment of public policies in the future.
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Objective To evaluate the construction status of a healthy city in central China, and clarify the weak links and construction results in the construction of a healthy city, and to provide a basis for the relevant government departments to issue policies. Methods Healthy city construction evaluation system in this city was established according to the National Healthy City Construction Evaluation System (2018) of the National Healthy City Evaluation Office Forty-two sets of health city construction index data in 2017-2018 were collected and analyzed. The single index was calculated according to the Guidance Manual for Filling in the Healthy City Evaluation Data, and the single index data was then standardized. The Delphi method was used to consult the weights of the three-level index. Finally, the sub-index and the total index of each dimension of the city's healthy city construction were calculated based on the health index method. Results The results of the 2017-2018 healthy city construction evaluation showed that 35 of the 42 indexes participated in the evaluation, and the total-indices of the two years were 77.71 and 79.95, respectively. The two-year sub-indices of the five dimensions of health service, health culture, health environment, healthy population, and healthy society were 17.17 and 18.32, 11.39 and 12.85, 19.21 and 17.94, 13.81 and 13.81, 16.12 and 17.04, respectively. Except for the decline in the health environment dimension, the other four sub-indices and the total healthy city index showed an upward trend year by year. In the past two years, the comprehensive proportions of the corresponding weight of the five dimensions sub-indices were 95.58% in health culture, 95.47% in health service, 73.99% in health environment, 73.27% in healthy society, and 69.52% in healthy people. Conclusion After the construction of national healthy city and the pilot construction of national healthy city, a city in central China achieved its first results in five dimensions of healthy city. In 2018, among the 35 indexes participated in the evaluation in this city, 30 were positive, and 26 were better than the national/ provincial target value. However, some construction indices were still far from the standard values. The development of the five dimensions was unbalanced, and there were weak links in different degrees.
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To investigate the clinical manifestations and risk factors in patients with systemic lupus erythematosus (SLE) and cancers. From October 2010 to February 2019, 5 566 SLE patients hospitalized in the First Affiliated Hospital of Zhengzhou University were enrolled. A total of 69 cancer patients were identified, and the clinical characteristics and previous treatment were analyzed. Cervical carcinoma (21.74%, 15/69) and thyroid cancer (21.74%, 15/69) were the most common types of cancer. Most cancers were diagnosed in SLE patients with an age 40~50 years. The disease duration of SLE was from 60~120 months. SLE patients without cancers were usually diagnosed between 20~30 years with duration of symptoms less than 12 months. As to the previous treatment of SLE, the uses of glucocorticoid, cyclophosphamide, methotrexate and azathioprine were comparable between patients with cancers and without (P>0.05). However, the use of hydroxychloroquine was more frequent in SLE patients than in patients with cancers (P<0.01). Correlation analysis revealed significant correlation between disease course of SLE (OR=4.25, 95%CI 1.79~10.01,P<0.001), hydroxychloroquine (OR=0.26, 95%CI 0.12~0.59,P<0.001) and cancer risk. Long disease course may be a risk factor for SLE patients to develop cancer, whereas hydroxychloroquine could be a protective factor.
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To investigate the clinical manifestations and risk factors in patients with systemic lupus erythematosus (SLE) and cancers. From October 2010 to February 2019, 5 566 SLE patients hospitalized in the First Affiliated Hospital of Zhengzhou University were enrolled. A total of 69 cancer patients were identified, and the clinical characteristics and previous treatment were analyzed. Cervical carcinoma (21.74%, 15/69) and thyroid cancer (21.74%, 15/69) were the most common types of cancer. Most cancers were diagnosed in SLE patients with an age 40~50 years. The disease duration of SLE was from 60~120 months. SLE patients without cancers were usually diagnosed between 20~30 years with duration of symptoms less than 12 months. As to the previous treatment of SLE, the uses of glucocorticoid, cyclophosphamide, methotrexate and azathioprine were comparable between patients with cancers and without ( P>0.05). However, the use of hydroxychloroquine was more frequent in SLE patients than in patients with cancers ( P<0.01). Correlation analysis revealed significant correlation between disease course of SLE ( OR=4.25, 95% CI 1.79~10.01, P<0.001), hydroxychloroquine ( OR=0.26, 95% CI 0.12~0.59, P<0.001) and cancer risk. Long disease course may be a risk factor for SLE patients to develop cancer, whereas hydroxychloroquine could be a protective factor.
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A 37-year-old woman presented with a congenital spinal meningocele for 37 years and ruptured for 6 months. She was admitted to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences in March 2018. The diameter of the lesion was about 10 cm, with purulent secretion and malodor. The superior gluteal artery perforator propeller flap was used to reconstruct the defect after the lesion resection. Part of the wound didn’t heal and cerebrospinal fluid leaked from the wound postoperatively. The wound eventually healed after wound debridement and drainage changing. Cerebrospinal fluid retention under the flap could result in wound dehiscence and cerebrospinal fluid leakage. The author introduced the treatment process and operative method. The preliminary experience in treating cerebrospinal fluid leakage after surgical management of the spinal meningocele was also summarized.
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Objective@#To analyze the clinical characteristics and gene mutations of early-onset epileptic encephalopathy(EOEE) caused by ion channel gene mutation, to identify the etiology, to guide the treatment and to provide the basis for genetic counseling.@*Methods@#The clinical data from 17 children with EOEE caused by ion channel gene mutation and the peripheral blood of the children and their parents were collected from June 2014 to May 2018 at the Department of Neurology, Tianjin Children′s Hospital.Epilepsy gene sequencing was performed by using disease gene targeting second generation sequencing technology.The mutation of pathogenic ion channel gene was found.The confirmed mutations were verified by Sanger sequencing and the source of the mutation was identified.@*Results@#Among 17 case with EOEE, 3 cases had genetic mutation, and 14 cases had denovo mutations.Dravet syndrome was found in 8 cases (47.1%), there were SCN1A gene missense mutation in 5 cases, SCN1A gene nonsense mutation in 3 cases, KCNQ2 gene missense mutation in 1 case (5.9%) and non-specific epileptic encephalopathy in 8 cases (47.1%). SCN2A gene missense mutation, SCN4A gene missense mutation, SCN8A gene missense mutation, KCNQ2 gene missense mutation and KCNH gene missense mutation were found in suspected pathogenic mutations.There were 1 missense mutation out of 5 genes, 1 missense mutation of CACNA1A gene, 1 missense mutation of GRIN2A gene and 1 missense mutation of GRIN3A gene.Seventeen patients were treated with 2 or more antiepileptic drugs, 4 with ketogenic diet and 1 with vitamin B6 supplementation.During 11 to 96 months of follow-up, seizures were completely controlled in 3 cases (17.6%), decreased in 7 cases (41.2%) by more than 50%, and decreased in 7 cases (41.2%) by less than 50%.@*Conclusions@#The clinical phenotypes for children with unexplained EOEE are varied, and gene mutations of ion cha-nnel are most common.Some gene sites are denovo mutations which have not been reported such as missense mutation for 3 case SCN1A gene, 1 case SCN2A gene, 1 case CACNA1A gene, 1 case KCNH5 gene, and nonsense mutation for 2 case SCN1A gene, which have enriched the mutation spectrum of EOEE.
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Health related behaviors are closely related to health outcomes. This paper reviews the studies on factors for health related behaviors worldwide published in recent 15 years, and systematically summarizes the current research status of the factors for health related behaviors. The factors influencing health related behaviors are individual social demographic factors, social cognitive factors of individuals, and social environmental factors. The individual social demographic factors mainly include gender, age, marital status, economic level and educational level. The social cognitive factors of individuals mainly include self-efficacy, health belief, social support and peer influence. The social environmental factors mainly include mass media, accessibility of facilities and level of urbanization, etc.
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Epilepsy is a chronic brain lesion caused by a variety of pathological factors. It is characterized by repeatability, transient and seizure, and is one of the common neurological systemic diseases in children. Seizures can induce structural changes of sleep and cause sleep disorders, and sleep disorders call induce interictal epileptiform discharges and seizures. The abnormal sleep structure of children with epilepsy is characterized by decreased total sleep time, prolonged sleep latency, prolonged latency of rapid eye movement (REM), and decreased proportion of sleep fragments and shortened sleep cycle time. Epilepsy and sleep are closely related and complex. Controlling seizures can help improve the quality of sleep. The normalization of sleep structure in children with epilepsy can help control seizures, thus improving overall quality of life and long-term prognosis.
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Objective To analyze the clinical characteristics and gene mutations of early -onset epileptic encephalopathy(EOEE)caused by ion channel gene mutation,to identify the etiology,to guide the treatment and to pro﹣vide the basis for genetic counseling. Methods The clinical data from 17 children with EOEE caused by ion channel gene mutation and the peripheral blood of the children and their parents were collected from June 2014 to May 2018 at the Department of Neurology,Tianjin Children′s Hospital. Epilepsy gene sequencing was performed by using disease gene targeting second generation sequencing technology. The mutation of pathogenic ion channel gene was found. The confirmed mutations were verified by Sanger sequencing and the source of the mutation was identified. Results Among 17 case with EOEE,3 cases had genetic mutation,and 14 cases had denovo mutations. Dravet syndrome was found in 8 cases(47. 1﹪),there were SCN1A gene missense mutation in 5 cases,SCN1A gene nonsense mutation in 3 cases, KCNQ2 gene missense mutation in 1 case(5. 9﹪)and non-specific epileptic encephalopathy in 8 cases(47. 1﹪). SCN2A gene missense mutation,SCN4A gene missense mutation,SCN8A gene missense mutation,KCNQ2 gene missense mutation and KCNH gene missense mutation were found in suspected pathogenic mutations. There were 1 missense mu﹣tation out of 5 genes,1 missense mutation of CACNA1A gene,1 missense mutation of GRIN2A gene and 1 missense mu﹣tation of GRIN3A gene. Seventeen patients were treated with 2 or more antiepileptic drugs,4 with ketogenic diet and 1 with vitamin B6 supplementation. During 11 to 96 months of follow-up,seizures were completely controlled in 3 cases (17. 6﹪),decreased in 7 cases(41. 2﹪)by more than 50﹪,and decreased in 7 cases(41. 2﹪)by less than 50﹪. Conclusions The clinical phenotypes for children with unexplained EOEE are varied,and gene mutations of ion cha﹣nnel are most common. Some gene sites are denovo mutations which have not been reported such as missense mutation for 3 case SCN1A gene,1 case SCN2A gene,1 case CACNA1A gene,1 case KCNH5 gene,and nonsense mutation for 2 case SCN1A gene,which have enriched the mutation spectrum of EOEE.