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Objective:To explore the effects of genistein-3'-sodium sulfonate (GSS) on on motor function and brain autophagy levels in Parkinson disease (PD) model mice.Methods:Forty C57BL/6J mice were randomly divided into control group, model group, low-dose GSS group (0.15 mg/kg), medium-dose GSS group (0.50 mg/kg) and high-dose GSS group (1.50 mg/kg), with 8 mice in each group.Mice in the model group and the high, medium, and low-dose GSS groups were injected intraperitoneally with 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine to establish the PD mouse model, then mice in high, medium and low-close GSS group were intraperitoneally injected with corresponding doses of GSS (once a day for 21 days). The mice in model group were injected with equal volume 0.9% sodium chloride solution(once a day for 21 days), while the control group mice were fed normally.After 21 days, the motor and cognitive abilities of mice were evaluated by gait analysis, open field test, rotarod test, and modified Y maze test.Western blot was used to detect the expression levels of LC3-Ⅱ and Beclin-1 proteins in the cerebral cortex and striatum tissues of mice.SPSS 26.0 software was used for data analysis.One-way ANOVA was used for normal distribution data comparison among multiple groups, and LSD test was used for further pairwise comparisons, while Kruskal-Wails H test was used for non normal distribution data comparison. Results:(1) Gait analysis showed that there were statistically significant differences in the stride length of left forelimb, left hindlimb, right hindlimb( F=5.93, 6.21, 3.78, all P<0.01) and regularity index( H=14.409, P<0.01). The regularity index of the model group mice was lower than that of the control group ( P<0.05), and the regularity indexes of the low, medium, and high-dose GSS groups were all higher than that of the model group (all P<0.05). (2)In the open field test, there were statistically significant differences in the total distance and speed of movement among the 5 groups ( F=5.49, 5.49, both P<0.01). The total distance and speed of movement in the model group were both lower than those in the control group (both P<0.05). The total distance and speed of movement in the medium-dose GSS group( (2 395.57±319.35) cm, (7.98±1.06) cm/s) and high-dose GSS group ((2 386.51±396.00) cm, (7.95±1.32) cm/s) were higher than those of the model group ((1 863.31±278.96) cm, (6.21±0.93) cm/s) and the low-dose GSS group ((1 956.90±297.15) cm, (6.52±0.99) cm/s) (all P<0.05). (3) In the rotarod test and modified Y maze test, there were significant differences in latency to fall and residence time among the 5 groups ( F=58.41, 9.90, both P<0.01). The latency to fall and residence time of model group were lower than those of control group (both P<0.05), while those in the medium-dose and high-dose GSS groups were higher than those in the model group and low-dose GSS group (all P<0.05). (4) Western blot results showed that there were significant differences in the expression levels of LC3-Ⅱ/LC3-Ⅰ ratio ( F=8.17, 15.47, both P<0.01)and Beclin-1 protein( F=29.07, 20.54, both P<0.01) in cerebral cortex and striatum among the five groups.The LC3-Ⅱ/LC3-Ⅰ ratio and Beclin-1 protein levels in the cerebral cortex ((0.51±0.14), (0.46±0.06)) and striatum ((0.58±0.09), (0.55±0.10)) of the model group were lower than those in the control group (cerebral cortex: (1.00±0.10), (1.00±0.05), striatumm: (1.00±0.06), (1.00±0.25), all P<0.01). The LC3-Ⅱ/LC3-Ⅰratio and Beclin-1 protein in the medium-dose GSS group were higher than those in the model group, low-dose and high-dose GSS groups in both cerebral cortex and striatum (all P<0.05). The level of Beclin-1 of cerebral cortex in model group was lower than those in various doses of GSS group(all P<0.05). There were no statistically significant differences of Beclin-1 protein levels between the model group mice and various doses of GSS groups in striatum (all P>0.05). Conclusion:GSS can improve the motor and cognitive functions of PD model mice, and the mechanism may be related to the upregulation of autophagic activity in the cerebral cortex and striatum of mice.
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Objectives:To investigate the prevalence,clinical characteristics and risk factors of coronavirus disease-2019(COVID-19)in patients with pulmonary hypertension(PH). Methods:A questionnaire survey was conducted from December 30,2022 to January 6,2023 through the WeChat official account of the PH Patients Mutual Aid Organization.PH patients aged≥18 years from 26 province(municipality/autonomous region)were recruited to fill in the electronic survey questionnaire. Results:A total of 293 valid questionnaires were collected from PH patients.The mean age of patients was(40.6±12.7)years,and 226 patients(77.1%)of them were female.The vaccination rate was 59.7%(175/293),117 patients(39.9%)received three or more doses of vaccine,145 patients(49.5%)received inactivated vaccine.242 patients(82.6%)had COVID-19.The most common symptoms during infection were fever(85.5%),cough(77.7%),and fatigue(66.5%).10.7%of the patients had severe or critical COVID-19.Age(OR =1.057,95%CI:1.027-1.087,P<0.001)and comorbid pulmonary disease(OR=3.341,95%CI:1.215-9.184,P=0.019)were associated with severe or critical COVID-19.After adjusting for confounding factors,age was an independent risk factor for severe or critical COVID-19(OR=1.049,95%CI:1.019-1.080,P=0.001).Severe or critical COVID-19 was an independent risk factor for worsening heart failure in PH patients during COVID-19 pandemic(OR=10.522,95%CI:4.311-25.682,P<0.001). Conclusions:The immunization coverage of PH patients is insufficient.PH patients have a higher risk of developing severe or critical COVID-19 than general population.Ageing is an independent risk factor for severe or critical COVID-19,and the risk of worsening heart failure in PH patients with severe or critical COVID-19 is significantly increased during COVID-19 pandemic.
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Objective:To investigate the postoperative effect of paranasal concavity augment by block united with diced autologous costal cartilage.Methods:The data of 76 patients who were underwent costal cartilage rhinoplasty together with paranasal augmentation from January 2016 to December 2019 were analyzed retrospectively. The surgical technique was described in detail. Medical charts and operative records were reviewed to summary the complications. Patients′subjective satisfaction of the postoperative nasal appearance was self-evaluated with grading (1 worse, 2 no change, 3 improved, and 4 much improved). Cosmetic effects were evaluated by the measurements of the nasolabial angle and the distance between ACJ and intertragic notch preoperatively and postoperatively.Results:The postoperative follow-up duration was 6 to 34 months. Overall, functional and aesthetic outcome was satisfactory in most patients, and the mean score by the patients′self-evaluation was 3.4±0.5. Graft exposure, mobility, or significant resorption, pneumothorax or significant donor-site pain were not observed. The average nasolabial angle was changed from (78.2±13.2)° preoperatively to (89.8±10.2)° 6 months postoperative at the last follow-up ( t=152.00, P<0.01). And the distance from the alar-cheek junction to the left tragus was increased by 3.8±2.1 (2.2-6.1) mm. Conclusions:Costal cartilage rhinoplasty combined with augmentation of parasal area can improve parasal depression, with stable postoperative effect and fewer postoperative complications, and has a good effect for patients with normal occlusal relationship or mild abnormality.
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【Objective】 To analyze the clinical data of prostate cancer patients with normal PSA level confirmed with transperineal prostate biopsy or transurethral prostate surgery, in order to improve the diagnostic level of this disease. 【Methods】 The clinical data of 6 patients were retrospectively analyzed. The age,clinical manifestations, body mass index (BMI),prostate specific antigen density (PSAD),blood triglycerides,blood cholesterol,color ultrasound imaging,magnetic resonance imaging (MRI),pathological types and Gleason scores were analyzed. The clinical characteristics and high-risk factors were summarized. 【Results】 Two cases were confirmed with prostate biopsy and four after prostate resection. Three patients had high blood triglycerides, three were negative for bone imaging, and the other three were not examined. PSAD was 0.017 to 1.215. Color ultrasound indicated that two cases had irregular morphology, two uneven echo, and one both irregular morphology and uneven echo; all six cases had calcification. In the three cases who received MRI, two had PIRADS4 nodules, one had PIRADS5 nodules, invasion of seminal vesicle, rectum, posterior wall of urinary bladder,bilateral thickening of NVB, and lymph nodes enlargement. Pathology suggested prostatic acinar adenocarcinoma in five cases, four of which had a Gleason score of 3+3=6 and one had 5+5=10; one case suggested a high-grade neuroendocrine carcinoma. 【Conclusion】 The clinical detection rate is low for prostate cancer with normal PSA. The biopsy indications should be determined by combining the characteristics and high-risk factors to improve the detection rate.
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Clinical data of a case of Munchausen syndrome by proxy (MSBP) admitted to the Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in November 2020 were retrospectively analyzed.The 4 years and 4 months old female patient presented with retrosternal and abdominal pain for 1 month, and aggravated with multi-organ pain for 20 days.She complained about the retrosternal pain with acid reflux, pain in the teeth, esophagus, and abdomen, etc.During the hospitalization, she frequently complained of multi-organ pain.Her mother repeatedly declared her painful hip joint and she often cried for pain at night, and even could not walk.However, the clinical examination showed no obvious abnormalities.Combining characteristics of the patient and her caregiver, the patient was confirmed as MSBP.It is suggested that MSBP in children should be concerned in cases with complicated severe chief complaints, frequent medical visits, and a strong willing to see a doctor or be hospitalized by their caregivers, but normal physical and auxiliary examination findings.
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Objective:To explore the effect of two different treatment methods of dorsum implants using autologous costal cartilage, accordion technique (AT) and multilayer oppositional suture technique (MOST), in preventing complications such as distortion and warping of the grafts.Methods:From January 2016 to December 2019, 119 patients underwent rhinoplasty with autologous costal cartilage as the dorsum implant. The dorsum implants were processed by two different techniuqes. Medical charts and operative records were reviewed to summary the complications, especially warping. Patients′ subjective satisfaction and doctors′ objective measurement of the postoperative nasal appearance were evaluated with a grading system.Results:The postoperative follow-up duration was 6 to 28 months. Graft exposure, mobility, or significant resorption, pneumothorax or significant donor-site pain were not observed. The warping rate was higher in the AT (7.8%, 6/77) than in the MOST (2.4%, 1/42) group, although not significantly. Overall, there were no differences in overall patient functional and aesthetic satisfaction between the two groups.Conclusions:Multilayered oppositional suture technique for the autologous costal cartilage grafting may minimize the complication of graft warping and might be an effective alternative for nasal dorsal augmentation, particularly in Asian patients.
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As coronavirus disease 2019 (COVID-19) outbreak, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), started in China in January, 2020, repurposing approved drugs is emerging as important therapeutic options. We reported here the first clinical study using hepatitis C virus (HCV) protease inhibitor, danoprevir, to treat COVID-19 patients. Danoprevir (Ganovo(R)) is a potent HCV protease (NS3/4A) inhibitor (IC50 = 0.29 nM), which was approved and marketed in China since 2018 to treat chronic hepatitis C patients. Ritonavir is a CYP3A4 inhibitor to enhance plasma concentration of danoprevir while it also acts as a human immunodeficiency virus (HIV) protease inhibitor at high doses. The chymotrypsin-like protease of SARS-CoV-2 shares structure similarity with HCV and HIV proteases. In the current clinical study (NCT04291729) conducted at the Nineth Hospital of Nanchang, we evaluated therapeutic effects of danoprevir, boosted by ritonavir, on treatment naive and experienced COVID-19 patients. The data from this small-sample clinical study showed that danoprevir boosted by ritonavir is safe and well tolerated in all patients. After 4 to 12-day treatment of danoprevir boosted by ritonavir, all eleven patients enrolled, two naive and nine experienced, were discharged from the hospital as they met all four conditions as follows: (1) normal body temperature for at least 3 days; (2) significantly improved respiratory symptoms; (3) lung imaging shows obvious absorption and recovery of acute exudative lesion; and (4) two consecutive RT-PCR negative tests of SARS-CoV-2 nucleotide acid (respiratory track sampling with interval at least one day). Our findings suggest that repurposing danoprevir for COVID-19 is a promising therapeutic option.
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Bilirubin is an important endogenous substance in human body, which can be divided into conjugated bilirubin and unconjugated bilirubin.Learning the production and transportation of bilirubin, the different types of bilirubin and their biological characteristics, the excretion and reabsorption of bilirubin and other metabolic processes will help us understand the pathogenesis and mechanisms of a series of clinical diseases with jaudice, which facilitate the diagnosis and treatment of related diseases.
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Cholestatic liver disease is the most common type of infantile liver disease,and malnutrition is very common in infantile cholestatic liver disease,which may seriously affect the growth and development of infants,and even lead to neuro-cognitive impairment.Some children with chronic cholestatic liver disease need liver transplantation at the end of the disease,while malnutrition might cause more complications and higher mortality.In order to improve the prognosis,active and appropriate nutritional management is considerably needed.
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OBJECTIVE@#To explore the clinical and genetic features of an infant with citrin deficiency (CD).@*METHODS@#Clinical data of the patient was collected and analyzed. Genomic DNA was extracted from peripheral blood samples collected from the patient and her parents. Targeted exome sequencing was performed to explore the genetic cause, and Sanger sequencing was used to confirm the detected variants. SLC25A13 mRNA was extracted from peripheral blood lymphocytes of the infant. The effect of novel mutation of SLC25A13 was analyzed by reverse transcription-PCR, cDNA cloning and Sanger sequencing.@*RESULTS@#The SLC25A13 genotype of the patient was determined as c.845_c.848+1delG/c.1841+3_1841+4delAA, with the latter having not been reported. The mutation has affected the splicing of the SLC25A13 mRNA, giving rise to an aberrant transcript [r.1841_1842ins1841+1_1841+67; 1841+3_c.1841+4del].@*CONCLUSION@#A novel SLC25A13 mutation c.1841+3_1841+4delAA and the resultant abnormal splicing variant were discovered by combined DNA sequencing and cDNA cloning. The finding has enabled definite diagnosis of CD and enriched the spectrum of SLC25A13 mutations.
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Female , Humans , Base Sequence , Citrullinemia , Mitochondrial Membrane Transport Proteins , Genetics , Mutation , PedigreeABSTRACT
Infantile cholestasis disease is a common liver disease in infancy (including neonatal period). It is caused by intra - or extrahepatic factors. First of all,a differential diagnosis of biliary atresia and non - biliary atresia intrahepatic cholestasis needs to be made. The diagnosis should be made according to clinical manifestation,laboratory test results,imaging results and liver pathology. Numerous etiologies can cause intrahepatic cholestasis. Genetic factors are research focus now. Therapy on the etiologies is an effective therapeutic measure.
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Objective To explore the effect of electroacupuncture (EA) at tusanli (ST36) on regulation of stress response under different doses of etomidate anesthesia in rats.Methods Sixty male Sprague-Dawley rats, weighing 280-310 g, were randomly divided into control group (group C), model group (group M), etomidate 60 mg/kg group (group E1), etomidate 30 mg/kg group (group E2), etomidate 60 mg/kg combined with EA group (group EA1) and etomidate 30 mg/kg combined with EA group (group EA2), n=10 in each group.All groups received inferior caudal trunk transection at the level between sacral spinal nerve 3 and 4 (S3, S4) to prepare acute stress response model except group C.Group M received no others treatment.The rats in group E1, group EA1, group E2 and group EA2 were intraperitoneally injected with 60, 60, 30 and 30 mg/kg etomidate, respectively.Group EA1 and group EA2 received EA ST36.The points were stimulated at a frequency of 2/100 Hz with 1 mA output and a dilatational wave, which lasted for 30 min.ACTH and Cor levels were measured by ELISA.The c-fos protein expression in hypothalamic tissue was examined by Western blot.Results Compared with group C, ACTH and Cor levels, and hypothalamic expression of c-fos protein in group M were significantly increased (P<0.05).Compared with group M, serum ACTH and Cor levels, and hypothalamic expression of c-fos protein in groups E1, E2, EA1 and EA2 were significantly decreased (P<0.05).Compared with group E1, serum ACTH and Cor levels, and hypothalamic expression of c-fos protein were significantly higher in groups E2 and EA1 (P<0.05).Compared with group E2, serum ACTH level and hypothalamic expression of c-fos protein were significantly lower in group EA2 (P<0.05).Conclusion EA at ST36 regulating stress response under etomidate anesthesia in rats is effective and two-way, and the mechanism may be due to the release of neurotransmitters induced c-fos protein in hypothalamus.
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In recent years,gastrointestinal microbiota and fecal microbiota transplantation(FMT)has gained rapidly development.The recent studies demonstrated that FMT has obvious clinical efficacy and safety on the treatment of clostridium difficile infection,inflammatory bowel disease and other diseases in adult.The present article will discuss the efficacy of FMT in treating digestive diseases in children.This review summarizes therapeutic advances in FMT,latest FMT therapies and presents the potential of FMT therapeutics in gastrointestinal and extra-intestinal conditions in children.
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Fecal microbiota transplantation(FMT)is a method to recover the gut microbiota and treat the intestinal or non-intestinal diseases through transplanting the fecal liquid from healthy population into patients' gastrointestinal tract.There are limited data about the FMT in children.The clinical practice needs professional workgroups,strict indications,normalized and precise procedures.
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Objective To evaluate the differential diagnostic value and superior of biliary atresia(BA)in the infants with cholestatic hepatopathy by high-frequency ultrasonography (HUS).Methods After 4 hours fasting,124 infants with cholestatic hepatopathy were scanned with high-frequency US.The data of hepatic size and parenchyma,gallbladder,triangular cord (TC) sign,bile duct,right hepatic artery (RHA)and portal vein (PV) were observed and measured.Meanwhile,the other data were collected,which included the clinical diagnosis,blood biochemical tests,the MRCP and dynamic duodenal liquid color check finding,the pathological results after liver puncture biopsy and so on.Results In 124 infants with cholestatic hepatopathy,BA was found in 61 infants and ruled out in 63.TC thickness,RHA diameter,and gallbladder length and width exhibited significant differences between the group with BA and the group non-BA(all P <0.001).The correctness for the diagnosis of BA was 90.3% by the combination of TC sign and abnormal gallbladder morphology,and 83.1 % by stool color,81.5 % by γ-GT,47.5 % by MRCP,83.3 % by dynamic duodenal liquid color check,95.2% by the pathology after liver puncture biopsy,respectively.Conclusions HUS is superior to other diagnostic methods in BA with higher accuracy rate,noninvasion,simplicity and economy.
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Objective To observe the clinical efficacy of bamboo-circled salt-partitioned moxibustion in treating arthritis of temporomandibular joint.Method Eighty patients were randomized into two groups. Forty cases in the bamboo-circled salt-partitioned moxibustion group received bamboo-circled salt-partitioned moxibustion at temporomandibular joint; forty cases in the warm needling group were intervened by selecting Xiaguan (ST7), Ashi point, etc. at the affected side. For the two groups, 3-day treatment was taken as a treatment course, and the therapeutic efficacy was analyzed after 2 treatment courses. The improvements in pain and mouth opening were observed before and after the treatment, and the treatment efficacy was evaluated by a 1-month follow-up study.Result The bamboo-circled salt-partitioned moxibustion group was superior to the warm needling group in comparing the real-time analgesic effect (P0.05).Conclusion Bamboo-circled salt-partitioned moxibustion can produce a real-time analgesic effect and improve mouth opening; it's especially suitable to treat the patients who are afraid of needling, as it's significantly effective, safe, non-invasive,and easy-to-operate.
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A 50?year?old woman presented with intermittent dull pain in the forehead and mild dizziness occasionally after her forehead was subjected to a mild bump accidentally 20 days prior to the presentation, and was diagnosed with angioneurotic headache in a local hospital. After the treatment with oral sibelium tablets, the condition wasn′t relieved obviously. Computed tomography (CT) scan showed multiple localized bone destruction and low?density area in the frontal and bilateral parietal bones with adjacent soft tissue swelling. Magnetic resonance imaging(MRI)revealed equal T1 signals and slightly long T2 signals for multiple nodules in the frontal and bilateral parietal bones, high signals on diffusion?weighted imaging (DWI), obvious enhancement on contrast?enhanced MRI, and linear enhancement in adjacent meninges. Whole?body bone scintigraphy showed multiple increased radionuclide uptake in the skull. Laboratory examination demonstrated that specific antibodies to Treponema pallidum (Tp) were positive, and the serum rapid plasma reagin(RPR)titer was 1∶128. Cerebrospinal fluid(CSF)examination showed normal CSF pressure, nucleated cell counts(8 × 106/L)and glucose level(4.0 mmol/L), slightly high chloride flux(129.1 mmol/L), high protein level(0.9 g/L), high CSF?RPR titer of 1∶16 and presence of specific antibodies to Tp. Histopathological examination revealed hyperemia of adjacent tissues in the cranial osteolytic area, hyperplasia of interstitial fibrous tissue, endothelial cell swelling, and infiltration of inflammatory cells mainly containing plasma cells. The treatment regimen for neurosyphilis was given, and headache was relieved after 1 week of treatment, basically disappeared after 2 weeks, and completely disappeared after 4 weeks, and no similar headache occurred thereafter. Finally, the patient was diagnosed with acquired syphilitic skull osteomyelitis complicated by syphilitic meningitis.
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Objective To study the regulation of serum FSH and E2 in the treatment of menopausal syndrome with 17 beta estradiol combined with DRSP. Methods A total of 90 female patients with menopausal syndrome treated in our hospital from November 2013 to November 2016 were selected. The patients were randomly divided into three groups: 17β group (30 patients, 17β-estradiol alone), DRSP group (30 patients treated with DRSP alone) and 30 patients (17β-estradiol combined with DRSP). Kupperman's menopausal syndrome was used to evaluate the physical symptoms of the patients and to compare the patients after the treatment. The patients' treatment efficiency was observed. The items examined before treatment included liver and kidney function, hematuria routine , Fasting blood glucose, FSH, E2, LDL, blood TC, electrocardiogram, intracavitary Doppler ultrasound, breast ultrasound, HDL, Kupperman evaluation table in accordance with the evaluation before the end of each treatment measure again, And performs the above-mentioned inspection. Results In the combined group, there was no significant difference in the scores of other symptoms except the differences between the ants on the skin and the treatment before treatment. There were significant differences in the scores of pain, headache, body sensation, agitation, palpitation, Pain, fatigue, insomnia and hot flashes were significantly different (P<0.01). In the DRSP group, pain, depression and insomnia were improved after treatment (P<0.05), other symptoms were (P<0.05), other symptoms were not improved;the total effective rate of combined group was 90.0%, DRSP (P<0.05), and the total effective rate of the group was significantly higher than that of the control group (P<0.05) .There was no significant difference The total effective rate was 73.33% in the group and 70.0% in the 17β group. There was significant difference between the combined group and the other groups (P<0.05). The difference of TC, E2 and FSH in the combined group before and after treatment (P<0.05). There was no difference in FSH between the two groups before and after treatment. There was no difference between the two groups before and after treatment. Conclusion 17β-estradiol combined with DRSP in the treatment of menopausal syndrome patients achieved good clinical effect, the serum levels of FSH and E2 in the body is significant.
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Objective To explore the early diagnosis and standard treatment of autoimmune hepatitis (AIH).Methods The process of clinical diagnosis and treatment in 2 children with AIH was retrospectively analyzed.The related literatures were reviewed.Results Two males were 6 years and 1 month old and 6 monthes and 18 days old,respectively.Both of them had the symptom of jaundice at onset,accompanied with the elevate aminotransferase and positive autoantibodies.One case showed elevated serum IgG and interface hepatitis in liver pathology,and all other causes were excluded.He had a good response to the treatment of hormone combined with azathioprine.The other case had a poor response to the treatment of single hormone.Conclusions Childhood AIH is rare in clinic.Its response to the therapy of glucocorticoid and immune inhibitors is good.So it should be diagnosised and treated early.
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Some achievements have been made in the research on liver diseases in children in China,with the help of several generations of physicians for 60 years.At present,liver biopsy,examination of duodenal fluid and bile,screening for inherited metabolic diseases,and new techniques of genetic diagnosis have been conducted in China.Planned immunization with hepatitis A and B vaccines significantly reduces the incidence rates of hepatitis A and B.Remarkable achievements have been obtained in the research on cytomegalovirus infection,cytomegalovirus hepatitis,nonalcoholic fatty liver disease,autoimmune liver diseases,and drug-induced liver disease.Intensive research on liver diseases in children in China may gradually narrow the gap between China and developed countries in future.