摘要
Objective:To explore the potential mechanisms of the relationship between socioeconomic status(SES)and depression of Chinese older adults through the mediating role of digital participation and health lifestyle.Methods:Using the nationally representative data from the China Family Panel Studies in 2020,4 846 participants aged 60 years and older were analyzed in our study.We explored the potential mechanisms of the relationship between SES and depression of Chinese older adults in the digital era through a chain multiple mediating effects model.The KHB(The Karlson,Holm,and Breen)method was used to analyze the mediating role of digital participation and health lifestyle and the propor-tion of mediating effect between the two was also calculated.A series of robustness tests were further con-ducted and the fit of the model was checked by structural equation modeling.Results:The mean age of the 4 846 older adults included in this study was(68.20±5.07)years,48.06%of whom were female and 51.94%were male.The KHB results showed that both digital participation and health lifestyle could mediate the relationship between SES and depression of older adults(P<0.000 1)and the mediating role of health lifestyle accounted for a greater proportion than digital participation.And our study mainly found three potential pathways of SES and depression of older adults,including:(1)SES → digital par-ticipation → health lifestyle → depression,(2)SES → health lifestyle → depression,and(3)SES →depression.Structural equation modeling tests proved the overall fit of the model in this study.Conclu-sion:Our findings showed that in the digital age,in addition to the direct relationship between SES and depression of older adults,and the health lifestyle as a mediator between the relationship,there is also a sequential mediating role of digital participation and health lifestyle to reduce the risk of depression.The findings suggest that we should pay more attention to the probability of the digital divide exacerbating health inequalities and socioeconomic inequalities accumulation in the digital age and promote the co-progress of digital literacy and health literacy among older adults.
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ObjectiveThis study aims to examine the effect of Rhei Radix et Rhizoma-Coptidis Rhizoma on reducing insulin resistance in db/db mice by regulating the adenylate activated protein kinase (AMPK)/UNC-51-like kinase 1 (ULK1)/key molecule of autophagy, benzyl chloride 1 (Beclin1) pathway and elucidate the underlying mechanism. MethodSixty 6-week-old male db/db mice were studied. They were randomly divided into the model group, metformin group (0.26 g·kg-1), and low-, middle-, and high-dose groups (2.25, 4.5, 9 g·kg-1) of Rhei Radix et Rhizoma-Coptidis Rhizoma. A blank group of db/m mice of the same age was set, with 12 mice in each group. After eight weeks of continuous intragastric administration, the blank group and model group received distilled water intragastrically once a day. The survival status of the mice was observed, and fasting blood glucose (FBG) was measured using a Roche blood glucose device. Fasting serum insulin (FINS) was measured using an enzyme-linked immunosorbent assay, and the insulin resistance index (HOMA-IR) was calculated. Hematoxylin-eosin (HE) staining was performed to observe the pathological changes in the liver of the mice. The protein expression levels of AMPK, Beclin1, autophagy associated protein 5 (Atg5), and p62 in liver tissue were determined by using Western blot. The protein expression levels of autophagy associated protein 1 light chain 3B (LC3B) and ULK1 in liver tissue were determined using immunofluorescence. Real-time fluorescence quantitative PCR (Real-time PCR) was used to measure mRNA expression levels of AMPK, Beclin1, Atg5, ULK1, and p62. ResultCompared with the blank group, the model group exhibited a significant increase in body mass (P<0.01). Additionally, the levels of FBG, FINS, and HOMA-IR significantly changed (P<0.01). The structure of liver cells was disordered. The protein expression levels of AMPK, Beclin1, and Atg5 in liver tissue were significantly decreased (P<0.01), while the expression level of p62 protein was significantly increased (P<0.01). The expression levels of mRNA and proteins were consistent. Compared with the model group, the body mass of the metformin group and high and medium-dose groups of Rhei Radix et Rhizoma-Coptidis Rhizoma was significantly decreased (P<0.05). FBG, FINS, and HOMA-IR were significantly decreased (P<0.05,P<0.01). After treatment, the liver structure damage in each group was alleviated to varying degrees. The protein expressions of AMPK, Beclin1, Atg5, LC3B, and ULK1 were increased (P<0.05,P<0.01), while the protein expression of p62 was decreased (P<0.01). The expression levels of mRNA and proteins were generally consistent. ConclusionThe combination of Rhei Radix et Rhizoma-Coptidis Rhizoma can effectively improve liver insulin resistance, regulate the AMPK autophagy signaling pathway, alleviate insulin resistance in db/db mice, and effectively prevent the occurrence and development of type 2 diabetes.
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@#Objective To analyze the research hotspots and progress of surgical treatment of myasthenia gravis. Methods The top 100 most cited articles on surgical treatment of myasthenia gravis were identified by searching the Web of Science database, and a bibliometric analysis was conducted. Results The publication year of the top 100 most cited articles ranged from 1939 to 2021, and the number of citations ranged from 55 to 850 per article. Most of the included articles were original research articles (75/100), which were mainly retrospective studies (64/75). The United States was the country with the most published articles and most citations, and Annals of Thoracic Surgery was the most sourced journal (n=20). Through VOSviewer analysis, high-density keywords were thymectomy, maximal thymectomy, extended thymectomy, transcervical thymectomy, thymoma, and autoantibodies. Conclusion The scope of surgical resection, surgical approach and pathogenesis are the current hotspots in the field of surgical treatment of myasthenia gravis. It is hoped that this paper can provide references for future researches in this field.
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ObjectiveTo reveal the intervention effect of Dahuang Mudantang on pancreatic injury in rats with acute pancreatitis (AP) of dampness-heat in large intestine syndrome and explore its possible mechanism based on network pharmacology. MethodNinety-six SPF-grade Wistar rats were randomly divided into the following six groups: a blank group, a model group, low-, medium-, and high-dose Dahuang Mudantang groups (3.5, 7, and 14 g·kg-1), and a Qingyi Lidan granules group (3 g·kg-1), with 16 rats in each group. The AP model of dampness-heat in large intestine syndrome was induced in rats except for those in the blank group by "high-temperature and high-humidity environment + high-sugar and high-fat diet + retrograde injection of 5% sodium taurocholate into the pancreaticobiliary duct". The blank and model groups received equal volumes of distilled water by gavage, while the treatment groups were administered Dahuang Mudantang or Qingyi Lidan granules 1 hour before modeling, and 12 and 24 hours after modeling. Samples were collected 1 hour after the last administration. The general conditions of the rats were observed. The AP model of dampness-heat in large intestine syndrome was evaluated. Serum amylase (AMS) and C-reactive protein (CRP) levels were determined using biochemical methods. Pancreatic tissue morphology was observed using hematoxylin-eosin (HE) staining. Network pharmacology was employed to predict potential targets of Dahuang Mudantang in the intervention in AP, and molecular biology technique was used to verify relevant targets. ResultCompared with the blank group, the model group exhibited lethargy, unkempt fur, loose and foul-smelling stools, elevated anal temperature with arching and twisting reactions, significantly increased serum levels of AMS and CRP (P<0.05), abnormal pancreatic ductules, disordered interlobular spaces, and inflammatory cell infiltration in histopathological examination, as well as pathological changes including pancreatic acinar cell swelling, congestion, and necrosis. Compared with the model group, the treatment groups showed varying degrees of improvement in general survival conditions, reduced twisting reactions, visibly improved stool characteristics, reduced pancreatic tissue edema and necrosis, decreased serum AMS and CRP levels (P<0.05), with the high-dose Dahuang Mudantang group showing the most pronounced effects (P<0.05). Network pharmacology prediction indicated that hederagenin, β-sitosterol, and quercetin were the most widely connected active compounds with disease targets. Protein-protein interaction (PPI) network analysis revealed that protein kinase B (Akt), tumor protein P53 (TP53), tumor necrosis factor (TNF), interleukin-6 (IL-6), transcription factor (JUN), vascular endothelial growth factor α (VEGFα), interleukin-1β (IL-1β), and vascular cell adhesion molecule-1 (VCAM1) were key targets in the "drug-disease" interaction. KEGG enrichment analysis suggested that the response of the mitogen activated protein kinase (MAPK) signaling pathway might be a core mechanism for DHMDT in the intervention in AP. Molecular biology analysis showed that compared with the blank group, the model group had significantly increased levels of TNF-α, IL-6, and VCAM-1 in pancreatic tissue (P<0.05), as well as significantly elevated expression levels of p38 mitogen-activated protein kinase (p38 MAPK), mitogen-activated protein kinase-activated protein kinase 2 (MK2), and human antigen R (HUR) genes and proteins (P<0.05). Compared with the model group, the treatment groups exhibited decreased levels of TNF-α, IL-6, and VCAM-1 in pancreatic tissue (P<0.05), reduced expression levels of p38 MAPK, MK2, and HUR genes and proteins, with the high-dose Dahuang Mudantang group showing the most pronounced effects (P<0.05). ConclusionDahuang Mudantang activates and regulates the p38 MAPK/MK2/HUR signaling pathway to suppress the release of inflammatory factors, thereby improving pancreatic injury.
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Objective:This paper mainly discusses the health policy of early life of pregnant women and infants in Beijing as an example,and to provide the basis for policy formulation and optimization.Methods:By using the content analysis method,149 policy texts are divided into two dimensions:policy objectives and policy instruments.The results are described by manual coding,cross analysis and trend analysis.Results:In regard to Policy Objectives,improvement of maternal and child health service levels accounts for the biggest proportion(61.7%),whereas improvement of research level accounts for the least(8.1%).In the four dimensions of policy instruments,mandatory,spontaneous,capacity-building,and incentive tools account for 90%,55%,48%and 42%respectively.According to the trend analysis,integrity of policy system has been continuously improved and the proportion of infant and child care has also increased.Both cross-analysis and trend analysis have showed the strong use of coercive and incentive tools by relevant policies;The use of spontaneous and capacity-building tools is low and decreases over time.Conclusion:Improving the level of maternal and child health services is the core concern of Beijing's early life health policy.However,relatively little attention is paid to the family,infant and child care,and scientific research construction.As for Policy Instruments,mandatory tools are widely used;Incentive Tools and Spontaneous Tools are mainly applied in well-being and soft guidance;insufficient use of Capacity-building Tools.Suggestions:In the future,the policy system should be further improved,which should be targeted and deficiency-mending.It is suggested that more resources should be increased for the family system,more attention should be paid to vulnerable groups early in life,and more financial support should be applied to scientific research on maternal and child health.
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@#Objective To assess the safety and clinical outcomes of segmentectomy in one- or two-staged video-assisted thoracoscopic surgery (VATS) for bilateral lung cancer. Methods We retrospectively enrolled 100 patients who underwent VATS segmentectomy for bilateral lung cancer at the Department of Thoracic Surgery of Peking Union Medical College Hospital from December 2013 to May 2022. We divided the patients into two groups: a one-stage group (52 patients), including 17 males and 35 females with a mean age of 55.17±11.09 years, and a two-stage group (48 patients), including 16 males and 32 females with a mean age of 59.88±11.48 years. We analyzed multiple intraoperative variables and postoperative outcomes. Results All 100 patients successfully completed bilateral VATS, and at least unilateral lung received anatomical segmentectomy. Patients in the one-stage group were younger (P=0.040), had lower rate of comorbidities (P=0.030), were less likely to have a family history of lung cancer (P=0.018), and had a shorter interval between diagnosis and surgery (P=0.000) compared with patients in the two-stage group. Wedge resection on the opposite side was more common in the one-stage group (P=0.000), while lobectomy was more common in the two-stage group. The time to emerge from anesthesia in the one-stage group was longer than that in the first and second operations of the two-stage group (P=0.000, P=0.002). Duration of surgery and anesthesia were similar between two groups (P>0.05). Total number of lymph node stations for sampling and dissection (P=0.041) and lymph nodes involved (P=0.026) were less in the one-stage group. Intraoperative airway management was similar between two groups (P>0.05). The one-stage group was associated with lower activities of daily living (ADL) scores. Conclusion Segmentectomy is safe in one- or two-staged VATS for bilateral lung cancer, including contralateral sublobectomy and lobectomy. Duration of surgery and perioperative complications are similar between two groups, but the one-stage group is associated with lower ADL scores. On the basis of comprehensive consideration in psychological factors, physical conditions and personal wishes of patients, one-staged sequential bilateral VATS can be the first choice.
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OBJECTIVE@#To provide useful information for selecting the most appropriate peripheral nerve injury model for different research purposes in nerve injury and repair studies, and to compare nerve regeneration capacity and characteristics between them.@*METHODS@#Sixty adult SD rats were randomly divided into two groups and underwent crush injury alone (group A, n = 30) or transection injury followed by surgical repair (group B, n = 30) of the right hind paw. Each group was subjected to the CatWalk test, gastrocnemius muscle evaluation, pain threshold measurement, electrophysiological examination, retrograde neuronal labeling, and quantification of nerve regeneration before and 7, 14, 21, and 28 days after injury.@*RESULTS@#Gait analysis showed that the recovery speed in group A was significantly faster than that in group B at 14 days. At 21 days, the compound muscle action potential of the gastrocnemius muscle in group A was significantly higher than that in group B, and the number of labeled motor neurons in group B was lower than that in group A. The number of new myelin sheaths and the g-ratio were higher in group A than in group B. There was a 7-day time difference in the regeneration rate between the two injury groups.@*CONCLUSION@#The regeneration of nerve fibers was rapid after crush nerve injury, whereas the transection injury was relatively slow, which provides some ideas for the selection of clinical research models.
Subject(s)
Animals , Rats , Nerve Fibers , Nerve Regeneration , Rats, Sprague-Dawley , Sciatic Nerve/injuries摘要
Variations in the dynein axonemal heavy chain gene, dynein axonemal heavy chain 6 (DNAH6), lead to multiple morphological abnormalities of the flagella. Recent studies have reported that these deficiencies may result in sperm head deformation. However, whether DNAH6 is also involved in human acrosome biogenesis remains unknown. The purpose of this study was to investigate DNAH6 gene variants and their potential functions in the formation of defective sperm heads and flagella. Whole-exome sequencing was performed on a cohort of 375 patients with asthenoteratozoospermia from the First Affiliated Hospital of Anhui Medical University (Hefei, China). Hematoxylin and eosin staining, scanning electron microscopy, and transmission electron microscopy were performed to analyze the sperm morphology and ultrastructure. Immunofluorescence staining and Western blot analysis were conducted to examine the effects of genetic variants. We identified three novel deleterious variants in DNAH6 among three unrelated families. The absence of inner dynein arms and radial spokes was observed in the sperm of patients with DNAH6 variants. Additionally, deficiencies in the acrosome, abnormal chromatin compaction, and vacuole-containing sperm heads were observed in these patients with DNAH6 variants. The decreased levels of the component proteins in these defective structures were further confirmed in sperm from patients with DNAH6 variants using Western blot. After intracytoplasmic sperm injection (ICSI) treatment, the partner of one patient with a DNAH6 variant achieved successful pregnancy. Overall, novel variants in DNAH6 genes that contribute to defects in the sperm head and flagella were identified, and the findings indicated ICSI as an effective clinical treatment for such patients.
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AIM: To analyze the efficacy of multimedia visual physiological stimulation combined with stereoscopic system training in the treatment of ametropic amblyopia in children.METHODS: A total of 102 patients(102 eyes)with ametropic amblyopia admitted to our hospital from June 2021 to June 2022 were randomly divided into two groups. The control group consisted of 51 patients(51 eyes)who received multimedia visual physiological stimulation on the basis of conventional treatment, while the observation group consisted of 51 patients(51 eyes)who received stereoscopic training on the basis of the control group. The binocular fusion function, binocular stereopsis and binocular disparity of the two groups of children were evaluated at 3mo after treatment, and the clinical efficacy was assessed based on the improvement of vision.RESULTS: After 3mo of treatment, the normal rates of binocular fusion function, binocular stereopsis, and binocular disparity in the observation group were significantly higher than those in the control group(all P<0.05). The total effective rate of the observation group was significantly higher than that of the control group(94.1% vs. 60.8%, P<0.05), and the total effective rate of treatment in children of different ages in the observation group was higher than that in the control group(P<0.05), with children aged 6-8 having the highest effective rate of treatment; The total effective rate of treatment for children with mild to moderate amblyopia in the observation group was higher than that in the control group(94.0% vs. 61.2%, P<0.05).CONCLUSION: The combination of multimedia visual physiological stimulation and stereoscopic system training has a good therapeutic effect on ametropic amblyopia, which can promote visual recovery, help reconstruct binocular stereopsis, and has a better effect on children aged 6-8 years or children with mild to moderate amblyopia.
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@#Objective To systematically review the clinical utilization of robotic bronchoscopes in diagnosis of pulmonary nodules, including MonarchTM and IonTM platforms, and then evaluate the efficacy and safety of the procedure. Methods PubMed, EMbase, Web of Science and Cochrane Central Register of Controlled Trials databases were searched by computer for literature about the biopsy of pulmonary nodules with robotic bronchoscope from January 2018 to February 14, 2022. The quality of research was evaluated with Newcastle-Ottawa Scale. RevMan 5.4 software was used to conduct the meta-analysis. Results Finally, 19 clinical studies with 1 542 patients and 1 697 targeted pulmonary nodules were included, of which 13 studies used the IonTM platform and 6 studies used the MonarchTM platform. The overall diagnostic rate of the two systems was 84.96% (95%CI 62.00%-95.00%), sensitivity for malignancy was 81.79%(95%CI 43.00%-96.00%), the mean maximum diameter of the nodules was 16.22 mm (95%CI 10.98-21.47), the mean procedure time was 61.86 min (95%CI 46.18-77.54) and the rate of complications occurred was 4.76% (95%CI 2.00%-15.00%). There was no statistical difference in the outcomes between the two systems. Conclusion Robotic bronchoscope provides a high efficacy and safety in biopsy of pulmonary nodules, and has a broad application prospect for pulmonary nodules diagnosis.
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@#Thymic neuroendocrine tumors (TNETs) are a series of rare diseases with aggressive biology and poor prognosis. Clinical manifestations of TNETs are atypical, and ectopic secretion of adrenocorticotropic hormone can be found in some cases, resulting in associated endocrine symptoms. Due to the low morbidity and strong heterogeneity, it’s difficult to diagnose, treat and obtain new treatment regimen. Early complete surgical resection is an effective treatment. For advanced cancer, clinical trials of new drugs are expected to improve the survival of patients.
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@#BACKGROUND: To investigate the clinical effectiveness of a pneumatic compression device (PCD) combined with low-molecular-weight heparin (LMWH) for the prevention and treatment of deep vein thrombosis (DVT) in trauma patients. METHODS: This study retrospectively analyzed 286 patients with mild craniocerebral injury and clavicular fractures admitted to our department from January 2016 to February 2020. Patients treated with only LMWH served as the control group, and patients treated with a PCD combined with LMWH as the observation group. The incidence of DVT, postoperative changes in the visual analogue scale (VAS) score, and coagulation function were observed and compared between the two groups. Excluding the influence of other single factors, binary logistic regression analysis was used to evaluate the use of a PCD in the patient's postoperative coagulation function. RESULTS: After excluding 34 patients who did not meet the inclusion criteria, 252 patients were were included. The incidence of DVT in the observation group was significantly lower than that in the control group (5.6% vs. 15.1%, χ2=4.605, P<0.05). The postoperative VAS scores of the two groups were lower than those before surgery (P<0.05). The coagulation function of the observation group was significantly higher than that of the control group, with a better combined anticoagulant effect (P<0.05). There were no significant differences between the two groups in preoperative or postoperative Glasgow Coma Scale scores, intraoperative blood loss, postoperative infection rate, or length of hospital stay (P>0.05). According to logistic regression analysis, the postoperative risk of DVT in patients who received LMWH alone was 1.764 times that of patients who received LMWH+PCD (P<0.05). The area under the receiver operating characteristic (AUROC) curve of partial thromboplastin time (APTT) and platelet (PLT) were greater than 0.5, indicating that they were the influence indicators of adding PCD to prevent DVT. Excluding the influence of other variables, LMWH+PCD effectively improved the coagulation function of patients. CONCLUSIONS: Compared with LMWH alone, LMWH+PCD could improve blood rheology and coagulation function in patients with traumatic brain injury and clavicular fracture, reduce the incidence of DVT, shorten the length of hospital stay, and improve the clinical effectiveness of treatment.
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Lung cancer ranks the first cancer-related morbidity and mortality in China. With the development and penetration of imaging technology, increasing small pulmonary peripheral Nodules (SPPNs) have been detected. However, precise location and diagnosis of SPPNs is still a tough problem for clinical diagnosis and treatment in department of thoracic surgery. With the development of electromagnetic navigation bronchoscopy (ENB), it provides a novel minimally invasive method for the diagnosis and treatment of SPPNs. In this review, we summarized the application and progress of ENB in preoperative positioning, diagnosis, and local treatment, then, discussed the clinical application of ENB in the hybrid operating room. .
Subject(s)
Humans , Bronchoscopy/methods , Electromagnetic Phenomena , Lung Neoplasms/surgery , Multiple Pulmonary Nodules/diagnosis , Thoracic Surgery摘要
Objective:To investigate the distribution of clustered regularly interspaced short palindromic repeats (CRISPR) in group B Streptococcus (GBS) in the genital tract of women during the third trimester and in infants with invasive infection and its relationship with multilocus sequence typing (MLST) and drug-resistance genes. Methods:This study retrospectively collected 84 GBS strains isolated from pregnant women with GBS colonization and infants with invasive GBS infection who were admitted to Children's Hospital Affiliated to Shanxi Medical University from January 2017 to January 2022. CRISPR, MLST, and drug-resistance phenotype and genes were detected and analyzed using χ 2 test or Fisher exact probability method. MEGA11 was used to construct a dendrogram. Results:There were ten sequence typing in the 84 GBS strains and ST10 was the dominant one (46.4%). GBS was sensitive to penicillin, and its resistance rates to erythromycin (75.0%) and clindamycin (73.8%) were high. Among the 17 invasive GBS strains, ST10 had 100% resistance to erythromycin, clindamycin, and levofloxacin. CRISPR1 gene was amplified in 62 strains (73.8%). CRISPR1-positive strains had a significantly higher proportion of ST10 [56.5%(35/62) vs 18.2%(4/22), χ 2=9.56, P=0.002] and ermB, gyrA, parC [54.8%(34/62) vs 22.7%(5/22), 67.7%(42/62) vs 36.4%(8/22), 71.0%(44/62) vs 36.4%(8/22); χ 2=6.73, 6.64, and 8.25, all P<0.05], and a lower proportion of ermA [6.5%(4/62) vs 31.8%(7/22), χ 2=7.09, P=0.008] than CRISPR1-negative strains. Conclusions:ST10 is the main GBS genotype among the colonized microbiota the genital tract of pregnant women and in infants with invasive GBS infection, which is also a dominant type in CRISPR1-positive strains. GBS is sensitive to penicillin and CRISPR1 gene is linked to the spread of some drug-resistance genes.
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【Objective】 To explore the effect of respiratory diseases on the mortality risk of the elderly in China. 【Methods】 Totally 12 946 elderly people interviewed by The Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2008 were taken as the research objects. The elderly in this cohort were followed up until 2018. The effect of respiratory diseases on the risk of mortality in the elderly was analyzed by constructing Cox proportional risk model, and heterogeneity was analyzed by gender and age groups. 【Results】 Compared with the elderly without respiratory diseases, respiratory diseases significantly increased the risk of mortality in the elderly. Specifically, after adjusting for confounding factors, respiratory diseases increased the overall mortality risk of the elderly by 22% (HR=1.22, 95% CI: 1.14-1.30), and self-rated respiratory diseases with little or great impact on their own life increased the mortality risk of the elderly by 18% (HR=1.18, 95% CI: 1.09-1.29) and 31% (HR=1.31, 95% CI: 1.18-1.46), respectively. Heterogeneity analysis showed that respiratory diseases increased the risk of mortality in male and female elderly by 32% (HR=1.32, 95% CI: 1.21-1.45) and 11% (HR=1.11, 95% CI: 1.01-1.23), respectively. Respiratory diseases increased the risk of mortality in the groups aged 65-79 years and 80-94 years by 49% (HR=1.49, 95% CI: 1.26-1.76) and 21% (HR=1.21, 95% CI: 1.26-1.76), respectively. However, they did not significantly affect the risk of mortality in the group aged 95-104 years (HR=1.09, 95% CI: 0.97-1.23). 【Conclusion】 Respiratory disease is an important risk factor that accelerates the mortality of the elderly, and the impact of respiratory diseases on the mortality risk of the male elderly is greater than that of the female counterparts, and the impact on the mortality risk of the young elderly is greater than that of the elderly.
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Neoadjuvant immunotherapy, including neoadjuvant single- or dual-drug immunotherapy or combined immunotherapy with chemotherapy or radiotherapy, has witnessed a rapid development in non-small cell lung cancer. Clinical trials exhibited the encouraging pathological responses and certain clinical benefits in selected patients, with tolerable toxicity. Nivolumab with chemotherapy has been approved by Food and Drug Administration (FDA) as the first immunotherapy-based treatment for non-small cell lung cancer in the neoadjuvant treatment setting. There is the need for further evaluation of long-term efficacy, side effects or surgical issues for neoadjuvant immunotherapy in non-small cell lung cancer. .
Subject(s)
Humans , Antineoplastic Agents, Immunological/therapeutic use , Carcinoma, Non-Small-Cell Lung/pathology , Immunotherapy/methods , Lung Neoplasms/pathology , Neoadjuvant Therapy , Nivolumab/therapeutic use摘要
OBJECTIVE To explore the protective mechanism of kaempferol (KAE)on cerebral ischemia/reperfusion (CI/R) injury in vitro and in vivo . METHODS Firstly,the potential targets of KAE in the treatment of CI/R injury were preliminarily screened by network pharmacology. AutoDock Vina software was used to conduct molecular docking between KAE and the top 10 core targets ,and the binding affinity was used as the evaluation standard to further clarify the possible mechanism of KAE in treating CI/R injury. Finally ,the above results were verified by in vivo and in vitro experiments. The oxygen glucose deprivation/ reperfusion(OGD/R)HT22 cell injury model and the middle cerebral artery occlusion (MCAO)rat model were constructed. The cell activity was detected by CCK- 8 method. The neural function score and TTC staining were performed on the rats and their brain tissues. The phosphorylation levels of protein kinase B (Akt)and Src in HT 22 cells and brain tissue of rats were detected by Western blot. RESULTS The results of network pharmacology screening showed that KAE in the treatment of CI/R injury was closely related to 10 core targets including prostaglandin-endoperoxide synthase 2,matrix metalloproteinase 9,JUN,Akt1,tumor necrosis factor ,caspase-3,mitogen activated protein kinase 8,intercellular cell adhesion molecule 1,vascular cell adhesion molecule 1 and Src. The results of molecular docking showed that KAE was stably bound with Akt 1 and Src . The results of in vitro and in vivo experiments showed that KAE could significantly improve the survival rate of OGD/R-injuried HT 22 cells (P<0.05), significantly reduced the neurological function score of MCAO model rats (P<0.05),significantly reduces the volume of cerebral infarction in rats (P<0.05),and significantly increased the phosphorylation levels of Akt and Src in HT 22 cells and brain tissue of rats(P<0.05),which showed a dose dependent trend. CONCLUSIONS KAE may play a neuroprotective role by regulating the phosphorylation expression of Akt and Src ,thus treating CI/R injury.
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OBJECTIVE@#To explore the influence of positive/negative effectivity on the mortality risk of the Chinese elderly.@*METHODS@#Using the latest four surveys data of Chinese longitudinal healthy longevity survey in 2008, 2012, and 2014, as well as 2018 and selecting 10 993 elderly people who were aged 65 and above as research objects, this paper compared the positive/negative effectivity status and differences of the elderly in different gender and age groups. And then this paper analyzed the effect of positive/negative effectivity on elderly people' s mortality risk by constructing Cox proportional hazards model.@*RESULTS@#Compared with the female elderly, the male elderly had lower negative effectivity and higher positive effectivity. With the increase of age, the negative effectivity of the elderly increased, while the positive effectivity decreased. The results showed that after adjusting for the basic demographic characteristics, health status and living habits of the respondents in the baseline survey, in the positive effectivity dimension, "clean preference" (HR=0.922, 95%CI: 0.889-0.956), "autonomy" (HR=0.933, 95%CI: 0.914-0.952) and "sense of youth" (HR=0.948, 95%CI: 0.927-0.969), had a protective effect on the mortality risk of the elderly, while in the dimension of "open-minded view", there was no significant difference in the mortality risk of the elderly with different answers. In the negative effecti-vity dimension, "tension and fear" (HR=1.039, 95%CI: 1.014-1.065), "loneliness" (HR=1.053, 95%CI: 1.029-1.079) and "uselessness" had a harmful effect on the mortality risk of the elderly. The more positive effectivity, the lower the mortality risk of the elderly (HR=0.967, 95%CI: 0.956-0.978), while the more negative effectivity, the higher the mortality risk of the elderly (HR=1.024, 95%CI: 1.013-1.035).@*CONCLUSION@#The negative effectivity of the elderly in all dimensions may increase the mortality risk of elderly people. We ought to dredge the negative emotions of the elderly in time. In the health promotion of the elderly, we should also pay attention to the encouragement of positive effectivity in all dimensions, which requires the joint efforts of families, communities and governments.
Subject(s)
Adolescent , Aged , Female , Humans , Male , China/epidemiology , Longevity , Longitudinal Studies , Proportional Hazards Models , Prospective Studies , Risk Factors摘要
Objective:To study the feasibility, safety and technique for laparoscopic anatomical liver resection of segment 8.Methods:The clinical data of 9 patients who underwent laparoscopic anatomical liver resection of segment 8 from January 2015 to December 2019 at Hunan Provincial People's Hospital were retrospectively analyzed. There were 6 males and 3 females, with age ranging from 29 to 67 years (average 53.6 years). The operation time, intraoperative blood loss , postoperative hospital stay, postoperative complications, and long-term survival and recurrence rates on follow-up were analysed.Results:Laparoscopic anatomical liver resection of segment 8 was successfully carried out in these patients. The mean operative time was 188.9 min(range 140-240 min). The mean estimated intraoperative blood loss was 117.8 ml (range 20-300 ml). The postoperative hospital stay was 6.9 days (range 3-12 days). One patient developed pleural effusion after operation and responded to conservative treatment. Another patients developed ascites with delayed extubation. The patient was successfully treated with conservative treatment. No patients developed complications above Clavien Dindo Ⅲa. There were no perioperative deaths. The postoperative pathological results showed hepatocellular adenoma ( n=2), hepatocellular carcinoma ( n=4), cholangiocarcinoma ( n=1), and metastatic liver cancer ( n=2). On follow-up for 12-58 months (median 22 months) one patient with hepatocellular carcinoma developed recurrence at 18 months after operation and was treated with microwave ablation. The other patients were well on follow-up. Conclusions:With adequate preoperative evaluation, reasonable case selection, rigorous surgical planning, and skilled laparoscopic techniques, laparoscopic anatomical liver resection of segment 8 was safe and feasible, and the short-term efficacy was good in this study.
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@#With the broad application of high-resolution computed tomography (CT) and high rates of early lung cancer screening, the number of patients diagnosed with synchronous multiple primary lung cancer (sMPLC) has been increasing. It becomes of great prominence to distinct sMPLC from intrapulmonary metastases in clinical practice. An increasing number of studies have developed high-throughput sequencing based genetic approaches to specify the molecular characteristics of sMPLC, which contributes to a better understanding of its tumorigenesis. The genetic profile of sMPLC also benefits its diagnosis, which mainly relies on its clinicopathological criteria. Here, we summarize the progresses on the diagnostic criteria for sMPLC, and also molecular features of sMPLC from the perspective of clonality analysis.