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OBJECTIVE: Hypertension requires continuous and long-term care to prevent associated complications. Chronic disease management mode (CDMM) was developed to improve patients' self-management. We aimed to evaluate quality of care and clinical outcomes of CDMM versus routine care. METHODS: 300 patients aged >30 years with primary hypertension were randomly allocated to the CDMM intervention group (n = 162) or the usual care control group (n = 138). CDMM comprised nursing consultations, telephone contact, online WeChat link, health education, and appropriate referrals during hospitalisation and after discharge. QLICD-HY (V 2.0) scale was used to evaluate the quality of life. Care outcomes were biochemical parameters, body mass index, blood pressure levels, waist circumference, psychological indicators and quality of life assessed on admission (baseline) and one month post-care for both groups. Data were collected and analysed using SPSS 20.0. RESULTS: After one month, the intervention group had 6 mm Hg (95% CI: -5.12 to -9.08) lower SBP and 0.6 mM/L (95% CI: -0.52 to -0.68) lower LDL than the control group. In terms of improvements in BMI, UmAlb or waist circumference, there were no differences between both groups. The intervention group scored better on psychological indicators than controls (P < 0.05), and scores reflecting social and psychological function in the intervention group were significantly higher than scores at baseline, and higher than scores of controls after one month (P < 0.05). In the control group, there was no statistically significant difference between the scores at baseline and after one month. CONCLUSIONS: Under CDMM hypertension care, improvement of blood pressure and LDL was clinically significant. Intervention care further improves social and psychological function among participants with primary hypertension.
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Hipertensão/terapia , Educação de Pacientes como Assunto/métodos , Encaminhamento e Consulta , Telemedicina/métodos , Adulto , Idoso , Doença Crônica , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do TratamentoRESUMO
This study aimed to assess the effects of human urinary kallidinogenase (HUK) on motor function outcome and corticospinal tract recovery in patients with acute ischemic stroke (AIS). This study was a randomized, controlled, single-blinded trial. Eighty AIS patients were split into two groups: the HUK and control groups. The HUK group was administered HUK and standard treatment, while the control group received standard treatment only. At admission and discharge, the National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI) and muscle strength were scored. The primary endpoint was the short-term outcomes of AIS patients under different treatments. The secondary endpoint was the degree of corticospinal tract fiber damage under different treatments. There was a significant improvement in the NIHSS Scale, BI and muscle strength scores in the HUK group compared with controls (Mann-Whitney U test; P â <â 0.05). Diffusion tensor tractography classification and intracranial arterial stenosis were independent predictors of short-term recovery by linear regression analysis. The changes in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) decline rate were significantly smaller in the HUK group than in the control group ( Pâ <â 0.05). Vascular endothelial growth factor (VEGF) increased significantly after HUK treatment ( Pâ <â 0.05), and the VEGF change was negatively correlated with changes in ADC. HUK is beneficial for the outcome in AIS patients especially in motor function recovery. It may have protective effects on the corticospinal tract which is reflected by the reduction in the FA and ADC decline rates and increased VEGF expression. The study was registered on ClinicalTrials.gov (unique identifier: NCT04102956).
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Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , AVC Isquêmico/complicações , Fator A de Crescimento do Endotélio Vascular , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/complicações , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/complicações , Tratos Piramidais/diagnóstico por imagem , Calicreínas TeciduaisRESUMO
Alterations of electrophysiological activities, such as changed spike firing rates, reshaping the firing patterns, and aberrant frequency oscillations between the subthalamic nucleus (STN) and the primary motor cortex (M1), are thought to contribute to motor impairment in Parkinson's disease (PD). However, the alterations of electrophysiological characteristics of STN and M1 in PD are still unclear, especially under specific treadmill movement. To examine the relationship between electrophysiological activity in the STN-M1 pathway, extracellular spike trains and local field potential (LFPs) of STN and M1 were simultaneously recorded during resting and movement in unilateral 6-hydroxydopamine (6-OHDA) lesioned rats. The results showed that the identified STN neurons and M1 neurons exhibited abnormal neuronal activity after dopamine loss. The dopamine depletion altered the LFP power in STN and M1 whatever in rest or movement states. Furthermore, the enhanced synchronization of LFP oscillations after dopamine loss was found in 12-35 Hz (beta frequencies) between the STN and M1 during rest and movement. In addition, STN neurons were phase-locked firing to M1 oscillations at 12-35 Hz during rest epochs in 6-OHDA lesioned rats. The dopamine depletion also impaired the anatomical connectivity between the M1 and STN by injecting anterograde neuroanatomical tracing virus into M1 in control and PD rats. Collectively, impairment of' electrophysiological activity and anatomical connectivity in the M1-STN pathway may be the basis for dysfunction of the cortico-basal ganglia circuit, correlating with motor symptoms of PD.
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Doença de Parkinson , Núcleo Subtalâmico , Animais , Humanos , Ratos , Dopamina/metabolismo , Vias Neurais/metabolismo , Oxidopamina/toxicidade , Oxidopamina/metabolismo , Doença de Parkinson/metabolismo , Núcleo Subtalâmico/metabolismoRESUMO
Parkinson's disease (PD) is characterized by aberrant discharge patterns and exaggerated oscillatory activity within basal ganglia-thalamocortical circuits. We have previously observed substantial alterations in spike and local field potential (LFP) activities recorded in the thalamic parafascicular nucleus (PF) and motor cortex (M1), respectively, of hemiparkinsonian rats during rest or catching movements. This study explored whether the mutual effects of the PF and M1 depended on the amplitude and phase relationship in their identified neuron spikes or group rhythmic activities. Microwire electrode arrays were paired and implanted in the PF and M1 of rats with unilateral dopaminergic cell lesions. The results showed that the identified PF neurons exhibited aberrant cell type-selective firing rates and preferential and excessive phase-locked firing to cortical LFP oscillations mainly at 12-35 Hz (beta frequencies), consistent with the observation of identified M1 neurons with ongoing PF LFP oscillations. Experimental evidence also showed a decrease in phase-locking at 0.7-12 Hz and 35-70 Hz in the PF and M1 circuits in the hemiparkinsonian rats. Furthermore, anatomical evidence was provided for the existence of afferent and efferent bidirectional reciprocal connectivity pathways between the PF and M1 using an anterograde and retrograde neuroanatomical tracing virus. Collectively, our results suggested that multiple alterations may be present in regional anatomical and functional modes with which the PF and M1 interact, and that parkinsonism-associated changes in PF integrate M1 activity in a manner that varies with frequency, behavioral state, and integrity of the dopaminergic system.
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Novel dummy magnetic molecularly imprinted polymers (dex-MMIPs) were prepared for highly selective recognition and fast enrichment of acrylamide (AA) in potato chips. Propionamide (PA) was used as dummy template molecule and the Fe3O4 nanoparticles modified with carboxymethyl dextran were developed as supports. Methacrylic acid (MAA) and ethyleneglycoldimethacrylate (EGDMA) were chosen as the functional monomer and cross-linker, respectively. Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), and transmission electron microscopy (TEM) were used to characterize the synthesized dex-MMIPs. The adsorption of dex-MMIPs reached equilibrium within 20 min, and the maximum adsorption quantity (Qm) was 19.28 mg/g with the dissociation constant (Kd) of 35.7 mg/L. Moreover excellent recognition toward acrylamide was achieved compared to analogs, such as N, N'-methylenebisacrylamide (MBA) and nicotinamide (VPP). The satisfactory recoveries of 83.9-96.8% were achieved for selective separation and enrichment of AA in spiked potato chips by dex-MMIPs.
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Acrilamida/análise , Análise de Alimentos/métodos , Nanopartículas de Magnetita/química , Impressão Molecular/métodos , Polímeros/química , Solanum tuberosum , Adsorção , Cromatografia Líquida de Alta Pressão , Culinária , Dextranos/química , Contaminação de Alimentos/análise , Magnetismo , Metacrilatos/química , Microscopia Eletrônica de Transmissão , Niacinamida/análise , Espectroscopia de Infravermelho com Transformada de Fourier , TermogravimetriaRESUMO
A biomimetic enzyme-linked immunosorbent assay (BELISA) which was based on molecularly imprinted polymers on paper (MIPs-paper) with specific recognition was developed. As a detector, the surface of paper was modified with γ-MAPS by hydrolytic action and anchored the MIP layer on γ-MAPS modified-paper by copolymerization to construct the artificial antibody Through a series of experimentation and verification, we successful got the MIPs-paper and established BELISA for the detection of carbaryl. The development of MIPs-paper based on BELISA was applied to detect carbaryl in real samples and validated by an enzyme-linked immunosorbent assay (ELISA) based on anti-carbaryl biological antibody. The results of these two methods (BELISA and ELISA) were well correlated (R2=0.944). The established method of MIPs-paper BELISA exhibits the advantages of low cost, higher stability and being re-generable, which can be applied as a convenient tool for the fast and efficient detection of carbaryl.
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Carbaril/análise , Biomimética , Ensaio de Imunoadsorção Enzimática , Impressão Molecular , PolímerosRESUMO
Herein, mesoporous calcite/chondroitin sulfate hybrid microrods are prepared through a one-pot method. Biological assays indicate that the microrods might be used as good active targeted drug delivery carriers to treat tumor tissues with high specificity and low toxic side effects.