Electrocardiogram Parameters Associated With the Diagnosis of Pulmonary Hypertension in High-Altitude Tibetan Populations: A Retrospective Single-Centre Study.

BACKGROUND: Electrocardiogram (ECG) is a commonly used diagnostic method for pulmonary hypertension (PH) in Tibetan areas, but its sensitivity and specificity are not good enough. This study aimed to investigate the ECG parameters associated with the diagnosis of PH in Tibetan areas. METHODS: Ninety-four PH patients of Tibetan ethnicity who were treated at the hospital between March 2019 and October 2020, and 52 Tibetan individuals as controls, were included. The ECG parameters were compared between groups. Multivariate logistic analysis was performed to identify the ECG parameters that can be used for the diagnosis of PH. The univariate significances of ECG parameters were included in the multivariate analyses, whereas those exhibiting opposite trends between different PH subtypes were excluded. RESULTS: Two ECG parameters were significant in multivariate analysis. The final model included S wave amplitude in lead V3 (OR 5.81; 95% CI 2.79-12.11; p<0.001) and a negative T wave in leads V1-V3 (OR 0.05; 95% CI 0.01-0.41; p=0.005). The ROC curve analysis on the final model yielded an AUC of 0.830 (95% CI 0.766-0.894; p<0.001), indicating good diagnostic performance. A nomogram for diagnosis of PH was also established using S wave amplitude in lead V3 and a negative T wave in leads V1-V3. CONCLUSION: The ECG parameters S wave amplitude in lead V3 and a negative T wave in leads V1-V3 were independent factors associated with the diagnosis of PH in high-altitude Tibetan populations.

Risk factors of primary acute mesenteric venous thrombosis in plateau area / 中华普通外科杂志

Objective:To explore the risk factors of primary acute mesenteric venous thrombosis (AMVT) in plateau area.Methods:Data of 54 primary AMVT cases admitted to the People's Hospital of Tibet Autonomous Region between Jan 2015 and Jul 2021 were retrospectively analyzed. There were 42 males and 12 females, aged from 29-79 years. One hundred and ninty matched volunteers severed as control. Logistic multivariate regression analysis was used to screen out independent risk factors. The receiver operating characteristic (ROC) curve and the area under the curve are used to evaluate the value of each indicator and model prediction.Results:Univariate analysis showed that the two groups were significantly different in gender, smoking history, drinking history, and hemoglobin concentration ( P<0.05); there was no significant difference in age, altitude of residence, uric acid and BMI ( P>0.05). Logistic multivariate regression analysis showed that male ( OR=2.466, 95% CI: 1.166-5.212, P=0.018), elevated hemoglobin levels ( OR=2.761, 95% CI: 1.411-5.403, P=0.003) were independent risk factors for primary AMVT. The area under the ROC curve of the two predictors and prediction model are 0.639 (95% CI: 0.559-0.719), 0.650 (95% CI: 0.563-0.737), 0.697 (95% CI: 0.618-0.776). Conclusion:Male and elevated hemoglobin levels are independent risk factors for primary AMVT in plateau areas.

[Mechanism of Wuwei Ganlu in treatment of knee osteoarthritis:a study based on network pharmacology and molecular docking].

Wuwei Ganlu, a formula for medicated bath, consists of medicinal materials of Ephedra sinica, Platycladus orientalis, Myricaria squamosa, Artemisia carvifolia, and Rhododendron anthopogonoides, which is effective in inducing perspiration, resisting inflammation, relieving pain, regulating yellow water disease, and activating blood circulation. On this basis, a variety of formulas for Tibetan medicated bath have been derived for the treatment of diseases in internal organs, joints, nerves, etc. Modern studies have confirmed that Wuwei Ganlu has a good therapeutic efficacy on knee osteoarthritis(KOA). The present study explored the mechanism of Wuwei Ganlu in treating KOA based on network pharmacology and molecular docking. Firstly, the chemical components of Wuwei Ganlu were obtained through literature mining and database retrieval, and corresponding potential targets were predicted according to the BATMAN-TCM database. The protein-protein interaction(PPI) network was obtained after the potential targets were input into the STRING database. The network function modules were analyzed by the Molecular Complex Detection(MCODE) algorithm, and the functions of the modules were annotated to analyze the action mode of Wuwei Ganlu. Secondly, the related targets of KOA were collected through the DisGeNET database, and the overlapping targets were confirmed to analyze the mechanism of Wuwei Ganlu in treating KOA. Finally, the key targets were selected for molecular docking with the main components of Wuwei Ganlu to verify the component-target interaction. A total of 550 chemical components and 1 365 potential targets of Wuwei Ganlu were obtained. PPI analysis indicated that this formula could exert the effects of oxidation-reduction, inflammation resistance, bone absorption, bone mineralization, etc. Nineteen common targets were obtained from the intersection of potential targets of Wuwei Ganlu and KOA disease targets. It was found that the Wuwei Ganlu mainly acts on nuclear factor-κB(NF-κB), interleukin-1 beta(IL1ß), tumor necrosis factor(TNF), IL6, IL1 receptor antagonist(IL1 RN), and prostaglandin-endoperoxide synthase-2(PTGS2) to treat KOA. Among the 550 chemical components of Wuwei Ganlu, 252 potential active components were docked with TNF and 163 with PTGS2, indicating good binding of the components with potential key targets. The study preliminarily explored the mechanism of Wuwei Ganlu in treating KOA to provide a reference for the further development and utilization of Tibetan medicated bath that has been included in the UN Intangible Cultural Heritage.

Intrahepatic cholestasis induced by α-naphthylisothiocyanate can cause gut-liver axis disorders.

Clinical studies have shown that Intrahepatic cholestasis is closely related to intestinal injury. The gut-liver axis theory suggests that the intestine and liver are closely related, and that bile acids are important mediators linking the intestine and liver. We compared two cholestasis models: a single injection model that received a single subcutaneous ANIT injection (75 mg/kg), and a multiple subcutaneous injection model that received an injection of ANIT (50 mg/kg) every other day for 2 weeks. We used Transmetil (ademetionine 1,4-butanedisulfonate) to relieve intrahepatic cholestasis in the multiple injection group. In the multiple injection group, we found increased hepatic bile duct hyperplasia, increased fibrosis of the liver, increased small intestine inflammation and oxidative damage, increased harmful bile acids, decreased bile acids transporter levels. After treatment with Transmetil, the liver and gut injuries were relieved. These results suggest that intrahepatic cholestasis can cause disorders of the gut-liver axis.

Characteristics of Cerebral Stroke in the Tibet Autonomous Region of China.

It is well known that cerebrovascular disease has become an important cause of adult death and disability. Strikingly, the Tibet Autonomous Region (TAR) ranks on the top in China for the incidence of stroke. To help explain this phenomenon, we have searched for and analyzed stroke-related literature for the TAR in the past 2 decades and have referenced reports from other regions at similar altitudes. This article focuses on epidemiology features, risk factors, and pathogenesis of stroke in the TAR in an effort to generate a better understanding of the characteristics of stroke in this region. The special plateau-related factors such as its high elevation, limited oxygen, the high incidence of hypertension, smoking, and the unique dietary habits of the region are correlated with the high incidence of stroke. In addition to these factors, the pathogenesis of stroke in this high-altitude area is also unique. However, there is no established explanation for the unique occurrence and high incidence of stroke in the TAR. Our study provides an important rationale not only for the clinic to prevent and treat this disease, but also for the government to develop appropriate health policies for the prevention of stroke in the TAR.

[Soil fertility evaluation of artificial afforestation areas in Tibet, China]. / è¥¿è—äººå·¥é€ æž—ä½œä¸šåŒºåœŸå£¤è‚¥åŠ›è¯„ä»·.

To master the soil fertility situation of afforestation areas, where trees would be planted, the soil samples of 524 afforestation areas were taken to test its nutrients in six prefectures of Tibet, and the soil fertility was analyzed by the method of modified Nemerow synthesis index. The results showed that the synthetic fertility index of afforestation areas was between 0.425 and 1.972 in Tibet. The numbers of afforestation areas with general level, barren level, and fecund level occupied 65.9%, 34.9% and 0.2%, respectively. The mean fertility index of each soil property was in the order of alkalytic nitrogen＞ pH ＞ total nitrogen ＞ available potassium ＞ organic matter ＞ available phosphorus ＞ total phosphorus ＞ total potassium, which was between 0.654 and 2.643. The fertility level of total nitrogen, alkalytic nitrogen was mostly at the fecund and very fecund level. That of available potassium, organic matter, and total phosphorus was mainly at the general level. That of available phosphorus and total potassium was mainly at barren level, and soil pH was at a proper level. The synthetic fertility index in different prefectures was in the order of Nyingchi ＞ Qamdo ＞ Shannan ＞ Lhasa ＞ Shigatse ＞ Ngari, which of afforestation areas was at the barren level in Ngari, Shigatse and Lhasa. The synthetic fertility index of Qamdo and Nyingchi were at general level. The number of afforestation areas at general level or barren level was nearly same in Shannan. The soil fertility of afforestation areas was low in Tibet as a whole. The soil synthetic fertility and sub-fertility of soil properties became gradually good from the northwest (Ngari) to the southeast (Nyingchi), suggesting obvious horizontal zonality.

[Speciation Distribution and Risk Assessment of Heavy Metals in Typical Material Roof Dusts].

With the modified BCR sequential extraction procedure, the chemical speciation and risk for 10 heavy metals (Ba, Co, Cr, Cu, Mn, Ni, Pb, Sb, Sr and Zn) in roof dusts were investigated. The subjects of this study were collected from four typical material paved roofs (i. e., ceramic tile, concrete, metal and asphalt) in southeast China. The results indicated that the average contents of heavy metals in roof dust significantly exceeded road dust. The analysis of chemical fraction showed that the acid soluble/exchangeable fraction of Zn was much higher than other elements, the existence of Pb and Cu was mainly in oxidization fraction, while other heavy metals dominated by the residual fraction. The mobility sequence percentages for all roof dust samples decreased in the order of Pb > Zn > Cu >>Mn > Co >>Sr > Sb > Ni > Ba > Cr, and it should be noted that Pb, Zn, Cu, Mn and Co all have more than 50% proportion in mobility sequence. Based on environmental risk assessment, the highest values of contamination factors (Cf) and risk assessment code (RAC) consistently was observed in Zn, which indicated that Zn had relatively high ecological risk. Health risk assessment showed that the non-carcinogenic hazard indexes (HI) of heavy metals decreased in the order of Pb > Cr > Sb > Zn > Mn > Cu > Ba > Ni > Co > Sr, the HI of heavy metals for adults were lower than safe value while the HI of Pb for children was higher than safe value, suggesting that they will not harm the adult's health except Pb for children. The carcinogenic risk for Cr, Co and Ni were all below the threshold values, which indicated that there was no carcinogenic risk.

[Kinetics of Cu crossing human erythrocyte membrane].

This study was aimed to investigate various factors influencing the proceduction of Cu(II) crossing human erythrocyte membrane, including concentration of Cu²âº, pH value of the medium, temperature and time of incubation, and to derive kinetic equation of Cu(II) crossing human erythrocyte membrane. Suspension red blood cells were incubated by Cu²âº, then content of Cu²âº crossed human erythrocyte membrane was determined by atomic absorption spectrometry under various conditions after digestion. The results showed that content of Cu²âº crossed human erythrocyte membrane increased with the increase of extracellular Cu²âº and enhancement of incubation temperature, and the content of Cu²âº crossed human erythrocyte membrane showed a increasing tendency when pH reached to 6.2-7.4, and to maximum at pH 7.4, then gradually decreased at range of pH 7.4-9.2. It is concluded that the Cu²âº crossing human erythrocyte has been confirmed to be the first order kinetics characteristics within 120 min, and the linear equation is 10³ × Y = 0.0497t +6.5992.

[Preparation and in vitro evaluation of crosslinked polyvinyl alcohol microspheres for embolization].

OBJECTIVE: To develop and study the properties of crosslinked polyvinyl alcohol microspheres (PVA-Ms) for embolization. METHODS: The PVA-Ms were produced by emulsion chemical crosslinking method. Fourier transform infrared spectroscopy (FT-IR) was used to investigate the special functional groups of PVA-Ms; the morphology and particle size of PVA-Ms were determined by optical microscope; the ratio of water absorption and the swelling ratio were also investigated; the compressibility was examined by texture analyzer. A new device was designed to measure the pressure of PVA-Ms during their delivery through catheter for embolization. RESULTS: The crosslinking reaction of PVA and formaldehyde was proved by FT-IR. The PVA-Ms were round with smooth surface. The average diameter of lyophilized PVA-Ms was 574.2 µm with a range of 80-1 800 µm and of wet PVA-Ms was 602.2 µm with a range of 100-1 900 µm. The average ratio of water absorption was 175% and the swelling ratio was 48.6%. The PVA-Ms were mechanically stable with appropriate elasticity and delivered through the catheter without any difficulty, and the pressure was higher for larger size of microspheres to be delivered. CONCLUSION: PVA-Ms prepared in this study was supposed to be suitable for clinical embolization according to the physicochemical properties. The study provides a series of methods to evaluate the properties of microspheres systemically for embolization in vitro.

Simultaneous determination of five diterpenoid alkaloids in Herba Delphinii by HPLC/ELSD / 药物分析学报

A HPLC-ELSD method was developed and validated for simultaneous determination of five Hetisane-type diterpenoid alkaloids in a Tibetan traditional herbal medicine, “Gebu Dilu” (Herba Delphinii), using a Kromasil C18 column (250 mm ? 4.6 mm, 5μm) with the mobile phase consisting of acetonitrile and 0.1% triethylamine in gradient (detected by evaporative light scattering detector). The linear ranges of five compounds were determined and method validation was evaluated completely. The established method is rapid and accurate with high repeatability, and can be applied for the quality control of Herba Delphinii.

Genotype v Japanese encephalitis virus is emerging.

Japanese encephalitis (JE) is a global public health issue that has spread widely to more than 20 countries in Asia and has extended its geographic range to the south Pacific region including Australia. JE has become the most important cause of viral encephalitis in the world. Japanese encephalitis viruses (JEV) are divided into five genotypes, based on the nucleotide sequence of the envelope (E) gene. The Muar strain, isolated from patient in Malaya in 1952, is the sole example of genotype V JEV. Here, the XZ0934 strain of JEV was isolated from Culex tritaeniorhynchus, collected in China. The complete nucleotide and amino acid sequence of XZ0934 strain have been determined. The nucleotide divergence ranged from 20.3% to 21.4% and amino acid divergence ranged from 8.4% to 10.0% when compared with the 62 known JEV isolates that belong to genotype I-IV. It reveals low similarity between XZ0934 and genotype I-IV JEVs. Phylogenetic analysis using both complete genome and structural gene nucleotide sequences demonstrates that XZ0934 belongs to genotype V. This, in turn, suggests that genotype V JEV is emerging in JEV endemic areas. Thus, increased surveillance and diagnosis of viral encephalitis caused by genotype V JEV is an issue of great concern to nations in which JEV is endemic.

[Integripetal rhodiola herb attenuates high altitude-induced pulmonary arterial remodeling and expression of vascular endothelial growth factor in rats].

The aim of this study was to investigate the effect of integripetal rhodiola herb on pulmonary arterial remodeling and expression of vascular endothelial growth factor (VEGF) in high altitude pulmonary hypertension in rats. Fifty healthy male Wistar rats were divided into five groups randomly: Plain control group (LC group), 10-day plateau group (H(10) group), 30-day plateau group (H(30) group), 10-day rhodiola-treated plateau group (R(10) group), and 30-day rhodiola-treated plateau group (R(30) group). Each group included 10 rats. The rats in LC group were kept in Chengdu (500 meters above sea level), and rats in H and R groups were kept in Lhasa (3 700 meters above sea level). The rats in R group were daily treated with integripetal rhodiola herb extract (24%, 10 mL/kg) intragastrically for 10 d or 30 d, while rats in LC and H groups were treated with the same volume of saline. Mean pulmonary arterial pressure (mPAP) was detected via a catheter in the pulmonary artery by pressure waveform monitoring. The ratio value of right ventricle weight to left ventricle plus septum weight [RV/(LV + S)] was measured. The microstructure of pulmonary arterioles was examined by electron microscopy. The expression of VEGF in the lung was investigated using immunohistochemistry. The results showed that mPAP and [RV/(LV + S)] in H(10) group and H(30) group were higher than those in LC group (P < 0.05); but there was no significant difference between H(10) group and R(10) group (P < 0.05); and mPAP and [RV/(LV + S)] in H(30) group were lower than those in H(30) group (P < 0.05). Electron microscopy showed that compared to LC group, arteriolar endothelial cells were arranged in a columnar or palisading form, protruding into the lumen, accompanied with luminal stenosis, irregular internal elastic membrane, and proliferation of vascular smooth muscle cells in H groups, which was more obvious in H(30) group than in H(10) group; while these pathological changes were attenuated in the R groups compared to H groups. The levels of VEGF protein in H groups were also higher than those in LC group (P < 0.05); while the expression of VEGF in R(30) group was lower than that in H(30) group. In summary, the results show that the integripetal rhodiola herb can attenuate high altitude-induced pulmonary arterial remodeling in rats, and the inhibition of VEGF protein expression by rhodiola may be one of the mechanisms.

Integripetal rhodiola herb attenuates high altitude-induced pulmonary arterial remodeling and expression of vascular endothelial growth factor in rats / 生理学报

The aim of this study was to investigate the effect of integripetal rhodiola herb on pulmonary arterial remodeling and expression of vascular endothelial growth factor (VEGF) in high altitude pulmonary hypertension in rats. Fifty healthy male Wistar rats were divided into five groups randomly: Plain control group (LC group), 10-day plateau group (H(10) group), 30-day plateau group (H(30) group), 10-day rhodiola-treated plateau group (R(10) group), and 30-day rhodiola-treated plateau group (R(30) group). Each group included 10 rats. The rats in LC group were kept in Chengdu (500 meters above sea level), and rats in H and R groups were kept in Lhasa (3 700 meters above sea level). The rats in R group were daily treated with integripetal rhodiola herb extract (24%, 10 mL/kg) intragastrically for 10 d or 30 d, while rats in LC and H groups were treated with the same volume of saline. Mean pulmonary arterial pressure (mPAP) was detected via a catheter in the pulmonary artery by pressure waveform monitoring. The ratio value of right ventricle weight to left ventricle plus septum weight [RV/(LV + S)] was measured. The microstructure of pulmonary arterioles was examined by electron microscopy. The expression of VEGF in the lung was investigated using immunohistochemistry. The results showed that mPAP and [RV/(LV + S)] in H(10) group and H(30) group were higher than those in LC group (P < 0.05); but there was no significant difference between H(10) group and R(10) group (P < 0.05); and mPAP and [RV/(LV + S)] in H(30) group were lower than those in H(30) group (P < 0.05). Electron microscopy showed that compared to LC group, arteriolar endothelial cells were arranged in a columnar or palisading form, protruding into the lumen, accompanied with luminal stenosis, irregular internal elastic membrane, and proliferation of vascular smooth muscle cells in H groups, which was more obvious in H(30) group than in H(10) group; while these pathological changes were attenuated in the R groups compared to H groups. The levels of VEGF protein in H groups were also higher than those in LC group (P < 0.05); while the expression of VEGF in R(30) group was lower than that in H(30) group. In summary, the results show that the integripetal rhodiola herb can attenuate high altitude-induced pulmonary arterial remodeling in rats, and the inhibition of VEGF protein expression by rhodiola may be one of the mechanisms.

Laser Doppler flowmeter study on regional cerebral blood flow in early stage after standard superficial temporal artery-middle cerebral artery bypass surgery for moyamoya disease.

BACKGROUND: Standard superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion can occur. In this study, the trendline of changes in regional cerebral blood flow (rCBF) after surgery were continually monitored near the site of anastomosis in order to investigate both the efficacy of the procedure for improving rCBF and the possible risk of hyperperfusion. METHODS: Standard STA-MCA bypass surgery was performed on 13 patients. rCBF was measured continually using laser Doppler flowmetry (LDF) until the 5th day after the operation with the LDF probe implanted adjacent to the area of the anastomosis. The trendline of rCBF changes postoperatively was recorded for the analysis performed using SPSS 13.0. RESULTS: The baseline LDF value of cortical rCBF was (84.68 + or - 14.39) perfusion unit (PU), which was linear relative to absolute perfusion volume before anastomosis and (88.90 + or - 11.26) PU immediately after anastomosis (P > 0.05). The value changed significantly from before to after anastomosis (P < 0.05); it was (417.72 + or - 21.35) PU on the 1st day after surgery, and (358.99 + or - 18.01) PU, (323.46 + or - 17.38) PU, (261.60 + or - 16.38) PU and (375.72 + or - 18.45) PU on the following 4 days, respectively. The rCBF decreased gradually from the 2nd day until the 4th postoperative day, but still was at a high level (P < 0.05). However, on the 5th postoperative day the rCBF increased again to the second highest level, which was significantly different compared with the baseline value (P < 0.05), but not significantly different compared with the values on the other 4 days (P > 0.05). CONCLUSIONS: STA-MCA anastomosis improves the cerebral blood supply significantly in the early stage after surgery, however, the risk of symptomatic hyperperfusion may exist, which may possibly occur on the 1st day and 5th day after surgery. A LDF is useful for postoperative monitoring for both the efficacy of bypass and possible risk of neurologic deterioration or bleeding from hyperperfusion.

Laser Doppler flowmeter study on regional cerebral blood flow in early stage after standard superficial temporal artery-middle cerebral artery bypass surgery for moyamoya disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Standard superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion can occur. In this study, the trendline of changes in regional cerebral blood flow (rCBF) after surgery were continually monitored near the site of anastomosis in order to investigate both the efficacy of the procedure for improving rCBF and the possible risk of hyperperfusion.</p><p><b>METHODS</b>Standard STA-MCA bypass surgery was performed on 13 patients. rCBF was measured continually using laser Doppler flowmetry (LDF) until the 5th day after the operation with the LDF probe implanted adjacent to the area of the anastomosis. The trendline of rCBF changes postoperatively was recorded for the analysis performed using SPSS 13.0.</p><p><b>RESULTS</b>The baseline LDF value of cortical rCBF was (84.68 + or - 14.39) perfusion unit (PU), which was linear relative to absolute perfusion volume before anastomosis and (88.90 + or - 11.26) PU immediately after anastomosis (P > 0.05). The value changed significantly from before to after anastomosis (P < 0.05); it was (417.72 + or - 21.35) PU on the 1st day after surgery, and (358.99 + or - 18.01) PU, (323.46 + or - 17.38) PU, (261.60 + or - 16.38) PU and (375.72 + or - 18.45) PU on the following 4 days, respectively. The rCBF decreased gradually from the 2nd day until the 4th postoperative day, but still was at a high level (P < 0.05). However, on the 5th postoperative day the rCBF increased again to the second highest level, which was significantly different compared with the baseline value (P < 0.05), but not significantly different compared with the values on the other 4 days (P > 0.05).</p><p><b>CONCLUSIONS</b>STA-MCA anastomosis improves the cerebral blood supply significantly in the early stage after surgery, however, the risk of symptomatic hyperperfusion may exist, which may possibly occur on the 1st day and 5th day after surgery. A LDF is useful for postoperative monitoring for both the efficacy of bypass and possible risk of neurologic deterioration or bleeding from hyperperfusion.</p>