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Objective To construct risk prediction models of death or readmission in patients with acute heart failure(AHF)during the vulnerable phase based on machine learning algorithms and screen the optimal model.Methods A total of 651 AHF patients with admitted to Department of Cardiology of the Second Affiliated Hospital of Army Medical University from October 2019 to July 2021 were included.The clinical data consisting of admission vital signs,comorbidities and laboratory results were collected from electronic medical records.The composite endpoint was defined as all-cause death or readmission for worsening heart failure within 3 months after discharge.The patients were divided into a training set(521 patients)and a test set(130 patients)in a ratio of 8:2 through the simple random sampling.Six machine learning models were developed,including logistic regression(LR),random forest(RF),decision tree(DT),light gradient boosting machine(LGBM),extreme gradient boosting(XGBoost)and neural networks(NN).Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate the predictive performance and clinical benefit of the models.Shapley additive explanation(SHAP)was used to explain and evaluate the effect of different clinical characteristics on the models.Results A total of 651 AHF patients were included,of whom 203 patients(31.2%)died or were readmitted during the vulnerable phase.ROC curve analysis showed that the AUC values of the LR,RF,DT,LGBM,XGBoost and NN model were 0.707,0.756,0.616,0.677,0.768 and 0.681,respectively.The XGBoost model had the highest AUC value.DCA showed that the XGBoost model exhibited greater clinical net benefit compared with other models,with the best predictive performance.SHAP algorithm analysis showed that the clinical features that had the greatest impact on the output of the model were serum uric acid,D-dimer,mean arterial pressure,B-type natriuretic peptide,left atrial diameter,body mass index,and New York Heart Association(NYHA)classification.Conclusion The XGBoost model has the best predictive performance in predicting the risk of death or readmission of AHF patients during the vulnerable phase.
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@#Objective To systematically evaluate the safety and efficacy of percutaneous closure of atrial septal defect (ASD) guided by echocardiography alone versus fluoroscopy. Methods The databases of PubMed, The Cochrane Library, EMbase, VIP, Wanfang Data and CNKI from January 2000 to October 2021 were searched by computer for relevant research literature. Two reviewers independently screened the literature, extracted the data and evaluated the quality according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. Results A total of 19 cohort studies and 1 randomized controlled study were collected, including 2 825 patients. The Newcastle-Ottawa Scale score for cohort studies was≥7 points. Meta-analysis showed that there was no statistical difference in the operative success rate (RR=1.01, 95%CI 1.00 to 1.02, P=0.17), incidence of occluder displacement/shedding (RR=0.77, 95%CI 0.26 to 2.27, P=0.63), incidence of arrhythmia (RR=0.50, 95%CI 0.21 to 1.14, P=0.10), incidence of pericardial effusion (RR=0.98, 95%CI 0.32 to 2.98, P=0.97), operative time (MD=–0.23, 95%CI –7.56 to 7.10, P=0.95) or cost (SMD=–0.39, 95%CI –1.09 to 0.30, P=0.27) between the two groups. The echocardiography group reduced the incidence of total postoperative complications (RR=0.42, 95%CI 0.30 to 0.60, P<0.001) and residual shunt (RR=0.70, 95%CI 0.50 to 0.98, P=0.04), and shortened length of hospital stay (MD=–0.43, 95%CI –0.77 to 0.09, P=0.01). Conclusion Compared with traditional fluoroscopy-guided percutaneous closure of ASD, echocardiography guidance alone is equivalent in terms of operative success rate, major postoperative complications, operative time and total cost, but it reduces the incidence of total postoperative complications and residual shunt, and has a shorter length of hospital stay.
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Objective:To investigate the clinical, imaging and endoscopic characteristics of idiopathic mesenteric phlebosclerosis (IMP).Methods:From January 2010 to December 2020, 14 patients with IMP diagnosed and treated at the Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People′s Hospital) were enrolled. All patients underwent abdominal X-ray, contrast enhanced computed tomography (CT) and endoscopy. Three cases accepted double-contrast barium enema and 11 cases underwent endoscopic biopsy. Three of the 14 IMP patients underwent surgery and pathological examination because of intestinal perforation or intestinal obstruction that failed conservative treatment. The general data (such as gender, drinking history, etc.), clinical symptoms, complications, imaging (abdominal X-ray, CT, double-contrast barium enema) and endoscopic features were retrospectively analyzed. Descriptive method was used for statistical analysis.Results:Among the 14 IMP patients, 13 cases were male and one case was female. All the 13 male cases had long history of drinking Chinese herbal medicine wine, among them, 8 patients consumed acanthopanax bark wine. Complications occurred in 7 cases, including 5 cases of intestinal obstruction and 2 cases of intestinal perforation. The clinical symptoms of 14 IMP patients were nonspecific, mostly manifested as abdominal pain (11 cases), abdominal distension (6 cases), diarrhea (6 cases), nausea and vomiting (4 cases), and constipation (2 cases). Abdominal X-ray images mainly showed multiple irregular calcifications along involved colon. The images of 3 patients received double-contrast barium enema demonstrated shallowness or disappearance of semilunar folds, rigid colonic wall, narrowed lumen and " thumb printing". The typical CT images indicated edema and thickening of the involved intestinal wall, blurred mesenteric fat space, spot, thread-like, and curved calcification of mesenteric vein and colonic wall. Typical endoscopic findings included dark-purple colored mucosa, congestion, edema, erosion and ulceration, and focal nodular surface and visible varicose veins.Conclusions:IMP has typical imaging and endoscopic characteristics, and the combination of them can diagnose and evaluate IMP more accurately.
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OBJECTIVE@#To explore the protective effect of SBi4211 (heptamidine), an inhibitor of S100B, against central nervous system injury induced by HIV-1 envelope protein gp120.@*METHODS@#In an @*RESULTS@#In the cell co-culture system, SBi4211 treatment significantly inhibited gp120-induced expression of S100B, RAGE and GFAP in U251 cells (@*CONCLUSIONS@#SBi4211 can protect neurons from gp120-induced neurotoxicity possibly by inhibiting the S100B/ RAGE-mediated signaling pathway.
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Animais , Camundongos , Astrócitos , Western Blotting , Sistema Nervoso Central , Proteína gp120 do Envelope de HIV , Neurônios , Subunidade beta da Proteína Ligante de Cálcio S100 , Transdução de SinaisRESUMO
OBJECTIVE@#To construct a HIV-1 gp120 transgenic mice (gp120 Tg) with vimentin (VIM) gene knockout.@*METHODS@#Female HIV-1 gp120 Tg mice were mated to VIM heterozygote mice (F0). All the offspring mice were derived from these original founders so that both genotypes had the same mixed genetic background. The F1 mice were bred to generate of VIM, VIM, VIM/gp120 Tg and VIM/gp120 Tg mice. PCR was performed for genotyping of the mice, and the expressions of VIM and gp120 in the brain tissues were examined using immunoblotting.@*RESULTS@#The results of PCR showed the presence of the target bands in VIM, VIM, VIM/gp120 Tg and VIM/gp120 Tg mice. In VIM/gp120 Tg mice, gp120 expression was detected throughout the brain regions while no VIM expression was detected.@*CONCLUSIONS@#We generated gp120 transgenic mouse models with VIM gene knockout, which facilitate the exploration of the role of VIM in gp120-induced neurotoxicity.
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Animais , Feminino , Camundongos , Encéfalo , Modelos Animais de Doenças , Proteína gp120 do Envelope de HIV , HIV-1 , Camundongos Knockout , Camundongos Transgênicos , VimentinaRESUMO
Objective:To investigate the reparative efficacy and mechanism of pressure-adjustable macroporous antibacterial hydrogel in the treatment of infected wounds.Methods:Staphylococcus aureus was used to establish wound infection models in healthy C57BL/6 mice. The models were divided into 3 groups subjected to 3 different treatments: a negative control group with no hydrogel treatment (group A), a control group treated by common medical hydrogel (group B) and an experiment group treated by pressure-adjustable macroporous antibacterial hydrogel (group C). On days 1, 3, 6, 9 and 12, the effects of 3 treatments were compared on the wound area and the number of bacterial colonies under scab, on the apoptosis of fibroblasts based on the changes of type Ⅰ procollagen, and on the inhibition of inflammation during wound repair by detecting the expression of interleukin-6 (IL-6) and tumor necrosis factor (TNF-α).Results:On days 1 and 3, there was no significant difference between the 3 groups in the wound area ( P>0.05), but on days 6, 9 and 12, there were significant differences between the 3 groups in the wound area ( P<0.05). On day 6, the wound areas in group B (1.23 cm 2 ± 0.16 cm 2) and in group C (1.14 cm 2 ± 0.12 cm 2) were significantly smaller than that in group A (1.56 cm 2 ± 0.16 cm 2) ( P<0.05), but there was no significant difference between groups B and C ( P>0.05). On days 9 and 12, the wound areas in group B (0.97 cm 2 ± 0.13 cm 2 and 0.76 cm 2 ± 0.10 cm 2) and in group C (0.66 cm 2 ± 0.06 cm 2 and 0.48 cm 2 ± 0.07 cm 2) were significantly smaller than those in group A (1.49 cm 2 ± 0.11 cm 2 and 1.39 cm 2 ± 0.13 cm 2), and those in group C were significantly smaller than those in group B (all P<0.05). On day 1, there was no significant difference between the 3 groups in the number of bacterial colonies under scab ( P>0.05). On days 3, 6, 9 and 12, the numbers of bacterial colonies under scab in groups B and C were significantly smaller than that in group A ( P<0.05), and that in group C was significantly smaller than that in group B ( P< 0.05). The nucleic acid electrophoresis showed that the grayscale bands in group C were significantly darker than those in groups A and B. The early apoptosis rate of the fibroblasts in group C[low-right positive fluorescence (LR%): 9.72%] was significantly lower than that in group A (43.99%) and that in group B (38.43%), and that in group B was significantly lower than that in group A ( P<0.05). On day 12, the ratio of the gray values of IL-6 and β-actin (0.64 ± 0.10) and the ratio of the gray values of TNF-α and β-actin (0.34 ± 0.05) in the fibroblasts in group C were significantly higher than those in group A (1.22 ± 0.21 and 0.60 ± 0.14) and in group B (0.88 ± 0.02 and 0.41 ± 0.06) ( P<0.01). Conclusion:The pressure-adjustable macroporous antibacterial hydrogel is an effective treatment of infected wounds and its mechanism may be related to the reduced apoptosis of fibroblasts.
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Objective:To investigate the feasibility of optimization of coronary computed tomography angiography (CCTA) with pre-scan size-specific dose estimate(SSDE).Methods:Ninety patients from Quzhou People′s Hospital during March and May 2018 who underwent CCTA were defined as modelled patients, the regression equation of body mass index (BMI) and water-equivalent diameter ( dw) were conducted and upper quartile of CTDI vol values was calculated. Other 67 patients were divided into two groups: control group (CCTA scan protocol, based on CTDI vol) and study group (CCTA scan protocol using SSDE). The image quality and radiation dose including breast dose (Dose bre) in two groups were assessed. Results:The positive correlation was found between BMI and dw with a linear regression equation of dw=9.241 + 0.644×BMI( r=0.823, P<0.05), and the upper quartile of CTDI vol was 7.92 mGy. The proportions of high-level image quality were 94.10% (367/390) and 93.93% (402/428) in the control and study groups, respectively ( P>0.05). The median signal to noise ratio (SNR) and contrast to noise ratio (CNR) were 21.08/24.39, 17.24/19.94 in the control and study groups, respectively ( P>0.05). The CTDI vol, SSDE and Dbreof the study group were reduced by 37.04%, 35.77% and 37.37% compared with the control group, and statistically significant differences were found( z=-7.041, t=18.479, 15.079, P<0.05) among them. Conclusions:The CCTA scan protocol based on the pre-scan SSDE can significantly reduce the radiation dose and provide the diagnostic image quality.
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Objective To investigate the difference of size-specific dose estimates ( SSDEs ) based on effective diameter ( def ) and water equivalent diameter ( dw ) in coronary computed tomography angiography ( CCTA) and explore the causes. Methods A total of 99 patients undergoing CCTA were enrolled in this retrospective study. SSDEs ( SSDEd ef and SSDEdw ) were calculated in two approaches using def and dw , respectively. Mean absolute relative difference ( MARD) was computed as an index to quantify the consistency of SSDEd ef and SSDEdw . Multivariate stepwise regression analysis was performed to study the factors influencing MARD. Results The values def and dw were positively correlated with body mass index (BMI) (r=0. 869, 0. 823, P<0. 05). The median (interquartile range) of SSDEdef and SSDEdw were 12. 34 ( 11. 75, 12. 98) mGy, 13. 78 ( 13. 02, 15. 04) mGy, respectively. SSDEdef was lower by 10. 45% than SSDEdw( Z=-8. 186, P<0. 05) . Both SSDEdef and SSDEdw were negatively correlated with BMI and dw(r=-0. 765, -0. 680, -0. 701, -0. 840, P<0. 05). MARD of SSDEdef and SSDEdw was generally at 11. 39%. No statistical significance was found in the correlation of MARD with BMI ( r=0. 031, P>0. 05) , however, positive correlation was shown between MARD and def ( r=0. 251, P<0. 05) , but negative correlation for MARD and dw(r=-0. 379, P<0. 05). With respect to the factors influencing MARD, four variables were included into the regression equation. MARD was positively correlated with the area of both air-filled lungs ( Arealow ) and soft tissues ( Areasoft ) (β=0. 634, 0. 102, P<0. 05) , and negatively correlated with the area of bone, enhanced cardiac chambers and aorta ( Areahigh ) and the CT value of air-filled lungs ( SIlow ) (β=-0. 234,-0. 343, P<0. 05) . Conclusions SSDEdef was approximately 10. 45% lower than SSDEdw , which was predominantly influenced by the area of air-filled lungs due to the characteristics of low X-ray attenuation in CCTA.
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This paper aims to study the effects of traditional Chinese medicine on multidrug resistant human gastric cancer cells in the cell proliferation, migration, invasion and apoptosis, and to study the apoptosis-inducing pathway. Different dilutions of extract were used to process human multidrug resistant gastric cancer SGC7901/ADR cells. Cell proliferation inhibition phenomenon was determined by MTT experiment. Nuclear morphological changes of apoptotic cells and apoptotic indexes were observed and determined by Hochest33528 staining followed with fluorescence microscope observing. Flow cytometry was used to detect cell apoptosis rate. Cell migration and invasion ability were observed and determined by Transwell method. Spectrophotometry was used to detect caspase-3 and caspase-9 enzyme activity. Western blotting was used to detect subcellular distribution of cytochrome c. The results showed that extract had obvious inhibition effect on proliferation of gastric cancer multidrug resistant SGC7901/ADR cells, which was time- and concentration-dependent. After processing multidrug resistant gastric cancer SGC7901/ADR cells with extract, the apoptotic index and apoptosis rate were significantly increased than those in the control group, which showed a time- and dose-dependent mode; but if a caspase inhibitor was added, apoptosis index was not obviously increased. Transwell method showed that migration and invasion ability of the extract-processed SGC7901/ADR cells dropped significantly. Spectrophotometry showed that in extract-processed SGC7901/ADR cells, caspase-3 and caspase-9 expression were increased, which had significant differences with the control group. Western blotting test showed that the distribution of cytochrome c decreased in mitochondria, while increased in the cytoplasm (i.e., cytochrome c escaped from mitochondria to the cytoplasm). In conclusion, extract could inhibit the proliferation, migration and invasion, and induce apoptosis in human gastric cancer multidrug resistant SGC7901/ADR cells; and cytochrome c, caspase-9 and caspase-3 might be involved in cell apoptosis induced by extract, suggesting endogenous or mitochondrial apoptotic pathway.
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Objective To analyze the four types of laparoscopic operation in the treatment of upper ureteral calculi with diameter more than 1 cm.Methods From July 2012 to September 2015,150 cases of patients with upper ureteral calculi diameter more than 1cm were analyzed.According to the different surgical methods,patients were divided into four groups.There are 39 cases in URL group,32 cases in RLU group,36 cases in PCNL group and 43 cases in FURL group.The diameter of calculi in RLU group and PCNL group was much larger than those in URL group and FURL group(P < 0.05).There was no difference in terms of sex,age,stone location,stone composition,and the ESWL treatment failure rate among the four groups(P > 0.05).The operation time,postoperative hospitalization days,postoperative bowel recovery,postoperative ESWL rate,complications and postoperative calculi clearance rate were compared among the four groups.Results In RLU,PCNL,URL and FURL group,the operation time were (38.5 ± 13.0) min,(83.4 ± 6.1) min,(69.6 ± 13.0) min and (50.1 ± 6.3) min,respectively,and there were significant differences among the four groups (RLU group > PCNL group > FURL group > URL group,P < 0.05).Postoperative hospitalization days of RLU group,PCNL group,URL group and FURL group were (6.5 ± 0.6) d,(9.5 ± 0.7) d,(8.4 ± 0.7) d and (7.7 ± 0.7) d respectively,and there were significant differences in terms of hospitalization days (RLU group > PCNL group > FURL group > URL group,P < 0.05).The calculi clearance rates of RLU group,PCNL group,URL group and FURL group were 79.5%,100.0%,94.4% and 88.4% at 3 days after operation,and 82.1%,100.0%,97.2% and 95.3% at 1 month after operation.The postoperative calculi clearance rates at 3 days and 1 month in RLU group were higher than those in URL group(P < 0.05),but there was no difference between PCNL group and RLU group (P > 0.05).Postoperative ESWL rates of RLU group,PCNL group,URL group and FURL group were 12.8%,0,2.8% and 4.7%,and there was no difference among the four groups.The decreased value of RBC in PCNL group and FURL group was higher than that of URL group and RLU group(P < 0.05).One patient in PCNL group suffered from massive hemorrhage,and required blood transfusion.The complication rates in the four groups were 23.1% (9/39),9.4% (3/32),13.9% (5/36) and 9.3% (4/43) respectively,and there was no difference of complication among them(P > 0.05).Conclusions Four types of endoscopes have the advantages of safety,small wound and quick recovery for ureter calculi larger than 1 cm.The URL operation is simple,with less injury,quick recovery,but low stone clearance rate.FURL requires high level of skill for the operator,and is an effective treatment for ureteric,renal pelvic,and kidney stones which are smaller than 2 cm.FURL avoids the extra ESWL treatment,but costs much.PCNL has more injury and requires high-level surgical skills with a high stone clearance rate.RLU has a high stone clearance rate but is much difficult,which can be used as a remedy for the failure of FURL or PCNL.
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Objective To investigate the effect of atorvastatin on the expressions of long non-coding RNA (LncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1)and inflammation factors in human umbilical vein endothelial cells (HUVECs) stimulated by high glucose. Methods The expression of MALAT1 in HUVECs incubated with high glucose(30 mmol/L) for different time periods were detected by real-time PCR. Under high glucose condition, the expressions of MALAT1, interleukin-6(IL-6), and interleukin-8 (IL-8) in HUVECs were detected after MALAT1 was silenced by siRNA or atorvastatin was added. Results (1) After HUVECs were incubated with high glucose for different time periods, the expressions of MALAT1 were increased to some extent(P<0.05), with the peak at 12h (P<0.01). The levels of IL-6 and IL-8 expression and secretion were increased after HUVECs were stimulated by high glucose for 12h (P<0.05). (2)The silence of MALAT1 markedly suppressed high glucose-stimulated expression and secretion of IL-6 and IL-8 (P<0.05). (3) Atorvastatin significantly inhibited high glucose-stimulated expressions of MALAT1, IL-6, and IL-8(all P<0.05). Conclusions High glucose induces the secretion of inflammatory factors by stimulating MALAT1 expression in endothelial cells. Atorvastatin significantly inhibits high glucose-stimulated MALAT1 expression and decreases inflammatory reaction.
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Objective To investigate the clinical effect of ilium grafting combined with Duhuojishengtang on the delay fracture healing and explore the effect on hemorheology. Methods Eighty patients with delayed fracture healing were randomly divided into two groups. Forty patients in control group were treated by ilium grafting and 40 patients in observation group were treated by ilium grafting combined with Duhuojishengtang. The clinical effect was observed after treatment and indexes of hemorheology were recorded after different treatment time. Results The cure rate of observation group was 62.5%, which was significantly higher than that of control group 35.0%, the effective rate of observation group was 92.5%, which was significantly higher than that of control group 72.5% (P0.05) . After the first, second, third course, the indexes of hemorheology of observation group were better than those of control group, with statistically significant differences (P<0.05) . Conclusions Ilium grafting com-bined with duhuojishengtang can improve the indexes of hemorheology, improve the cure and effective rate and also has high security. It has high clinical value and worth of popularization and application.
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BACKGROUND:The use of three-dimensional cel culture techniques can better simulate the cel ular microenvironment, providing new tools for tissue engineering research. OBJECTIVE:To analyze the biomaterial selection and application characteristics in three-dimensional cel culture as wel as applications in tumor tissue engineering. METHODS:We searched Wanfang database and PubMed database 1998-2015 years for relevant literature using keywords of“three-dimensional cultures;scaffold;cel growth;cel differentiation;tumor tissue engineering”in Chinese and English, respectively. RESULTS AND CONCLUSION:The selection and application of three-dimensional scaffold materials is one of the keys. So far, scaffold materials, such as col agen gels, gelatin sponge, agarose, chitosan, demineralized bone matrix, cannot provide the extracel ular matrix similar to the micro-environment in which seed cel growth and proliferation are not affected, and the ability to secrete type II col agen and glycosaminoglycan is decreased, although they can provide three-dimensional space for seed cel s. Biomimetic scaffold characterized as little trauma and strong plasticity gradual y shows its unique advantages. Three-dimensional culture conditions raise pro-angiogenic growth factor secretion from tumor cel s, and this feature is positively correlated with the occurrence of in vivo tumor angiogenesis.
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<p><b>OBJECTIVE</b>To test the effect of the c-Met inhibitor cabozantinib in inhibiting infections by Listeria monocytogenes (LM) in mice.</p><p><b>METHODS</b>C57BL/6 mice at 6 weeks of age were subjected to intraperitoneal injection of LM and randomized into 4 groups for treatment with intraperitoneal injection of PBS, intragastric administration of cabozantinib (20 µg/g), intraperitoneal injection of ampicillin (Amp, 20 µg/g), or cabozantinib plus Amp. The survival curves were drawn for each group, and the number of bacteria in the blood and brain tissues was determined; serum IL-10 level and NF-κB p65 level in the cerebrospinal fluid (CSF) were assayed, and Evans Blue (EB) content and pathological changes in brain were examined.</p><p><b>RESULTS</b>Compared with PBS-treated mice, the mice treated with cabozantinib showed a significantly higher survival rate, lower bacterial counts in the blood and brain (P<0.05 or 0.001), lower IL-10 (P<0.05) and NF-κB p65 levels (P<0.01), lower brain EB content (P<0.001), and milder pathological changes in the brain. The blood and brain bacterial counts (P<0.001), IL-10 (P<0.01) and NF-κB p65 levels (P<0.001), and brain EB content (P<0.001) were all significantly lower in mice treated with the combination of drugs than in mice treated with cabozantinib alone.</p><p><b>CONCLUSION</b>Cabozantinib can inhibit LM infection in mice and has important values in developing new anti-intracellular infection drug.</p>
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Animais , Camundongos , Anilidas , Farmacologia , Encéfalo , Microbiologia , Patologia , Injeções Intraperitoneais , Interleucina-10 , Sangue , Listeria monocytogenes , Listeriose , Tratamento Farmacológico , Camundongos Endogâmicos C57BL , Piridinas , Farmacologia , Fator de Transcrição RelA , Líquido CefalorraquidianoRESUMO
BACKGROUND:Vertebroplasty and kyphoplasty can effectively repair osteoporotic vertebral compression fractures, but bone cement injection can cause the change of stress in the fractured vertebrae and adjacent vertebrae after surgery, leading to new fractures. OBJECTIVE: To analyze the stress changes of the fractured vertebrae and adjacent vertebrae after vertebroplasty with different elastic modulus bone cement by a three-dimensional finite element method. METHODS: One healthy adult male volunteer was selected for lumbar spine CT scan. The acquired images were imported for three-dimensional reconstruction using Mimics. The three-dimensional model was smoothed, polished and denoised by Geomagic software, and then the solid mode was built under Workbench Ansys. An osteoporotic vertebral compression fracture model in L2-4 segments was established after assignment. Bone cement (4 mL) with different elastic moduli (8 000, 4 000, 2 000 and 1 000 MPa) injected into the L3 segment distributed in the middle of the vertebrae as spherical shape. 500 N pre-load was applied on the L2 surface with an additional bending moment of 50 N?m. The lower surface free degree of L4 was restrained. The L2-4 forward flexion, posterior extension, right flexion and axial rotation on the right side were stimulated. The stress changes of the fractured vertebrae and the upper and lower adjacent vertebrae before and after bone cement injection with different elastic moduli were compared. RESULTS AND CONCLUSION:The stress of the fractured vertebrae and adjacent vertebrae were significantly increased compared with that before operation. With the increase of elastic modulus, the stress of the fractured vertebrae increased, but there were no changes in the stress of adjacent vertebrae. These findings indicate that the elastic modulus of bone cement may be a method to reduce new fractures of the fractured and adjacent vertebrae after bone cement injection.
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OBJECTIVE:To discuss the effect of recombinant human growth hormone(HGH)on serum sndotoxin,inflamma-tory cytokines,wound healing time,hospitalization time and prognosis of elderly patients with severe burn. METHODS:96 elder-ly patients with severe burn in our hospital were randomly divided into treatment group (48 cases) and control group (48 cases). All patients received wound surface care,nutritional support,maintaining water and electrolyte and acid-base balance. Control group received 1 ml 0.9% Sodium chloride solution,sc,qd. Treatment group received 0.3 IU/kg. Recombinant HGH for injection, sc,qd. All patients were treated for 21 d. Serum endotoxin content in 2 groups before and 14,21 d after treatment was compared, inflammatory cytokines (TNF-α,IL-6, IL-8) before and after treatment,wound healing time,hospitalization time and the inci-dence of multiple organ disorder syndrome(MODS),death and systemic infection were observed. RESULTS:There was no signifi-cant difference in serum endotoxin content before and 14 d after treatment(P>0.05);after 21 d,serum endotoxin contents in 2 group obviously decreased,and treatment group was significantly lower than control group,with statistical significance(P<0.05). After treatment,IL-8 level in treatment group was significantly higher than control group,TNF-α and IL-6 were significantly lower than control group,with statistical significances (P<0.05). Wound healing time and hospitalization time in treatment group were significantly shorten than control group,with statistical significances(P<0.05). The incidence of MODS,death and systemic infec-tion in treatment group were significantly lower than control group,with statistical significances(P<0.05). CONCLUSIONS:The application of recombinant HGH in elderly patients with severe burn can reduce toxins absorption of patients and decrease inflamma-tory cytokines to promote wound healing and improve prognosis.
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BACKGROUND:Vertebroplasty and kyphoplasty can effectively repair osteoporotic vertebral compression fractures, but postoperative change of stress in the fractured vertebrae and adjacent vertebrae can lead to new fractures. OBJECTIVE:To analyze the stress changes of the fractured and adjacent vertebrae with different bone cement injection volume by three-dimensional finite element method. METHODS:One healthy adult male volunteer was selected for lumbar spine CT scan. The acquired images were imported for three-dimensional reconstruction using Mimics. The three-dimensional model was smoothed, polished and denoised by Geomagic software, and then the solid mode was built under Workbench Ansys. The osteoporotic vertebral compression fracture model in L2-L4 segments was established after assignment. Bone cement of 1, 2, 4, 6 mL was injected into the L3 vertebrae respectively and distributed in the middle of the vertebrae as spherical shape. 500 N pre-load was applied on L2 surface with an additional moment of 50 N·m. The lower surface free degree of L4 was restrainted. The L2-L4 forward flexion, extension, right flexion and axial rotation on the right side were stimulated to compare the stress changes of fractured vertebrae and adjacent vertebrae before and after the bone cement injection with different volume. RESULTS AND CONCLUSION:The stresses of fractured and adjacent vertebrae after the bone cement injection were significantly increased; meanwhile, the stresses of fractured and adjacent vertebrae increased with the increase of bone cement injection volume, which may be one of the factors leading to the compression fractures of adjacent vertebrae.
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<p><b>OBJECTIVE</b>To study the role of outer membrane protein T (OmpT) in the pathogenesis of uropathogenic Escherichia.coli.</p><p><b>METHODS</b>In cultured human bladder epithelial cell line 5637, we examined the adhesion ability of wild-type (CFT073), ompT gene knockout (COTD), and revertant (pST) strains of E.coli to the cells and the extracellular matrix (ECM). The expressions of the adhesion gene iha and virulence gene iroN were detected by real-time PCR. Murine models of urinary tract infection with the 3 strains were established to evaluate the bacterial burden of the bladder and kidney tissue and bacterial counts in blood. We also detected the expressions of interleukin-6 (IL-6) and IL-8 in the bladder and kidney tissues of the mice.</p><p><b>RESULT</b>The COTD strain showed a significantly lower cell adhesion rate than CFT073 strain [(4.62∓0.39)% vs (8.81∓1.13)%, P<0.05] with also a lower ECM-adhesion rate [(4.95∓0.59)% vs (8.85∓0.79)%, P<0.05]. The mRNA expressions of iha and iroN in CFT073 strain were 2.1 and 3.8 times that of COTD strain. In the mouse model, the mean bacterial load of CFT073 strain in the bladder tissue was 6.36∓0.06, significantly greater than that of COTD (6.01∓0.07) and revertant (6.29∓0.06) strains (P<0.05); the bacterial load of CFT073 strain in the kidney tissue was also significantly higher than that of COTD strain (6.25∓0.05 vs 5.87∓0.06, P<0.05). In mice infected with the wild-type, knockout, and revertant strains, the detection rates of IL-6, which were identical to those of IL-8, in the inflammatory bladder and kidney tissues were 60%, 12.5%, and 50%, respectively.</p><p><b>CONCLUSIONS</b>OmpT may regulate the expression of the adhesion gene iha and the transferrin gene iroN to affect the adhesion of uropathogenic E.coli to host cells.</p>
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Animais , Humanos , Camundongos , Aderência Bacteriana , Carga Bacteriana , Proteínas da Membrana Bacteriana Externa , Metabolismo , Linhagem Celular Tumoral , Infecções por Escherichia coli , Patologia , Proteínas de Escherichia coli , Metabolismo , Técnicas de Inativação de Genes , Inflamação , Interleucina-6 , Metabolismo , Interleucina-8 , Metabolismo , Rim , Microbiologia , Peptídeo Hidrolases , Metabolismo , Receptores de Superfície Celular , Metabolismo , Bexiga Urinária , Microbiologia , Infecções Urinárias , Microbiologia , Patologia , Escherichia coli Uropatogênica , VirulênciaRESUMO
<p><b>OBJECTIVE</b>To establish a method for detecting circulating brain microvascular endothelial cells (cBMECs), a novel biomarker of blood-brain barrier (BBB) injury.</p><p><b>METHODS</b>Blood samples were collected from 33 patients with AIDS encephalitis and 13 healthy subjects for detection of cBMECs, cECs and EPCs using magnetic affinity isolation and immune identification technology.</p><p><b>RESULTS</b>The numbers of cBMECs, cECs and EPCs were significantly higher in the AIDS patients than in the control subjects (t=4.298, P<0.01; t=4.886, P<0.01; t=4.889, P<0.01). An significant association was also noted between HIV load and cBMEC number (r=0.928, P<0.01).</p><p><b>CONCLUSION</b>We have successfully established a method for detecting peripheral blood cBMECs, which can be of important value in non-invasive assessment of BBB injury.</p>
Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida , Biomarcadores , Barreira Hematoencefálica , Patologia , Separação Celular , Métodos , Células Cultivadas , Células Progenitoras Endoteliais , Biologia CelularRESUMO
BACKGROUND:Percutaneous vertebroplasty and kyphoplasty are both effective in the treatment of osteoporotic vertebral compression fractures, but different in the distribution and dispersion of bone cement. <br> OBJECTIVE:To analyze the factors affecting the bone cement dispersion within the vertebral body in treatment of osteoporotic vertebral compression fracture with vertebroplasty or kyphoplasty. <br> METHODS:A total of 41 patients with osteoporotic vertebral compression fractures were included, and divided into three groups:group A (22 cases receiving high viscosity bone cement vertebroplasty treatment), group B (5 cases receiving high viscosity bone cement kyphoplasty), group C (14 cases receiving low viscosity bone cement vertebroplasty treatment). The groups A and C were divided into subgroups according to bone cement injection volume, time from fracture to operation, preoperative degree of vertebral compression. The distribution and dispersion of bone cement in the vertebra were reconstructed by the CT three-dimensional imaging and volume rendering analysis. <br> RESULTS AND CONCLUSION:In the three groups, after operation, relative dispersion area and relative dispersion volume in the vertebrae had no obvious difference, and the bone cement could al diffuse to upper and lower lamina cross the vertebral midline. There was no significant difference in bone cement diffusion coefficient among the three groups. In a certain range, the bone cement injection volume and bone cement dispersion volume was positively correlated. In groups A and C, bone cement diffusion coefficient decreased with the increasing of bone cement injection volume, time from fracture to operation, and the compression degree of the fractured vertebrae, but showed no significant correlation with bone cement viscosity.