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Objective:To evaluate the predictive value of age-adjusted Charlson comorbidity index (ACCI) for in-hospital mortality and 1-year mortality in patients with acute type A aortic dissection (ATAAD).Methods:This was a retrospective cohort study, and the clinical data of ATAAD patients admitted to Wuhan Union Hospital from January 1, 1999 to December 31, 2018 were collected for analysis. All the patients were confirmed by computed tomography angiography or magnetic resonance imaging of the aorta and the onset time was less than 14 days. Patients who survived at discharge were followed up to obtain 1-year survival information. The ACCI score was calculated for patients based on their comorbidities and age at admission, and they were divided into three groups of 0, 1 and ≥2 according to the ACCI score. The in-hospital mortality and 1-year mortality of the three groups were compared. Logistic regression analysis was applied to determine the independent predictors for in-hospital mortality and 1-year mortality.Results:Among 1 133 ATAAD patients, 383, 357 and 393 patients had ACCI score of 0, 1, and ≥2, respectively. The in-hospital mortality and 1-year mortality of patients with ACCI score ≥2 were significantly higher than those of patients with ACCI score of 0 (25.4% vs. 17.0%, 30.0% vs. 19.6%, both P<0.05). Multivariate Logistic regression analysis showed that ACCI score ≥2 was an independent risk factor for in-hospital mortality ( OR=1.670, 95% CI: 1.176-2.370, P=0.004) and 1-year mortality ( OR=1.762, 95% CI: 1.264-2.456, P<0.001). Age (per 10-year increase) and cerebrovascular diseases were independent risk factors for in-hospital mortality and 1-year mortality, while diabetes mellitus was a protective factor for in-hospital mortality. Conclusions:ACCI can predict the in-hospital mortality and 1-year mortality of ATAAD patients, and patients with ACCI score ≥2 have a poorer prognosis.
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BACKGROUND: Single tooth loss at posterior mandibular area is difficult to complete regularly axial implantation under limited conditions. Concerning this problem, some scholars employ the skill of tilted implantation with abutment angulations to restore it. However, the security study of this design has been limited until now. OBJECTIVE: To provide theoretical evidence for tilted implantation in the posterior mandibular area, and to make a biomechanical analysis on bone-implant interface after titled implantation under the same dynamic force stress. METHODS: First, restoration models of implant crown at different tilting angles in posterior mandibular area were built and optimized using the software CBCT and DICOM. Then dynamic force stress was applied in chewing cycles of the crown model. Finally, the stress-strain analysis of bone-implant interface was made by utilizing the three-dimensional finite element software Ansys. RESULTS AND CONCLUSION: (1) When the dental implant in the axis implantation was tilted to the lingual side at 5° or 10°, the maximum stress and strain values at the bone interface were 53.8 MPa and 2 671, respectively, under three loading conditions: the force during the chewing cycle was given vertical to the implant, toward the lingual side from the buccal side at 45° with the long axis of the tooth, and toward the buccal side from the lingual side at 45° with the long axis of the tooth. (2) When the implant inclined to the lingual side at a 15° angle, the rear edge of the implant was close to the interface between the cortical and cancellous bone, and the stress and strain values were bigger than those at any other implantation angle. (3) When the implant inclined to the lingual side at a 20° angle, the rear edge of the implant was beyond the interface between the cortical and cancellous bone, and contacted with the cortical bone that provided a support for the rear part of the implant. The stress and strain values on the bone interface were both reduced. The stress was concentrated in the cortex around the neck of the implant, and reduced a lot in the cancellous bone. The maximum strain value appeared at the contact site between the bone interface and the implant neck or rear part. It is concluded that in posterior mandibular area, the dental implant can be implanted at a < 10° linguoclination angle.
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BACKGROUND: It is of vital importance to fabricate an interface on the titanium implant surface which can promote early cell adhesion, proliferation, and differentiation, and exert better antibacterial effects with no cytotoxicity. OBJECTIVE: To prepare a TiN/Ag composite coating on the surface of pure titanium implant, and to explore its antibacterial properties and effects on MC3T3-E1 biobehaviors. METHODS: Acid etching blasting and multi-arc ion plating were adopted to prepare TiN/Ag composite coating on the smooth surface of pure titanium. Then, MC3T3-E1 cells that grew well were inoculated onto pure titanium plate, sandblasted and acid-etched titanium plate, and TiN/Ag-coated titanium plate. Twenty-four hours later, cell adhesion and viability were observed under confocal laser scanning microscope, and cell morphology was observed under scanning electron microscope. Cell counting kit-8 was used to detect cell proliferation and cytotoxicity at 24,48,72 hours after inoculation.In addition,Staphylococus aureus solution was dropped onto the smooth titanium plated, acid-etched and sandblasted titanium and TiN/Ag-coated titanium plate, and the growth of bacteria was observed by the laser confocal scanning microscope at 16 hours. RESULTS AND CONCLUSION: Under the confocal laser scanning microscope, spindle cells with bipolar or three poles were observed on the smooth titanium surface, and there was less F-actin and filopodia expression; cells on the TiN/Ag-coated titanium surface and sandblasted and acid-etched titanium surface were scattered with a large amount of interconnected filopodia that were fully stretched and adhered to the titanium surface, highly expressed F-actin was detected, and actin fibers were thickened. Under the scanning electron microscope, the cells on the smooth titanium surface were not fully adhered and stretched, and those on the TiN/Ag-coated titanium surface or the sandblasted and acid-etched titanium surface exhibited better adhesion and extension. Findings from the cell counting kit-8 showed that after 72 hours of inoculation,the cells on the smooth titanium surface grew well,with cytotoxicity level 1.In addition,Staphylococus aureus grew well on the smooth titanium surface under the confocal laser scanning microscope,while a large amount of Staphylococus aureus died on the TiN/Ag-coated titanium surface or on the sandblasted and acid-etched titanium surface. These findings indicated that TiN/Ag coating has good biocompatibility and antibacterial properties.
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In this study, solid dispersion system of magnolol in croscarmellose sodium was prepared by using the solvent evaporation method, in order to increase the drug dissolution. And its dissolution behavior, stability and physical characteristics were studied. The solid dispersion was prepared with magnolol and croscarmellose sodium, with the proportion of 1∶5, the in vitro dissolution of magnolol solid dispersion was up to 80.66% at 120 min, which was 6.9 times of magnolol. The results of DSC (differential scanning calorimetry), IR (infra-red) spectrum and SEM (scanning electron microscopy) showed that magnolol existed in solid dispersion in an amorphous form. After an accelerated stability test for six months, the drug dissolution and content in magnolol solid dispersion showed no significant change. So the solid dispersion prepared with croscarmellose sodium as the carrier can remarkably improve the stability and dissolution of magnolol.
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<p><b>OBJECTIVE</b>To explore the ratio of lymphocyte subsets in peripheral blood of patients with aplastic anemia (AA) and patients with hypoplastic myelodysplastic syndrome (hypo-MDS) patients and to evaluate their significance.</p><p><b>METHODS</b>The clinical data of 181 cases of AA and 111 cases of hypo-MDS from January 2008 to December 2014 were collected from Blood Diseases Hospital of Chinese academy of medical sciences, and then the differences of lymphocyte subsets and its effect in 2 groups were analyzed.</p><p><b>RESULTS</b>CD4/CD8ratio, proportion of CD3cells and its subsets CD3CD4/CD3CD8cells in hypo-MDS group were not significant different from AA group (P>0.05). the proportion of CD3CD16/CD56NK cells and CD3CD57T-LGL cells in hypo-MDS group was significantly higher than that in AA group (P<0.05, P<0.01), but CD19B lymphocyte percentage in hypo-MDS patients was lower than that in AA patients (P<0.05). After dividing group according to CD4/CD8ratio, the ratios of CD3CD16/CD56NK cells and CD3/CD57T-LGL cells were higher only in normal CD4/CD8ratio group of hypo-MDS patients than those in AA patients, while the ratio of B lymphocytes was significant different in inverted CD4/CD8ratio group between hypo-MDS and AA patients. The CD19B lymphocyte ratio in hypo-MDS patients was significantly lower than that in AA patients (P<0.05). As well, the levels of erythrocytes and platelets in peripheral blood between hypo-MDS and AA patients only in normal CD4/CD8ratio group were significantly different, while the significant difference of WBC count and reticulocyte ratio were observed in high CD4/CD8ratio and non-inverted CD4/CD8ratio groups, respectively; the significant difference of bone marrow blast ratio and muture monocyte ratio was found in high CD4/CD8ratio group.</p><p><b>CONCLUSION</b>The changes of lymphocyte subsets can be used as an reference indicator for differential diagnosis of hypo-MDS and AA. The comparative analysis of patients with these 2 kinds of diseases after dividing into subgroups according to ratio of CD4/CD8cells is beneficial to differentiat diagnosis.</p>
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Empathy, a basic prosocial behavior, is referred to as an ability to understand and share others' emotional state. Generally, empathy is also a social-behavioral basis of altruism. In contrast, impairment of empathy development may be associated with autism, narcissism, alexithymia, personality disorder, schizophrenia and depression. Thus, study of the brain mechanisms of empathy has great importance to not only scientific and clinical advances but also social harmony. However, research on empathy has long been avoided due to the fact that it has been considered as a distinct feature of human beings from animals, leading to paucity of knowledge in the field. In 2006, a Canadian group from McGill University found that a mouse in pain could be shared by its paired cagemate, but not a paired stranger, showing decreased pain threshold and increased pain responses through emotional contagion while they were socially interacting. In 2014, we further found that a rat in pain could also be shared by its paired cagemate 30 min after social interaction, showing long-term decreased pain threshold and increased pain responses, suggesting persistence of empathy for pain (empathic memory). We also mapped out that the medial prefrontal cortex, including the anterior cingulate cortex, prelimbic cortex and infralimbic cortex, is involved in empathy for pain in rats, suggesting that a neural network may be associated with development of pain empathy in the CNS. In the present brief review, we give a brief outline of the advances and challenges in study of empathy for pain in humans and animals, and try to provide a novel bio-psychosocial-behavioral model for study of pain and its emotional comorbidity using laboratory animals.
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Animals , Humans , Mice , Rats , Cerebral Cortex , Physiology , Emotions , Empathy , Gyrus Cinguli , Physiology , Models, Animal , Pain , Pain Threshold , Prefrontal Cortex , PhysiologyABSTRACT
<p><b>OBJECTIVE</b>The assessment result of microcirculatory perfusion provides significant evidence for the detection of microcirculatory alterations in sepsis patients, and functional capillary density based on vessel segmentation can reflect microcirculatory perfusion effectively.</p><p><b>METHODS</b>First, preprocessing comprise operations to improve the quality of images in order to maximize the contrast between background and vessels. Secondly, adaptive local thresholding is used for initial segmentation to get the general vessel region. Finally, post-processing technique reduces the image artifacts and links the vessel fragment, and then functional capillary density is calculated based on the segmentation results.</p><p><b>RESULTS</b>Several sublingual microcirculatory data have been tested, and the agreement between the results by AVA and the proposed algorithm reached up to 92%.</p><p><b>CONCLUSIONS</b>The method can realize automated assessment of sublingual microcirculatory perfusion rapidly and accurately, and has strong clinical value.</p>
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Algorithms , Image Processing, Computer-Assisted , Methods , Microcirculation , Mouth FloorABSTRACT
Objective To evaluate the efficacy and safety of trimebutine combined with mosapride on functional dyspepsia. Methods Patients with functional dyspepsia were randomly divided into three clinical groups. Group A (n=116) received 0.2 g trimebutine after meal,group the drug combination B (n=116) received 5 mg mosapride before meal,and the drug combination group (n=115) received 0. 2 g trimebutine after meal plus 5 mg mosapride before meal. All medications were taken orally three times daily for 4 weeks. Improvement in clinical symptoms and adverse reactions in each group were evaluated at the end of study. Results A total of 339 patients among 347 enrollees completed the treatment and follow-up. The clinical efficacy on postprandial fullness, early satiation, epigastric pain, epigastric burning, upper abdominal bloating and nausea were 88. 4%,76. 9%,72. 9%,61. 8%,86. 7% and 81. 7%,respectively in the drug combination group after 4-week treatment,which were superior to those in group A or B (P<0. 05) except for epigastric burning. The total effective rate of the drug combination group was 78. 8%,significantly higher than the other two groups (P<0. 05). The total incidence of side effects in the drug combination group was 1. 8%,similar to that of group A and B (1. 8% and 0. 9%,respectively, P =0. 776). Conclusion Trimebutine combined with mosapride is safe and effective for improving symptoms in functional dyspepsia.
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<p><b>OBJECTIVE</b>To explore the effect and mechanism of berberine on diabetic nephropathy in experimental rats.</p><p><b>METHOD</b>The rat model of diabetic nephropathy was induced by injection of streptozocin (STZ). The rats were divided into 6 groups: control group, model group, 3 berberine treatment groups and Xiaoke Wan (XKW) treatment group. The fasting blood glucose (FBG), kidney weight/body weight (KW/BW), blood urea nitrogen (BUN), creatinine (Cr) and urinary protein (Upro) were tested 8 weeks later. The expression of transforming growth factor-beta1 (TGF-beta1) and type IV collagen (IV-C) proteins in renal tissue of diabetic rats with nephropathy were observed by optical micrography.</p><p><b>RESULT</b>Berberine could reduce the levels of FBG, KW/BW, BUN, Cr, Upro and the expression of TGF-beta1 and IV-C proteins in renal tissue of diabetic rats with nephropathy.</p><p><b>CONCLUSION</b>Berberine may protect renal function and slow down the progression of diabetic nephropathy in rats by suppressing the expression of TGF-beta1 and IV-C proteins in renal tissue.</p>
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Animals , Male , Rats , Berberine , Pharmacology , Collagen Type IV , Genetics , Diabetes Mellitus, Experimental , Metabolism , Diabetic Nephropathies , Metabolism , Gene Expression Regulation , Mesangial Cells , Metabolism , Rats, Wistar , Streptozocin , Transforming Growth Factor beta1 , GeneticsABSTRACT
OBJECTIVE To investigate the distribution of the clinical isolated pathogenic bacteria and the drug resistance of common bacteria so as to provide evidence for clinical rational use of drugs.METHODS The data of 3848 strains isolated from clinical specimens during from Mar 2007 to Oct 2008 and their sensitivity to antibiotics were statistically analyzed by WHONET 5.3.RESULTS Total of 3848 strains were identified including 857 Gram-positive strains(22.3%),2270 Gram-negative strains(59.0%) and 721 fungal strains(18.7%).The top three pathogens were Candida albicans,Escherichia coli and Acinetobacter baumannii.The detection rate of MRSA,MRSE,and MRCNS was 51.7%,80.7%,and 83.6%,respectively.There were no vancomycin-resistant staphylococci and enterococci detected.The detection rate of ESBLs producing strains in E.coli,K.pneumoniae,and Proteus mirabilis was 56.6%,28.3% and 5.9% respectively.All kinds of Enterobacteriaceae are sensitive to imipenem,resistance rate ranged from 0 to 1.3%.A.baumannii and Pseudomonas aeruginosa had higher resistance rate to imipenem(38.3% and 19.0%,respectively).CONCLUSIONS The detection rate of fungi and non-fermentative bacteria increase and the resistance of the pathogens is increasing.We should pay more attention to the status,and enhance the resistance surveillance.
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<p><b>OBJECTIVE</b>To provide anatomical evidences for the morphological and histological identification of 20 medicinal species in Hypericum.</p><p><b>METHOD</b>Morphological and anatomical study on the organs of 20 medicinal species in Hypericum using tissue clearing, paraffin sectioning and thin sectioning.</p><p><b>RESULT</b>According to their anatomical characteristics, the secretory structures can be divided into nodules, secretory cavities (canals) and tiny secretory tubes of 20 medicinal species in Hypericum. Hypericin was produced and stored in the nodules, while the volatile oil was produced and stored in the secretory cavities (canals) and tiny secretory tubes. The types differed markedly from each other in location, diameter and distributional density of leaf, and the anatomical structures differed from each other of stem, calyx, petal, anther and fruit among the 20 species in Hypericum.</p><p><b>CONCLUSION</b>The secretory structures may be as anatomical evidences for the morphological and histological identification of 20 medicinal species in Hypericum.</p>
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Flowers , Chemistry , Fruit , Chemistry , Hypericum , Chemistry , Classification , Oils, Volatile , Perylene , Plant Leaves , Chemistry , Plant Stems , Chemistry , Plants, Medicinal , Chemistry , Classification , Species SpecificityABSTRACT
<p><b>OBJECTIVE</b>To evaluate the estrogenic activity of several kinds of Chinese herbal medicines.</p><p><b>METHOD</b>Use zoopery and reporter gene technique to study the estrogenic activity of five Chinese herbal medicines. Zoopery: weanling female Kunming mice weight 9-12 g were administrated botanical extracts of Selaginella tamariscina, Pinus Massoniana, Corallodiscus flabellate, Dryopteris sublaeta and Leonurus heterophyllus, the positive control group with Nilestriol tablets and control group with water, respectiely. On the eighth day, the animals were sacrificed and the uteri were separated solely and weighed. Reporter gene technique: Induce the expression of reporter gene controlled by ERE and measure the activity of luciferase on cell's clear supernatant.</p><p><b>RESULT</b>The botanical extracts of S. tamariscina can increase weights of mice (P < 0.01); In the expression of reporter gene controlled by ERE, Either ERalpha or ERbeta's has estrogenic activity (P < 0.01). Follow in the zoopery we find the water part and the n-butanol part of S. tamariscina are the two active parts.</p><p><b>CONCLUSION</b>S. tamariscina and it's water part and n-butanol part have estrogenic activities, effect on ERbeta is greater than ERalpha.</p>