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Objective To explore the possible effects and the underlying molecular mechanisms of xueshuantong[The main active component is panax notoginseng(PNS)]on the cognitive function and neural excitability of mice with Alzheimer's disease(AD).Methods The APP/PS1 mice were used as an animal model for AD research,at the stage when amyloid protein was not detected in mice(2 months of age).Mice in the xueshuantong group(APP/PS1+PNS)were administered by gavage once a day at a dose of 60 mg/kg for six months(for 8 months of age).The mice of the control group were given 0.9%sodium chloride(APP/PS1+Vehicle)intragastric treatment of the same volume,while the wild-type mice of the same age were given 0.9%sodium chloride intragastric treatment as the normal control group(WT+Vehicle)(15 mice in each group,n=15).After six months,the cognitive function of the mice was evaluated by the Novel Object Recognition(NOR)task and Morris Water Maze(MWM)test.The activity of BACE1,the distribution and expression of Nav1.1α,as well as the expression and enzymatic hydrolysis of Navβ2(Navβ2 full-length and Navβ2-CTF fragments)in cortex and hippocampus were detected by EEG,Western blot and cell surface biotinylation assay,respectively.Results The NOR task showed that compared with the mice in the APP/PS1+Vehicle group,the Discrimination index(DI)of mice in the APP/PS1 group was significantly increased after xueshuantong administration(P<0.05).The MWM test found that,the escape latency of the mice in the xueshuantong group was shortened followed six months in gastric administration(P<0.05),while the stay time in the target quadrant and the number of platforms significantly increased(P<0.05)after the removal of the platform.The results of EEG recording showed that xueshuantong reduced the frequency of spike-wave discharges in APP/PS1 mice(P<0.05).Furthermore,xueshuantong significantly reduced the expression of BACE1(P<0.05).In the APP+PNS group,the expression of Navβ2 full-length was increased(P<0.05),as well as corrected the abnormal distribution of Nav1.1α inside and outside of neurons(P<0.05).Conclusion Treatment with xueshuantong can significantly improve the learning and memory ability and correct the abnormal excitability of the brain in AD model mice.The mechanism may be related to the inhibition of BACE1 activity,the reduction of APP/PS1-induced excessive enzyme digestion of Navβ2,the correction of the abnormal expression and distribution of Nav1.1α in cortical and hippocampal neurons,as well as the subsequent regulation of neuronal excitability.
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Objective To investigate the anti-inflammatory effects of Bupi Yichang Pills on mice with experimental colitis and its potential mechanism of action.Methods Dextran sulfate sodium(DSS)was used to model the experimental colitis,and low-,medium-and high-doses of Bupi Yichang Pills(1.5,3.0,6.0 g·kg-1·d-1)and Mesalazine(300 mg·kg-1·d-1)were fed at the same time.Mice were observed for general behavior and weighed.Hematoxylin-eosin staining was used to observe the pathological injury of colonic tissues.qPCR and ELISA were used to detect the levels of inflammatory cytokines(TNF-α,IL-1β,IL-6,IL-10,IL-35 and TGF-β1),qPCR and Western Blot were used to detect the mRNA and protein levels of glucose transporters and glycolytic kinases.Results Low-,medium-and high-doses of Bupi Yichang Pills significantly down-regulated disease activity index in colitis mice(P<0.05,P<0.01).The body mass and colon length were significantly increased,while colon mass,colon mass index and unit colon mass index were significantly reduced(P<0.05,P<0.01),and ulcer formation and inflammatory cell infiltration in colonic tissue were significantly improved.In addition,medium-and high-doses of Bupi Yichang Pills significantly down-regulated the mRNA levels and concentrations of pro-inflammatory cytokines including TNF-α,IL-1β and IL-6(P<0.01),while significantly up-regulated the mRNA levels and concentrations of anti-inflammatory cytokines such as IL-10,IL-35 and TGF-β1(P<0.01).We further found that high-dose of Bupi Yichang Pills significantly down-regulated the mRNA and protein expressions of glucose transporters(Glut1,Glut2,Glut4)and glycolytic kinases(HK2,Aldolase A,PKM2)in colonic tissue(P<0.01).Conclusions Bupi Yichang Pills effectively alleviates DSS-induced experimental colitis,and its specific mechanism of action is related to the improvement of glycolytic metabolic pathways and the regulation of inflammatory cytokine expression.
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Chinese medicinal formulae (CMF), as the main form and means of clinical treatment, are a key link in traditional Chinese medicine (TCM) theory and clinical practice. Exploring the relationship between the chemical substances of CMF and the life activities of the body, as well as their complex interaction patterns, is one of the key issues in modern research of TCM. However, due to the complexity of chemical composition and the diversity of biological effects, evidence remains to be mined for the chain involving chemical composition, in vivo process, and pharmacological activity of CMF, which results in serious fragmentation of related studies. Integrated pharmacology is proposed as an effective strategy for analyzing the molecular interactions of complex systems in TCM. Particularly, it reflects the new trend of using new technologies such as the Internet, big data, and artificial intelligence to drive the development of complex systems in TCM in the context of the fourth wave represented by the biotechnology revolution. This provides a practical and feasible approach for systematically revealing the interaction, integration patterns, and principles of action between multi-component drugs and the body. This article reviews the emergence and development, research ideas, key technologies, and applications of integrated pharmacology of TCM, providing support for explaining the scientific connotation of TCM theory and the scientific value of original thinking of TCM, inheriting the experience of famous doctors, and facilitating the quality control, mechanism explanation, and new medicine development of TCM.
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Tumor metastasis is closely related to high mortality rate of cancer.It is well known that glutamine plays an important role in the malignant progression of cancer.Notably,as an important carbon and nitrogen donor,glutamine has been found to be closely related to tumor metastasis in recent years.Glutamine is not only involved in regulating the proliferation of tumor cells,but is also closely related to the migration and invasion of tumor cells.Furthermore,various enzymes along with transporters in the metabolism of glutamine are involved in the process of tumor metastasis through different signaling pathways.This review provided a summary of the role of glutamine in tumor metastasis in recent years and proposed therapeutic targets to provide new strategies for the clinical treatment of tumor metastases.
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Depression is a major cause of disability and has adverse effects.Despite the many types of anti-depressants,clinical treatments of depression remain poor.Therefore,novel anti-depressant mechanisms need to be explored.The beneficial effects of irisin on the nervous system are gradually being elucidated,and studies have found that irisin has an anti-depressant effect,which may become a new treatment for depression.This study explored the mechanism of irisin and its upstream and downstream anti-depressants by reviewing the existing studies explaining the link between irisin and depression,and proposes that SIRT1/PGC-1α may mediate FNDC5/irisin to regulate BDNF to promote neurogenesis and improve depression,which provides a new idea to study irisin and its upstream and downstream anti-depressants.
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Objective:It aims at constructing the equipment visualization management system in orthopedics on the basis of Godot engine,as well as exploring and discussing its values related to equipment visualization management system in orthopedics of hospitals.Methods:The equipment visualization management system in orthopedics on the basis of Godot engine was designed which further contained data collection,model drawing and function development,then,it further realized the equipment visualization management in orthopedics by relying on the movable terminal.180 medical equipment commonly used in orthopaedic clinic of Beijing Puren Hospital were selected in 2021-2022.Moreover,they were managed by two modes of management which were respectively the traditional equipment management mode(traditional equipment mode)and equipment visualization management system in orthopedics on the basis of Godot engine(visual system).Finally,the effectiveness of the two management modes of the medical equipment,the level of management and the satisfaction scores of doctors,nurses and patients on the two management modes were assessed accordingly.Results:The time utilization rate,quality stability rate and diagnosis and treatment effectiveness rate of the visual system equipment were respectively(95.37±4.06),(96.74±4.72)and(96.41±5.01)%,which were higher than that of the traditional equipment model and the differences were all statistically significant(t=9.608,9.438,4.909,P<0.05).the standardized placement rate,standardized recording rate and intact rate of the visual system equipment were respectively 97.22%(175/180),97.78%(176/180)and 99.44%(179/180),which were higher than that of the traditional equipment model and the differences were all statistically significant(x2=6.972,11.429,9.656,5.236,P<0.05).the failure rate of the visual system was 5.00%(9/180),which was lower than the traditional equipment mode(x2=5.236,P<0.05).the satisfaction scores of doctors,nurses and patients for the visual system equipment were respectively(95.63±3.47),(96.85±3.21)and(95.79±3.92),which were higher than that of the traditional equipment mode and the difference was statistically significant(t=14.068,17.996,14.438,P<0.05).Conclusion:The application of equipment visualization management system in orthopedics on the basis of Godot engine can visualize and manage medical equipment in orthopedics of hospitals,enhance the equipment effectiveness,intensify the equipment management level,as well as improve the users'satisfaction degree with the equipment.
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Exosomes are extracellular vesicles that regulate various signaling pathways in the body by mediating the release of proteins, nucleic acids and lipids, thus playing an important role in pathophysiological processes such as inflammation, tumor, immunity and nervous system. More and more studies have shown that exosomal non-coding RNA (ncRNA) plays a crucial role in pancreatic diseases. This article reviews the role of exosome ncRNA in the occurrence, diagnosis and treatment of pancreatic diseases such as acute pancreatitis and pancreatic cancer, in order to provide a reference for clinical practice.
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To report a case of onychocytic carcinoma in China. A 76-year-old female patient presented with a subnail mass on her left thumb for 3 years. Skin examination showed thickening of the left thumb plate whose surface was partially yellow and black in color, slight curving of the distal plate, obvious telangiectasia under the nail plate, and verrucous hyperplasia under the nail plate and at the lateral edge of the nail plate. Histopathological examination showed that the tumor grew and infiltrated downward in clumps, with obvious keratosis and necrosis in the center of the mass, and many "squamous vortex" structures, atypical cells, and pathological mitotic figures could be seen. Immunohistochemical study revealed that HK31 and HK85 were positively expressed in the squamous vortex region, K6/K16 was positively expressed in the basal part of the tumor, and HK75 was strongly expressed in the whole tumor region. The diagnosis of onychocytic carcinoma was confirmed. The patient received surgical excision combined with 3 sessions of photodynamic therapy, and no recurrence was observed during 18 months of follow-up.
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Da Chaihutang from the Treatise on Febrile Disease (Shanghanlun) has the function of harmonizing lesser Yang and discharging internal heat. It is formulated by ZHANG Zhongjing for the concurrent diseases of lesser Yang and Yang brightness and has been widely used in the treatment of digestive system diseases, especially malignant tumors. By review of the articles published in the last 20 years, this paper summarizes the application of Da Chaihutang in treating digestive system tumors from syndrome analysis, clinical research, and mechanism research. Da Chaihutang can treat the syndrome involving lesser Yang and Yang brightness in the digestive system, release interior and exterior to expel pathogen, and remove obstruction by conforming to the descending nature of the six fu-organs. In clinical practice, Da Chaihutang can directly treat digestive system malignant tumors such as liver cancer, pancreatic cancer, intestinal cancer, gastric cancer, and gallbladder cancer. In addition, it can relieve common complications of digestive system malignant tumors, such as cancerous fever, malignant obstructive jaundice, and constipation. Moreover, it can alleviate the adverse reactions caused by Western medical treatment, such as post-embolization syndrome, side effects of chemotherapy, and incomplete postoperative obstruction. Da Chaihutang is effective when used alone as it can relieve clinical symptoms, improve prognosis, and prolong survival of advanced patients and is safe and non-toxic, suitable for long-term use by tumor patients. Regarding the mechanism, Da Chaihutang can promote the apoptosis and inhibit the proliferation of tumor cells, reduce inflammation and inflammatory injury, and improve the liver function. The clear effect and mechanism confirms the anti-tumor effect of Da Chaihutang. This paper comprehensively describes the current research status of Da Chaihutang in the treatment of digestive system tumors and puts forward the deficiencies and improvement measures for the current research, aiming to provide reference for the application of this formula in treating digestive system tumors, the establishment of Chinese and Western medicine treatment schemes of tumors, and the research and development of anti-tumor drugs.
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Based on the data of a national sampling survey, this paper described and analyzed the understanding, attitude, behavior, and their differences and influencing factors of Chinese medical researchers on ethical review of biomedical research involving human subject. The survey found that researchers with master’s degree or below, working in scientific research institutes or universities, no overseas experience, living in the central region and not serving as committee members have relatively poor acquaintance of "ethical review" ; researchers with the characteristics of male, the younger age, living in the western region, knowing less about "ethical review" , agree more with the view that "ethical review consumes too much time and energy" ; researchers who serve as members of the ethics committee are more likely to participate in scientific research projects that have not passed the ethical review process. Therefore, recommendations are put forward: comprehensively popularizing the training of ethical review, focusing on strengthening the vulnerable groups and regions, strictly implementing ethical review laws and regulations, and strengthening evaluation and supervision, so as to improve the service quality and efficiency of ethical review in multiple directions.
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OBJECTIVE To investigate the intervention effect and potential mechanism of breviscapine on hepatic fibrosis (HF) in rats based on the transforming growth factor-β(1 TGF-β1)/Smad2/extracellular signal-regulated protein kinase 1(ERK1) and Kelch-like epichlorohydrin-associated protein 1(Keap1)/nuclear factor-erythroid 2-related factor 2(Nrf2)/heme oxygenase-1(HO-1) pathways. METHODS Totally 60 rats were randomly divided into normal control group, model group, breviscapine low-dose, medium-dose and high-dose groups (5.4, 10.8, 21.6 mg/kg), and colchicine group (positive control, 0.45 mg/kg), with 10 rats in each group, half male and half female. Except for the normal control group, HF model of the other groups was induced by carbon tetrachloride. Subsequently, each drug group was given corresponding medicine by gavage once a day for 28 days. The liver appearance of rats in each group was observed and their liver coefficients were calculated. The levels of alanineaminotransferase (ALT) and aspartate aminotransferase (AST)in serum, those of ALT, AST, superoxide dismutase (SOD),malondialdehyde (MDA) and glutathione peroxidase (GSH- Px) in liver tissue were detected. The liver tissue inflammatory and fibrotic changes were observed. The protein and mRNA expressions of TGF-β1, Smad2, ERK1, Nrf2, Keap1 and HO-in liver tissue were detected. RESULTS Compared with the normal control group, the model group showed large areas of white nodular lesions in the liver, obvious inflammatory cell infiltration and collagen fiber deposition. The body weight, the levels of SOD and GSH-Px in liver tissue, the protein and mRNA expressions of Nrf2 and HO-1 were significantly lowered in the model group (P<0.05); the liver coefficient, the percentage of Masson staining positive area, ALT and AST levels of serum and liver tissue, MDA level of liver tissue, the protein and mRNA expressions of TGF-β1, Smad2, ERK1 and Keap1 were significantly increased (P<0.05). Compared with the model group, the liver lesions of rats in each drug group were improved, and the above quantitative indexes were generally reversed (P<0.05). CONCLUSIONS Breviscapine has a good intervention effect on HF rats, which may be related to inhibiting TGF-β1/Smad2/ERK1 pathway for anti-fibrosis and regulating Keap1/Nrf2/HO-1 pathway to inhibit oxidative stress.
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OBJECTIVE To explore the improvement mechanism of proanthocyanidins on acute kidney injury (AKI) induced by gentamicin in rats. METHODS Gentamicin sulfate was injected intraperitoneally to construct the AKI rat model; the model rats were randomly divided into model control group, benazepril hydrochloride 5 mg/kg group (positive control), proanthocyanidins 50 mg/kg group, proanthocyanidins 100 mg/kg group, and proanthocyanidins 200 mg/kg group, with 10 rats in each group; in addition, 10 normal rats were selected to be treated as the normal control group. The rats in each administration group were given corresponding liquid intragastrically, and the normal control group and model control group were given equal volumes of normal saline intragastrically, once a day, for 28 consecutive days. After the last administration, the levels of serum creatinine (SCr), blood urea nitrogen (BUN), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and 24 h urinary protein (UP) were detected; the renal index was calculated; the pathological changes of renal tissue were observed and the pathological score was calculated; the apoptotic rate of cells in renal tissue and the expression levels of Caspase-3 and Bcl-2 associated X protein (Bax), as well as the phosphorylation levels of silent information regulator of transcription 1 (SIRT1) and AMP-activated protein kinase (AMPK) were detected. RESULTS Compared with the model control group, the levels of SCr, BUN, UP and MDA, the renal index, the pathological score of renal tissue, the apoptotic rate of cells in renal tissue, the protein expression levels of Caspase-3 and Bax in renal tissue of rats in each administration group were decreased significantly; SOD and GSH-Px levels, phosphorylation levels of SIRT1 and AMPK protein were increased significantly (P<0.05), and the effect of proanthocyanidins was in a dose-dependent manner (P<0.05). There were no significant differences in the above indexes between proanthocyanidins 200 mg/kg group and benazepril hydrochloride 5 mg/kg group (P>0.05). CONCLUSIONS The improvement effect of proanthocyanidins on AKI rats may be related to the activation of SIRT1/AMPK signaling pathway to inhibit oxidative stress.
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Esophageal cancer is a common malignant tumor of the digestive tract. At present, the pathogenesis of esophageal cancer has not been fully clarified. Although surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy have achieved good clinical results in the treatment of esophageal cancer, there are still many complications and severe adverse reactions. As an important part of traditional Chinese medicine (TCM), in recent years, many basic experiments and clinical studies have proved that Chinese medicine has a good effect in treating esophageal cancer. At the same time, the multi-component and multi-target characteristics of Chinese medicine and unclear pathogenesis of esophageal cancer determine that there are some problems such as unclear mechanisms of Chinese medicine in preventing and treating esophageal cancer. It is necessary to start with modern medicine and reveal the mechanism of Chinese medicine in preventing and treating diseases from the aspects of molecular biology and network pharmacology. It is believed in TCM that the occurrence of esophageal cancer is mostly attributed to stagnation of liver Qi, phlegm stasis and Qi stagnation, fluid consumption and heat accumulation, the decline of healthy Qi, and the cementation of cancer toxicity. According to the literature review, Chinese medicinal compounds mainly include tonic formulae (such as Liu Junzitang), drying and moistening formulas (such as Qigesan), and heat-clearing formulas (such as Fufang Kushen injection). Chinese medicinal monomers mainly include drugs potent in attacking poison and killing insects, clearing heat, activating blood and resolving stasis, and regulating Qi, which is consistent with the etiology and pathogenesis of esophageal cancer in TCM. It is also found that Chinese medicine can promote cell apoptosis and autophagy, block cell cycle, and reverse cell resistance by regulating phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), neurogenic locus notch homolog protein (Notch), Wnt/β-catenin, mitogen-activated protein kinase (MAPK), nuclear factor-κB (NF-κB), Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3), and other related signaling pathways, but there is no systematic summary. This study systematically summarized the relevant signaling pathways of Chinese medicine in regulating esophageal cancer, which is helpful to clarify the relevant mechanisms of Chinese medicine in the process of esophageal cancer occurrence, development, invasion, and metastasis, so as to provide new targets and new perspectives for the treatment of esophageal cancer and promote the modernization of TCM.
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BACKGROUND: Bisphenol A (BPA), a common endocrine-disrupting chemical (EDC), has been revealed to be closely associated with the induction of abnormal heart development, obesity, prediabetes, and other metabolic disorders. However, the underlying mechanism of maternal BPA exposure on fetal heart development abnormalities is not clear. METHODS: To explore the adverse effects of BPA and its potential mechanism on heart development, C57BL/6 J mice and human cardiac AC-16 cells were used to conduct in vivo and in vitro studies. For the in vivo study, mice were exposed to low-dose BPA (40 mg/(kg·bw)) and high-dose BPA (120 mg/(kg·bw)) for 18 d during pregnancy. In vitro study, human cardiac AC-16 cells were exposed to BPA of various concentrations (0.01, 0.1, 1, 10, and 100 µM) for 24 h. Cell viability and ferroptosis were evaluated using 2,5-diphenyl-2 H-tetrazolium bromide (MTT), immunofluorescence staining, and western blotting. RESULTS: In BPA-treated mice, the alterations of fetal cardiac structure were observed. Increased NK2 homeobox 5(Nkx2.5) was detected in vivo with the induction of ferroptosis, revealing that BPA induced abnormal fetal heart development. Furthermore, the results showed that SLC7A11 and SLC3A2 decreased in low- and high-dose BPA-treated groups, suggesting that system Xc- mediated BPA-induced abnormal fetal heart development via inhibiting the expression of GPX4. Observing AC-16 cells confirmed that cell viability declined significantly with various concentrations of BPA. Moreover, BPA exposure suppressed GPX4 expression by inhibiting System Xc- (the decrease of SLC3A2 and SLC7A11). Collectively, system Xc- modulating cell ferroptosis might play important in abnormal fetal heart development induced by BPA exposure.
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Ferroptosis , Embarazo , Femenino , Ratones , Humanos , Animales , Ratones Endogámicos C57BL , Exposición Materna/efectos adversos , Corazón Fetal/metabolismo , Compuestos de Bencidrilo/metabolismoRESUMEN
OBJECTIVE@#To explore the feasibility of using indocyanine green angiography in mapping the superficial temporal vessels and assisting design and harvesting of the superficial temporal artery based forehead flap.@*METHODS@#A clinical data of 14 patients with facial soft tissue defects repaired with superficial temporal artery based forehead flaps between October 2015 and November 2022 was retrospectively analyzed. There were 9 males and 5 females with a median age of 9.5 years (range, 3-38 years). The forehead flaps were used to reconstruct facial soft tissue defects following excision of facial scar (8 cases) or congenital melanocyte nevus (6 cases). The size of defects ranged from 3 cm×2 cm to 24 cm×9 cm. Before operation, the indocyanine green angiography was used to map the superficial temporal artery and vein, and to analyze the relationship of the arteries and veins. The forehead flaps with unilateral superficial temporal fascia as the pedicle was transferred to repair the small facial defect in 2 cases. The facial pedicle contained the frontal branch of the superficial temporal artery and 2 cm of the superficial temporal fascia around the vessel, and the tiny accompanying vein of the frontal branch of the superficial temporal artery was used as the outflow of the flap. The forehead flaps with the skin pedicle including bilateral or unilateral superficial temporal fascia and the overlying skin was pre-expanded and transferred to repair the large facial defect in 12 cases. The skin pedicle contained the frontal branch of superficial temporal artery and one of main branches of superficial temporal vein. Among the 12 cases, the frontal branch of superficial temporal vein was used as the outflow in 4 cases, and the parietal branch was used as the outflow in 8 cases. The size of the flaps ranged from 3 cm×2 cm to 30 cm×13 cm. The skin pedicles were divided at 3 weeks after the flap transfer.@*RESULTS@#Indocyanine green angiography could clearly showed the course and branching of the superficial temporal artery and vein. Individual differences existed in the location where the frontal branch of the superficial temporal artery entered the forehead. The superficial temporal vein had great variability and did not follow the artery. One patient had expander-related complication, which resulted in 3-cm flap necrosis. The necrotic tissue was debrided and repaired with skin grafting. The other flaps totally survived and the incisions healed by first intention. All patients were followed up 2-24 months, with a median of 11.5 months. The color, texture, and thickness of the flaps matched well with those of recipient sites. Hypertrophic scar was not observed in recipient or donor site. All patients were satisfied with the reconstructive outcomes.@*CONCLUSION@#Indocyanine green angiography can clearly visualize the course and the branches of the superficial temporal arteries and veins, which can help surgeons understand the position, distribution, and concomitant relationship of the superficial temporal vessels, and make a rational surgical plan of the forehead flap.
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Masculino , Femenino , Humanos , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Arterias Temporales/cirugía , Verde de Indocianina , Frente/cirugía , Estudios Retrospectivos , Trasplante de Piel , Angiografía , Traumatismos de los Tejidos Blandos/cirugía , Colgajo Perforante/irrigación sanguínea , Resultado del TratamientoRESUMEN
OBJECTIVE@#To review the research progress of the principle and clinical application of keloid core excision technique.@*METHODS@#The literature on keloid core excision technique at home and abroad in recent years was extensively reviewed, and the principle, development history, indications, advantages and disadvantages of this technique were summarized, and the existing controversies were analyzed.@*RESULTS@#Keloid core excision is a technique to remove the inner fibrous core from the keloid and cover the defect with the keloidal flap. It reduces the wound tension, yields good aesthetic results in the treatment of ear keloids, and reduces the recurrence rate of keloids combining with adjuvant therapies.@*CONCLUSION@#The keloid core excision technique has specific advantages, yet its overall efficacy remains controversial. Further studies are imperative to explore the mechanisms regarding keloid recurrence and the vascular supply principles of the keloidal flap. It is also necessary to define appropriate surgical indications and safety protocols of this technique.
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Humanos , Queloide/patología , Recurrencia , Colgajos Quirúrgicos/patología , Procedimientos de Cirugía Plástica , Resultado del TratamientoRESUMEN
Objective:To analyze the frequency and characteristics of polymyositis (PM) in idiopathic inflammatory myopathy (IIM), and to investigate whether PM is over-diagnosed.Methods:Patients diagnosed as IIM according to the Bohan & Peter criteria of IIM hospitalized in the Department of Rheumatology of China-Japan Friendship Hospital from 2008 to 2019 were involved in the study. Definite PM (dPM) was defined as typical clinical and pathological features including elevated creatine kinase (CK) level, muscle weakness and muscle biopsy findings with endomysial CD8 + T cell infiltration and expression of MHC-1 on sarcolemma. Meanwhile, dermatomyositis (DM), anti-synthase syndrome(ASS), immune-mediated necrotic myopathy(IMNM), sporadic inclusion body myositis(sIBM) and other myopathies were excluded according to the new classification criteria of IIM subtypes respectively. Statistical analysis was performed using SPSS software 24.0. The Kruskal-Wallis test and χ2 test were used to compare the clinical characteristics between the dPM group and other IIM subtypes. Results:A total of 1 259 patients with IIM including 1 015 (80.6%) DM and 244(19.4%) PM were enrolled in this study. According to the strict definition of PM criteria, only 0.5% of patients (6/1 259) in IIM could be diagnosed as dPM. Most PM patients were IMNM and ASS according to the new IIM subtypes criteria, of which 48.0% (117/244) were IMNM and 32.0% (78/244) were ASS. 66.7%(4/6) of dPM patients were women. One complicated with RA, and one was dPM overlaped with systemic sclerosis. All of them had muscle weakness, mild elevation of CK level [611(391,1 451) U/L], and were myositis-specific autoantibodies negative. Except one dPM patients who did not receive immunoregulatory therapy due to chronic obstructive pulmonary disease, the others were administrated with low or medium dose prednisone combined with or without immunosuppressive agents. After a median follow-up of (38±26) months, the muscle strength of dPM patients were improved.Conclusion:dPM is a very rare clinical subtype of IIM. PM is an over-diagnosed entity in clinical practice. Patients with dPM have mild symptoms and good outcome.
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Objective To investigate the regulatory effect of Bupi Yichang pill(BPYCP)on CD4+T cell subsets of ulcerative colitis(UC)mice.Methods Forty-eight C57BL/6 mice were randomly divided into 4 groups:the control group(n=10),the model group(DSS group,n=13),the model +BPYCP group(DSS+BPYCP group,n=13)and the model+ mesalazine(5-ASA)group(DSS+5-ASA group,n=12).The mouse UC model was induced by 2.5%dextrosan sulfate(DSS)solution.The DSS+BPYCP group and the DSS+5-ASA group were given BPYCP or 5-ASA for 2 weeks,respectively,and fecal viscosity and blood in stool were observed.The colon length was measured.Colonic mass index and unit colonic mass index were calculated.Hematoxylin-eosin(HE)staining was used to observe pathological changes of colon and to score the pathological tissue damage.The level of CD4+T cell subsets in mesenteric lymph nodes was detected by flow cytometry.The expression levels of cytokines interferon-γ(INF-γ),interleukin(IL-4),IL-17A,IL-10 and IL-21 secreted by CD4+T cell subsets in colon tissue were detected by ELISA.Real-time fluorescence quantitative PCR was used to detect colon tissue CD4+T cell subset nuclear transcription factors,mRNA expression levels of T-frame protein 21(T-bet),GatA-binding protein 3(GATA-3),retinoa-associated nuclear orphan receptor γt(RORγt),B cell lymphoma-6(Bcl-6)and Foxp3 in rats.Results Compared with the DSS group,the diarrhea and hematostoecium symptoms of UC mice in the DSS+BPYCP group and the DSS+5-ASA group were significantly improved,body weight and colon length of mice were increased,and colon mass,colon mass index and unit colon mass index were decreased(P<0.05).The mucosal epithelium was more complete than that in the DSS group,and gland arrangement was more regular.The inflammatory cell infiltration was less,and the pathological tissue damage score was significantly decreased(P<0.01).The proportion of Th2 cells in mesenteric lymph nodes was decreased,the proportion of Th17 cells and the level of IL-17A were decreased,and the mRNA levels of T-bet,GATA-3,RORγt and Bcl-6 in colon tissue were decreased(P<0.05).In the DSS+BPYCP group,the proportion of Th1 cells decreased,the proportion of CD4+CD25+Treg cells,CD4+CD25+Foxp3+Treg cells and the level of IL-10 increased,and the proportion of CD4+CXCR5+Tfh cells and the level of IL-21 decreased.The level of Foxp3 mRNA increased(P<0.05).The proportion of Th1 cells and the level of IFN-γ were decreased in the DSS+5-ASA group(P<0.05).Conclusion BPYCP may alleviate UC by remodeling the homeostasis of CD4+T cell subpopulations.
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Objective This paper discusses the influence factors of the citation frequency of internal control papers in public hospitals,and understands the overall development and hot trends in this field.Methods Descriptive statistics and re-gression analysis was used to analyze the articles searched from CNKI database from 2012 to October 2022.Results 1 682 valid literature was achieved and it was found that the papers with a frequency of citations greater than or equal to seven are highly cited papers,accounting for 16.77%;There are a number of stable high-level researchers and high-quality research institutions in this fields,which are important forces to promote the development of disciplines;Regression analysis found that articles funded and published in core journals were cited frequently;The frequency of citations in research topics such as System construction,Finan-cial control,Contract control and Asset control is significantly higher than other topics.Conclusion High-level researchers,high-level research institutions,high-quality papers and high-quality journals are mutually successful;Fully understanding the"Management Measures for Internal Control in Public Hospitals"is the foundation of internal control construction in the medical and health industry;Strengthening information technology construction is the focus of future internal control work in public hospitals;In-ternal control should work together with other policies in the healthcare industry to promote the reform of the healthcare system.
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Objective:To evaluate the effects of foods for special medical purposes (FSMP) on physical performance, body composition, nutritional metabolic indicator levels, and inflammatory factor levels in patients at nutritional risk.Methods:A single-center, double-blind, randomized, controlled clinical study was conducted. Patients at nutritional risk were randomized to two groups. Both groups received the nutritional management for 8 weeks, including 30 gram of nutritional preparations thrice a day, standard meals, and nutritional education. The intervention group was given full nutritional FSMP while the control group was given isocaloric placebo. The primary outcomes were the changes in timed up and go (TUG) test score, grip strength and muscle mass measured by bioelectrical impedance analysis after the intervention. The secondary outcomes were the walking speed as measured by 4-meter walk test, calf circumference, blood 25 hydroxyvitamin D 3 (25-OH-VD 3), and high-sensitivity C-reactive protein. Other indicators examined included serum albumin and prealbumin and inflammatory factors, and T cell and B cell subsets. Results:Forty-five patients were enrolled and 25 completed the intervention and follow-up period. There were no significant differences between groups in sex, age, height, and weight. Muscle mass ( P=0.042), upper limb muscle mass ( P=0.035), and grip strength ( P=0.032) were significantly increased in the intervention group compared to the control group, while TUG score was significantly reduced ( P=0.047). Four-meter walk test time, calf circumference, inflammatory indicators, and serum indicators did not change significantly after the intervention( P>0.05). TUG score was positively correlated with 4-meter walk time, interleukin-8, while negatively correlated with grip strength, 25-OH-VD 3 and serum albumin. Conclusions:The full nutritional FSMP was safe and effective for long term use in patients at nutritional risk, improving physical performance and muscle mass. However, no significant effect of full nutritional FSMP were observed on serum nutritional indicators and inflammatory factors.