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Hepatocellular carcinoma (HCC) is a common malignant tumor of the liver characterized by a high incidence rate, rapid progression, and poor prognosis. In recent years, it has been found that non-coding RNA (ncRNA) participates in the regulation of tumor immunity in tumor microenvironment (TME) and in turn affects the biological behavior of HCC. This article briefly describes the regulatory effect of ncRNA on immune cells in TME and introduces the potential value of ncRNA in the diagnosis and treatment of HCC, in order to provide potential diagnostic and treatment strategies for HCC.
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Objective:To observer the effect of electroacupuncture at "Neiguan", "Ximen" and "Hegu" acupoints of the Pericardium Meridian and observe the expression of CaMK Ⅱ mRNA and apoptosis in the myocardial ischemic rats with reperfused injury.Methods:The Wister rats were randomly divided into sham operation group, model group, Acupuncture Neiguan group, Acupuncture Ximen group and Acupuncture Hegu group, with 10 rats in each group. Exceptthe sham operation group, the othergroups were all ligated with the left anterior descending branch of the coronary artery. Before ligating the coronary artery, electroacupuncture was performed at "Neiguan", "Ximen" and "Hegu" points for 20 minutes respectively. After the ligation for 40 minutes, electroacupuncture was performed at the above points for 20 minutes and then restore coronary perfusion for 60 minutes. The ECG changes of rats were recorded. The level of CaMK Ⅱ mRNA was detected by RT-PCR and the apoptosis rate of cardiomyocytes was detected by TUNEL. The correlation between the expression rate of CaMK Ⅱ mRNA and the apoptosis rate of cardiomyocytes was analyzed according to the pearson correlation.Results:At 20, 40 and 60 min after the ligation of coronary artery and 30 and 60 min after the loosening of coronary artery, compared with the model group and Acupuncture Hegu group, the ST segment difference of Acupuncture Neiguan group and Acupuncture Ximen group was decreased ( P<0.01); The levels of CaMK Ⅱ mRNA (0.483 ± 0.050, 0.432 ± 0.079 vs. 0.935 ± 0.109) in Acupuncture Neiguan group and Acupuncture Ximen group were significantly decreased ( P<0.01). The apoptosis rate of cardiomyocytes (10.86% ± 2.17%, 9.66% ± 4.09% vs. 36.22% ± 1.69%) significantly decreased ( P<0.01). Conclusions:There is a positive correlation between CaMK Ⅱ mRNA level and cardiomyocyte apoptosis during myocardial ischemia-reperfusion. Acupuncture can effectively reduce CaMK Ⅱ mRNA level and cardiomyocyte apoptosis rate and protect cardiomyocytes.
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Objective:To systematically review the efficacy and safety of new oral anticoagulants(NOACs)for the treatment of patients over 70 years with atrial fibrillation.Methods:Studies comparing NOACs(dabigatran, rivaroxaban, apixaban, ximelagatran and edoxaban)versus warfarin for the treatment of patients over 70 years with atrial fibrillation were searched through databases including PubMed, Embase and the Cochrane Library, from the earliest electronic records to those published in March 2021.Stata15.0 software was used for meta-analysis.Results:A total of 19 studies and 215 471 patients were included.Meta-analysis results showed that, compared with warfarin, either a low-dose(110 mg)or a standard-dose(150 mg)of dabigatran reduced the risk of stroke/systemic embolism(SSE)in patients over 70 years with atrial fibrillation.A standard-dose of dabigatran did not decrease the risk of major bleeding, but a low dose was able to achieve it.A standard-dose(20 mg)of rivaroxaban could considerably reduce the risk of SSE in geriatric patients over 70 years with atrial fibrillation without increasing the risk of major bleeding.A standard-dose(5 mg)of apixaban could considerably decrease the risk of SSE and major bleeding in patients over 70 years with atrial fibrillation; A standard-dose(36 mg)of ximelagatran was as effective as warfarin in decreasing the incidence of SSE in patients over 70 years with atrial fibrillation, but could also considerably decrease the risk of major bleeding; A low-dose(15-30 mg)or a standard-dose(30-60 mg)of edoxaban decreased the incidence of SSE in patients over 70 years with atrial fibrillation, as did warfarin, but edoxaban considerably decreased the risk of major bleeding.Conclusions:Compared with warfarin, most of new oral anticoagulants show good efficacy in patients over 70 years old with atrial fibrillation, NOACs given at standard doses increase the risk of major bleeding, but at low doses can realize both efficacy and safety.
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Sorafenib, as the first-line treatment drug for advanced hepatocellular carcinoma (HCC), can effectively improve the prognosis of patients with HCC, but sorafenib resistance has become a major obstacle to the therapeutic outcome of HCC. Recent studies have shown that non-coding RNA plays a key role in sorafenib resistance in HCC. This article summarizes that non-coding RNA regulates the sensitivity of HCC to sorafenib by inducing the autophagy of hepatoma cells, promoting the proliferation of liver cancer stem cells, promoting the EMT process of hepatoma cells, inhibiting the apoptosis of hepatoma cells, and regulating the microenvironment of liver cancer tissue. It is pointed out that the molecular mechanism of non-coding RNA in regulating sorafenib resistance in HCC has potential clinical significance in overcoming sorafenib resistance in HCC.
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Objective:To investigate the relationship between sarcopenia and early renal dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 198 elderly patients with T2DM aged over 60 years undergoing treatment in the Geriatric Department of Beijing Hospital from July 2018 to July 2019 were enrolled in this retrospective case-control study.The estimated glomerular filtration rate(eGFR)is calculated according to the CKD-EPI Cr-Cys formula.Based on the eGFR, the patients were divided into normal renal function group(n=63, in CKD 1 stage)and mild renal dysfunction group(n=135, in CKD 2-3a stage). All subjects underwent physical examination, laboratory examination and dual energy X-ray bone density examination. Results:The age, weight, body mass index, abdominal circumference, serum creatinine, cystatin C, uric acid, diastolic pressure, the proportions of diabetes and hypertension were lower, and the high-density lipoprotein cholesterol, appendicular skeletal muscle mass(ASM)and skeletal muscle mass index(SMI)were higher, in the normal renal function group than in the mild renal dysfunction group( P<0.05 or 0.01). Spearman correlation analysis showed that eGFR was positively correlated with SMI( r=0.343, P<0.01). Logistic regression analysis showed that body weight( OR=1.318, 95% CI: 1.091-1.594), uric acid( OR=1.007, 95% CI: 1.001-1.012), diastolic blood pressure( OR=1.072, 95% CI: 1.033-1.112), years of diabetes( OR=1.075, 95% CI: 1.013-1.142)were risk factors, and the LSM( OR=0.136, 95% CI: 0.047-0.392)and SMI( OR=0.778, 95% CI: 0.703-0.860)were protective factors for the early renal dysfunction in elderly patients with T2DM. Conclusions:Elderly patients with T2DM are often co-existed with sarcopenia.Sarcopenia is associated with early renal dysfunction in elderly patients with T2DM.
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With the acceleration of the aging process in China, the incidence rates of coronary heart disease and cerebral infarction have significantly increased.And iodine contrast agent is often used in imaging diagnosis and percutaneous intervention therapy.The contrast medium is filtered from the glomerulus in its original form and is not absorbed by renal tubules.However, the accumulation of iodine contrast medium in the kidney can lead to acute kidney injury.Kidney is one of the most important excretory and endocrine organs in human body.The prevention and treatment of contrast-induced nephropathy(CIN)have been widely concerned.The incidence rate of contrast-induced renal damage is higher and the prognosis is poorer in the elderly than in the non-elderly due to the decline of organ function in the elderly.At present, the mechanism of action for oxygen free radicals in CIN of the elderly is still unclear.This article reviews the researches on the role of oxygen free radical in CIN of the elderly studied by domestic and foreign scholars in recent years.
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Objective:To increase the understanding of neuroleptic malignant syndrome, rhabdomyolysis and acute renal injury in advanced-aged patients with Parkinson's disease after abdominal surgery.Methods:We report a case of malignant syndrome, rhabdomyolysis and acute renal injury in an 85-year-old patient with Parkinson's disease after abdominal surgery in our department.The diagnosis and successful treatment experience were summarized, and a literature review was conducted.Results:The body temperature was as high as 40.5℃ in this patient, accompanied by stiffness, sustained involuntary shaking, increased muscle tone, serum creatine kinase at 104 615 U/L, tachycardia, low blood pressure, accelerated breathing rate, disturbance of consciousness, excessive sweating and other clinical manifestations, which met the diagnostic criteria for neuroleptic malignant syndrome.The patient had complications including concurrent rhabdomyolysis, acute renal injury and shock.The emergency was resolved after an early diagnosis and proactive treatment.Conclusions:If patients with Parkinson's disease have a high fever with rigidity or sudden aggravation within a short period of time after medication, the possibility of neuroleptic malignant syndrome should be considered and the causes should be screened.
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Objective:To compare the application of three different glomerular filtration rate(eGFR)-estimating equations in the elderly aged 60 years and over.Methods:The patients aged ≥ 60 years in our hospital from January 2012 to October 2017 were included as research subjects who underwent three GFR detection(as measured GFR i. e.mGFR)of serum creatinine(Scr), serum cystatin C(sCysC)and GFR by 99mTc-DTPA renal dynamic imaging.The advantages and disadvantages of each GFR-estimating(eGFR)equation in the elderly patients were compared.Results:A total of 122 patients were enrolled, including 90 males(73.8%), with a median age of 77 years.The median Scr and sCysC were 109 μmol/L and 1.39 mg/L, respectively, with their average of mGFR being(45.70±18.91)ml·min -1·1.73m -2.Overall, each eGFR-Scr equation over-estimated the GFR in varying degrees.In eGFR-Scr, full age spectrum equation(FAS)-Scr had the smallest bias(2.34)and the best accuracy(P30 75.4%), followed by Berlin Initiative Study(BIS)-Scr(P30 71.3%). In eGFR-CysC, the P30 of FAS-CysC and chronic kidney disease(CKD)-Epidemiology Collaboration(EPI)-CysC were 75.4% and 71.3%, respectively, and the accuracy of eGFR-CysC was comparable to that of BIS-Scr and FAS-Scr.In eGFR-combi, the bias of FAS-combi was the smallest(1.10), and the accuracy of FAS-combi, BIS-combi and CKD-EPI-combi was comparable, the P30 was 81.1%, 79.5% and 74.6%, respectively, and the P30 of FAS-combi and BIS-combi was higher than that of eGFR-Scr and eGFR-CysC.In the 60-80 age group, the accuracy of FAS-combi and BIS-combi was the best, P30 was 77.8% and 76.4% respectively, while, the accuracy of other equations were poor.In patients ≥ 80 years old, except for the modification of diet in renal disease(MDRD)equations and CKD-EPI-scr equation, the accuracy of other equations was acceptable, among which the accuracy of eGFR-combi equation was the best, and the P30 of FAS-combi, BIS-combi and CKD-EPI-combi were 86.0%, 84.0% and 80.0%, respectively. Conclusions:In elderly patients aged 60 years and over, the application of eGFR-combi equation is better than that of the respective eGFR-Scr and eGFR-CysC equations.The FAS equation has the best bias and accuracy, followed by the BIS equation.
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Objective:To compare the advantages and disadvantages of several formulas for estimated glomerular filtration rate (eGFR) based on serum creatinine in elderly patients with chronic kidney disease (CKD) over 60 years old.Methods:CKD patients aged≥60 years old in Beijing Hospital from January 2012 to October 2017 were selected as subjects. Measured glomerular filtration rate (mGFR) was detected by 99mTc-DTPA renal dynamic imaging and used as a reference standard. According to the mGFR value, the patients were divided into 4 groups: mGFR<30 ml·min -1·(1.73 m 2) -1 group, 30≤mGFR<45 ml·min -1·(1.73 m 2) -1 group, 45≤mGFR<60 ml·min -1·(1.73 m 2) -1 group and mGFR≥60 ml·min -1·(1.73 m 2) -1 group. The deviation of each formula was compared by Bland-Altman scatter chart, and the accuracy of each formula was evaluated by the proportion of eGFR within mGFR (1±30%) ( P30) and root mean square error ( RMSE). Wilcoxon paired rank sum test was used to compare the deviation of each formula, and McNemar test was used to compare the difference of P30 among these formulas. Results:A total of 628 patients with CKD were enrolled in this study. The median age was 76.0(71.0, 81.0) years old. The median serum creatinine and mGFR were 110.0(86.0, 152.0) μmol/L and 42.90(29.88, 55.68) ml·min -1·(1.73 m 2) -1, respectively. Each eGFR formula based on serum creatinine overestimated glomerular filtration rate in varying degrees. Among them, the accuracy of Berlin Initiative Study (BIS) formula and full age spectrum (FAS) formula was the best ( P30 were 68.3% and 68.0% respectively), followed by the Chinese race coefficient of Chronic Kidney Disease Epidemiology Collaboration (C-CKD-EPI) formula ( P30 was 65.4%). The accuracy of the other formulas was poor. In terms of deviation, C-CKD-EPI formula was the best (0.27). In the group of mGFR<30 ml·min -1·(1.73 m 2) -1, the accuracy of all formulas was poor, and the accuracy of FAS formula was slightly better than that of other formulas ( P30 was 51.0%). In the group of 30≤mGFR<45 ml·min -1·(1.73 m 2) -1, the deviation of C-CKD-EPI formula was the smallest (3.11). In terms of accuracy, BIS and FAS formulas were better than others, and the P30 were 64.6% and 63.0% respectively. In the group of 45≤mGFR<60 ml·min -1·(1.73 m 2) -1, the deviation of C-CKD-EPI formula was also the smallest (0.72), and the accuracy of BIS formula was the best ( P30 was 82.5%), followed by FAS formula ( P30 was 79.7%). In the group of mGFR≥60 ml·min -1·(1.73 m 2) -1, the deviation and accuracy of Xiangya formula were the best (the deviation and P30 were -0.53 and 96.5% respectively), and the P30 of BIS and C-CKD-EPI formulas were 87.6% and 87.6%, respectively. Conclusions:In the elderly patients with CKD over 60 years old, the accuracy of eGFR based on serum creatinine increases with the increase of mGFR. BIS and FAS formulas are recommended first. The accuracy of each formula is poor in patients with severe renal insufficiency.
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Chronic kidney disease(CKD)increases the risks of diabetes, hypertension, heart disease and stroke in the elderly, which leads to the increase of mortality and disability rate, to the decline of the functional status and to the elevation of medical expenses, and has become an important public health problem.In recent years, comprehensive geriatric assessment of the elderly has become a research hotspot.This article reviews the application of comprehensive geriatric assessment, and lifestyle and medical intervention in elderly patients with chronic kidney disease.
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Objective To observe the changes ofmacular structure and choroidal capillary blood flow density in patients with acute central serous chorioretinopathy (CSC).Methods Prospective cross-sectional study.A total of 24 eyes of 24 patients with monocular acute CSC (case group) diagnosed by clinical examination from Shanxi Eye Hospital during January and March 2018 were included in the study.The eyes (24 eyes) and contralateral eyes (24 eyes) of the patients in the case group were set to CSC group and contralateral eye group,respectively.Twenty-one eyes of 21 healthy volunteers with age and gender matching were selected as normal control group.The macular structure of the eyes were observed by OCT and OCT angiography (OCTA),and the blood vessel density of choroidal capillary layer in the circular area of the macular area with a radius of 1 mm was measured.The paired t-test was used to compare the differences in blood flow density in the choroidal capillaries between the three groups.Results The results of OCT showed that the serous neuroepithelial detachment in the macular area was observed in all eyes of the CSC group,with or without RPE detachment being 20 or 4 eyes,respectively.Of the 24 eyes in the contralateral eye group,13 eyes (54.2%) had thick choroidal RPE lesions (PPE).There was no abnormality in the retina and choroidal structure in the macular area of the normal control group.The results of OCTA showed that the blood flow density of choroidal capillaries in the CSC group,the contralateral eye group and the normal control group were 1.759 ± 0.132,1.924± 0.463,and 1.940± 0.033,respectively.Compared with the eyes of the contralateral eye group and the normal control group,the blood flow density of choroidal capillaries in the CSC group was significantly lower (t=6.611,6.474;P=0.000,0.000).There was no significant difference in the blood flow density of choroidal capillary layer between the contralateral eye group and the normal control group (t=1.328,P > 0.05).In the contralateral eye group,there was no significant difference in the blood flow density of choroidal capillary layer between PPE eyes and no RPE eyes (t=0.806,P>0.05).Conclusions There is 54.2% of the contralateral eyes in the monocular acute CSC patients with PPE.The choroidal capillary layer blood flow density is lower than that of the contralateral and normal eyes.
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Objective To establish a monkey model of muscle atrophy by fixing the right lower limb and set up e-valuation criteria for that model. Methods Twelve healthy,6-7 year old male cynomolgus monkeys(body weight 6-7 kg)were used in this study. All animals were normal and had no malformed lower limb bones. Right lower limbs of the an-imals were fixed with fiberglass bandage(from knee joint to anklebone)for 15 weeks. Body weight,crus perimeter and crus volume were recorded every two weeks. MRI examinations of the gastrocnemius muscle were conducted at weeks 11,13 and 15. Muscle biopsy was taken for pathological examination at week 15. Results There were no obvious changes of body weight during the experiment. At 15 weeks after modeling,the right crus perimeter and crus volume of the experimental an-imals were significantly decreased(P <0.05),and some biochemical indexes such as serum creatinine,gloucose and al-kaline phosphatase were significantly decreased(P <0.05), while cholesterol was significantly increased(P <0.05).MRI showed atrophy of the right gastrocnemius muscle. Muscle biopsy also showed muscle atrophy and muscle fibers be-came thinner in the right gastrocnemius,and the cross-section area of the muscle fibers was significantly decreased. Con?clusions It is easy to operate and establish a muscle atrophy model in Cynomolgus monkeys by fixing the right lower limb. This model is suitable for objective and easy evaluation of muscle atrophy by measurement of crus perimeter and crus volume of the limb,blood biochemical parameters,MRI examination,and histopathological examination in combination.
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Objective To investigate the clinical features of elderly patients with stage 3-4 chronic kidney disease ( CKD ) and to analyze the risk factors of the kidney function progression. Methods This was a cross-sectional study. The clinic data of elderly patients (≥60 years) with stable clinical manifestation in Beijing Hospital from January ,2014 to December ,2015 was collected.Based upon the eGFR derived from Cockcroft-Gault (CG) equation ,all patients were divided into groups of CKD 3a group ,CKD 3b group and CKD 4 group ,respectively. Moreover ,patients were separated into the old group (< 80 years) and the very old group (≥80 years) based on the age. The demographic features ,primary diseases history ,body mass index (BMI) ,blood routine ,urine routine , blood biochemistry ,Cystatin C and iPTH were recorded.Logistic regression analysis of kidney function progression was also conducted. Results One-hundred and eighty-three cases were enrolled with a mean age of(80 ± 9)years.Along with the descent of kidney function ,the age ,levels of proteinuria and iPTH gradually ascended (F= 12.352 ,5.910 ,5.910 ;P= 0.000 ,0.003 ,0.003 ,respectively) and the BMI and serum albumin gradually descended (F=9.758 ,11.088 ;P=0.000 ,0.000 ,respectively).In addition ,compared to the old group ,very old group was associated with decreased level of eGFR [(37.1 ± 9.9) ml·min-1·1.73 m -2vs. (44.0 ± 12.0) ml·min-1·1.73 m -2,t= -4.280 ,P=0.000] and increasedlevelofCystatinC[(1.71±0.84)mg/L vs. (1.40±0.69)mg/L ,t=3.484 ,P=0.001].The Logistic regression analysis indicated that the proteinuria was an independent risk factor for the progression of kidney function ( OR =3.856 ,P=0.004). Conclusions As the gradually descended of the eGFR level in elderly patients with stage 3-4 CKD ,age ,proteinuria and iPTH gradually ascended ,BMI and serum albumin descended ,respectively. The level of eGFR decreased and CystatinC increased significantly with the increasing age. Proteinuria was an independent risk factor for progression of the kidney function.
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Objective To investigate the effect of iso-osmolar contrast media (IOCM) on renal function in elderly patients. Methods The clinical data of 77 patients aged over 65 years undergoing vascular angiography and interventional therapy using IOCM with a dose>100 ml from September 2016 to May 2017 were retrospectively analyzed. Serum creatinine (CRE), urea and uric acid were measured before angiography, within 48 h and 3-7 d after angiography. The incidence of contrast-induced nephropathy (CIN)and the renal function before and after angiography were compared. Results Among the 77 patients, 58 were males and 19 were females, with an average age of (73.8 ± 7.2) years. The mean serum CRE values before and 3-7 days after angiography were (84.55±39.92)μmol/L and (83.87±38.45)μmol/L respectively (t=0.140, P=0.889);the mean serum urea levels were (5.64±2.36) mmol/L and (6.44±3.15) mmol/L (t=3.041,P=0.003);the mean serum uric acid levels were (281.39±85.30)μmol/L and (333.29±89.89)μmol/L (t=7.297, P<0.001), respectively. CIN occurred in 7 patients with an incidence of 9.1%. In 7 patients with CIN, the mean CRE values increased from (135.71±102.41)μmol/L before angiography, to (180.00±100.45)μmol/L within 48 h and (142.86 ± 92.97) μmol/L 3-7 d after angiography (F=9.876,P=0.011); and the uric acid levels progressively decreased from (353.43 ± 86.73)μmol/L before angiography, to (339.14 ± 85.69)μmol/L within 48 h after angiography and (299.57 ± 95.71) μmol/L 3-7 d after angiography (F=5.713,P=0.029). Conclusion In elderly patients, IOCM has relatively mild effect on renal function during vascular angiography or interventional therapy.
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Objective To establish reference values for blood pressure in cynomolgus monkeys in different ages.Methods The blood pressures and blood lipids indexes were detected in 521 cynomolgus monkeys using an American BECKMAN-CX4 automatic biochemical analyzer and a wrist electronic blood pressure monitor.Statistical tests were performed to analyze the data.Results Significant differences were found in blood pressure values of cynomolgus monkeys in different ages.Blood pressure values in the elderly group were higher than those of other groups.The morbidity of hypertension in the elderly group was higher than those of the other groups.Body mass index (BMI) in the hypertension group was higher than that of normal group in the same age.The incidence of hypertension in the elderly group with hyperlipemia was higher than that of other groups.Logistic regression analysis showed that age, BMI and hyperlipidemia in the hypertensive group were 1.435, 1.218, and 2.337 times higher than those of the normal group when predicting the risk of hypertension.Conclusions We have initially established reference values of blood pressure in cynomolgus monkeys in different ages.Age, BMI and hyperlipidemia are risk factors of spontaneous hypertension in cynomolgus monkeys, and the measurement of blood pressure may provide a basis for the screening of cynomolgus monkey model of spontaneous hypertensive and related research.
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Objective To investigate the expression levels of regulator of G-protein signaling 4 (RGS4) in pediatric nephroblastoma and pericancerous tissues, and explore the relationship between RGS4 and the occurrence and development of pediatric nephroblastoma. Methods Thirty-seven samples of pediatric nephroblastoma tissues and 8 samples of pericancerous tissues were collected after surgery to detect the expression of RGS4 protein by immunohistochemistry. Another 8 samples of fresh cancer tissues and corresponding pericancerous tissues were collected to detect the mRNA and protein levels of RGS4 by qRT-PCR and Western blot assay, respectively. Results Immunohistochemistry results showed that RGS4 protein was positively expressed both in pediatric nephroblastoma and pericancerous tissues, and its high expression rate was lower in pediatric nephroblastoma than that in pericancerous tissues [(37.83%(14/37) vs. 87.5%(7/8),χ2=4.675, P<0.05]. The expression level of RGS4 mRNA was significantly lower in pediatric nephroblastoma than that in pericancerous tissues (1.064 ± 0.549 vs. 5.374 ± 0.735, t=13.290, n=8, P < 0.01). Western blot results showed that the expression level of RGS4 protein was lower in pediatric nephroblastoma than that of pericancerous tissues (0.301±0.092 vs. 0.779 ± 0.041, t=13.424, n=8, P < 0.01). Conclusion The expression level of RGS4 is down-regulated in pediatric nephroblastoma, which may be related to the occurrence and development of pediatric nephroblastoma.
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Objective To investigate the mechanism of neural protection of mouse nerve growth factor combined with sub-hypothermia in the treatment of patients with severe traumatic brain injury. Methods 90 cases of severe traumatic brain injury were randomly divided into study group and control group with 45 cases of each group, the control group were given routine treatment; the study group were given on the basis of routine treatment of mouse nerve growth factor combined with sub-hypothermia treatment, with 2 weeks treatment, the clinical indicators and corresponding nerve injury, inflammation, oxidative stress indexes, clinical effect and complications were compared after 2 weeks treatment. Results Compared with before treatment or control group, scores of Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) and montreal cognitive assessment (MoCA) in study group after the treatment increased, National Institute of Health stroke scale (NIHSS) score decreased(P<0.05), neuronspecific enolase (NSE), myelin basic protein (MBP) and S100 beta levels decreased(P<0.05), the serum tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6), IL-10 levels decreased (P<0.05), the malondialdehyde (MDA) decreased, the glutathione peroxidase (GPx) and oxidation resistance (AOA) levels increased (P<0.05). The control group efficiency was 73.33%, the study group efficiency was 91.11%, there was significant difference (P<0.05). All patients were followed up, no case off, there was no significant difference in adverse drug reaction rate between two groups. Conclusion Mouse nerve growth factor and sub-hypothermia has the significant neural protection for patients with severe traumatic brain injury, and its mechanism may be related to reduce nerve injury indicators and improve inflammatory factor and oxidative stress response.
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Objective To investigate serum vitamin D levels and influencing factors in elderly patients with stage 3 to 4 chronic kidney disease (CKD) and to analyze the relationship between vitamin D deficiency and left ventricular hypertrophy (LVH).Methods This study involved 107 elderly outpatients (≥60 years) with stage 3 to 4 CKD who had visited Beijing Hospital between January 2014 and September 2016.We retrospectively analyzed their clinical and laboratory data including gender,age,height,weight,blood pressure,glycosylated hemoglobin,hemoglobin (Hb),albumin,creatinine,lipid,calcium,phosphorus,intact parathyroid hormone (iPTH),high sensitivity C-reactive protein,B-type natriuretic peptide (BNP),25-OH-D3,and ultrasonic cardiogram.Based on estimated glomerular filtration rate,patients were divided into three groups:the stage 3a CKD group,the stage 3b CKD group,and the stage 4 CKD group.Differences in the parameters between the groups were compared.In addition,25-OH-D3 levels were used to determine whether the patient had vitamin D deficiency and the left ventricular mass index was used to identify left ventricular hypertrophy (LVH),and the relationship between vitamin D deficiency and LVH was examined.Results Body mass index,body surface area and calcium levels declined while age,phosphorus and BNP levels increased with the development of stage 3a,stage 3b and stage 4 CKD.Mean 25 O)H-D3 levels were 22.6 (5.9-58.0) μg/L and 17.5 (10.1 46.3) μg/L for CKD stage 3 and 4 patients,respectively,and the difference between them was statistically significant (Z =-2.121,P 0.033).Compared with patients with no vitamin D deficiency,patients with vitamin D deficiency were more likely to be female (x2 7.460,P=0.006) and were associated with higher P (Z=-2.090,P=0.037),iPTH (Z=-2.855,P=0.004) and BNP (Z=-3.134,P 0.002),and lower Hb (t=-3.305,P=0.001).The rates of LVH in vitamin D deficient patients and non-vitamin D deficient patients were 8 cases(34.8 %) and 12 cases(14.3 %),respectively (P=0.035).Conclusions Vitamin D levels show progressive decline as chronic kidney disease advances into later stages.In addition,vitamin D deficiency is more common among female patients and is often accompanied by lower Hb levels,higher BNP levels and higher incidences of calcium-phosphate metabolism disorders and LVH.The results suggest that vitamin D may play an important role in renal anemia,calcium-phosphate metabolism and LVH.
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Objective To evaluate the value of hysterosalpingo-contrast-sonography in assessment the patency of fallopian tube after tubal interventional recanalization. Methods A total of 56 cases of fallopian tube recanalization were performed in Shanghai Putuo Hospital from January 2015 to September 2016. Seventy-eight fallopian tubes in 40 cases were treated with hysterosalpingo-contrast-sonography and hysterosalpingography before recanalization. Totally 106 fallopian tubes in 56 cases were performed hysterosalpingography before and after recanalization. Seventy-eight fallopian tubes in 40 cases were evaluated with hysterosalpingo-contrast-sonography before recanalization. The patency of the tubal was assessed by hysterosalpingo-contrast-sonography 3 months after recanalization, and the re-occlusion rate was calculated. Chi square test was used to compare the results of hysterosalpingo-contrast-sonography and hysterosalpingography before and after recanalization, and the patency of fallopian tube at just after operation and 3 months after recanalization. Results Before recanalization, the results of hysterosalpingo-contrast-sonography showed 40 obstructed and 38 partially obstructed. The results of hysterosalpingography showed 44 obstructed and 34 partially obstructed. There was no significant difference between the results of hysterosalpingo-contrast-sonography and hysterosalpingography. Before recanalization, 106 fallopian tubes in 56 cases showed 53 obstructed and 53 partially obstructed. After recanalization, 72 unobstructed, 34 partially obstructed, and no obstruction. However, 22 fallopian tubes were re-obstructed 3 months after recanalization, and the rate of re-occlusion was 20.7% (22/106). The re-occlusion rate of unobstructed fallopian tubes was 19.4% (14/73) and the re-occlusion rate of partially obstructed fallopian tubes was 23.5% (8/34). There was no statistically significant difference between them. Conclusions Re-obstruction may be present in some cases 3 months after tubal recanalization. Hysterosalpingo-contrast-sonography can provide an objective and effective basis for guiding pregnancy plan after tubal recanalization.
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Objective To investigate serum vitamin D levels and influencing factors in elderly patients with stage 3 to 4 chronic kidney disease (CKD) and to analyze the relationship between vitamin D deficiency and left ventricular hypertrophy (LVH).Methods This study involved 107 elderly outpatients (≥60 years) with stage 3 to 4 CKD who had visited Beijing Hospital between January 2014 and September 2016.We retrospectively analyzed their clinical and laboratory data including gender,age,height,weight,blood pressure,glycosylated hemoglobin,hemoglobin (Hb),albumin,creatinine,lipid,calcium,phosphorus,intact parathyroid hormone (iPTH),high sensitivity C-reactive protein,B-type natriuretic peptide (BNP),25-OH-D3,and ultrasonic cardiogram.Based on estimated glomerular filtration rate,patients were divided into three groups:the stage 3a CKD group,the stage 3b CKD group,and the stage 4 CKD group.Differences in the parameters between the groups were compared.In addition,25-OH-D3 levels were used to determine whether the patient had vitamin D deficiency and the left ventricular mass index was used to identify left ventricular hypertrophy (LVH),and the relationship between vitamin D deficiency and LVH was examined.Results Body mass index,body surface area and calcium levels declined while age,phosphorus and BNP levels increased with the development of stage 3a,stage 3b and stage 4 CKD.Mean 25 O)H-D3 levels were 22.6 (5.9-58.0) μg/L and 17.5 (10.1 46.3) μg/L for CKD stage 3 and 4 patients,respectively,and the difference between them was statistically significant (Z =-2.121,P 0.033).Compared with patients with no vitamin D deficiency,patients with vitamin D deficiency were more likely to be female (x2 7.460,P=0.006) and were associated with higher P (Z=-2.090,P=0.037),iPTH (Z=-2.855,P=0.004) and BNP (Z=-3.134,P 0.002),and lower Hb (t=-3.305,P=0.001).The rates of LVH in vitamin D deficient patients and non-vitamin D deficient patients were 8 cases(34.8 %) and 12 cases(14.3 %),respectively (P=0.035).Conclusions Vitamin D levels show progressive decline as chronic kidney disease advances into later stages.In addition,vitamin D deficiency is more common among female patients and is often accompanied by lower Hb levels,higher BNP levels and higher incidences of calcium-phosphate metabolism disorders and LVH.The results suggest that vitamin D may play an important role in renal anemia,calcium-phosphate metabolism and LVH.