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With the effects of activating blood and resolving stasis, and moving Qi to relieve pain, Jingtong Granules is widely used in the treatment of cervical radiculopathy in China. Long-term clinical application and related evidence have shown that the prescription has ideal effect in alleviating the pain in neck, shoulder, and upper limbs, stiffness or scurrying numbness, and scurrying pain caused by this disease. However, there is a lack of consensus on the clinical application of Jingtong Granules. Therefore, clinical first-line experts and methodology experts from all over the country were invited to compile this expert consensus. This expert consensus is expected to guide clinicians to use Jingtong Granules in a standardized and reasonable way, improve clinical efficacy, reduce medication risks, and benefit patients. First, according to the clinical experience of experts and the standard development procedures, the indications, syndrome characteristics, clinical advantages, and possible adverse reactions of Jingtong Granules were summarized. Then, through face-to-face interview of clinical doctors in traditional Chinese medicine and western medicine and survey of the clinical application, the clinical problems were summed up, and the consensus was reached with the nominal group method to form the final clinical problems. Third, evidence retrieval was carried out for the clinical problems, and relevant evidence was evaluated. The GRADE system was employed to rate the quality of evidence. Fourth, 5 recommendation items and 3 consensuses items were summarized with the nominal group method. Opinions and peer reviews on the consensus content were solicited through expert meetings and letter reviews. The final consensus includes the summary of evidence on the clinical indications, effectiveness, and safety of Jingtong Granules, which can serve as a reference for clinicians in hospitals and primary health institutions.
Subject(s)
Humans , Drugs, Chinese Herbal/adverse effects , Consensus , Radiculopathy/drug therapy , Medicine, Chinese Traditional , Pain/drug therapyABSTRACT
AIM: To assess the differences in corneal biomechanical parameters and their correlation with other ocular biometric parameters in myopic patients using a corneal visualisation scheimpflug technology(Corvis ST).METHODS: A total of 132 myopic patients who received treatment in the department of refractive surgery of Eyegood Ophthalmic Hospital from May to December 2021 were selected, and the data of right eye were taken. The subjects were classified into low and moderate myopia(-0.50 to -6.00D), high myopia(>-6.00D to <-8.00D), and super high myopia(≥-8.00D)according to the spherical equivalent(SE). The basic parameters of corneal biomechanical deformation measured with Corvis ST included the amount of corneal displacement at highest degree of concavity(DA), radius of curvature at highest concavity(HCR), and distance between the two peaks of the cornea at highest concavity(PD); stiffness parameters at applanation 1(SP-A1), integrated radius(IR), deformation amplitude ratio(DA ratio), Ambrosio relational thickness horizontal(ARTh), Corvis biomechanical index(CBI). Other ocular biometric parameters measured included SE, intraocular pressure(IOP), axial length(AL), central corneal thickness(CCT), white-to-white(WTW)and retinal nerve fiber layer(RNFL)thickness. The differences in corneal biomechanical parameters were compared among the three groups of myopic patients, and the correlation between corneal biomechanical parameters and other ocular biometric parameters and age was further analyzed.RESULTS: The SP-A1 in the low and moderate, high, and super high myopia groups were 106.8±16.2, 115.6±21.9, and 106.9±11.5, respectively. The SP-A1 in the high myopia group was higher than that in the low and moderate and severe myopia groups(all P<0.05). All corneal biomechanics were significantly correlated with CCT(P<0.01); all corneal biomechanics were correlated with IOP except ARTh(P<0.05); AL was significantly and positively correlated with PD(r=0.270, P=0.002), weakly and positively correlated with HCR(r=0.177, P=0.043), and weakly and negatively correlated with IR(r=-0.183, P=0.036); WTW was positively correlated with PD, DA and DA ratio(r=0.363, P<0.001; r=0.252, P=0.003; r=0.200, P=0.02); there was no correlation between corneal biomechanical parameters and age, SE, and RNFL.CONCLUSION: Corneal stiffness was higher in high myopia patients than in patients with low to moderate and super high myopia. IOP and CCT were both important factors affecting corneal biomechanics. Some of the biomechanical parameters also have certain correlation with AL and WTW. As the growth of axial length, the PD of corneal deformation and HCR were larger, and IR was smaller, but HCR and IR had little significance; the longer the WTW, the greater the corneal deformation amplitude. In clinical practice, attention should be paid to the corneal biomechanical parameters in patients with super high myopia.
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Traditional Chinese medicine has unique advantages in the treatment of degenerative bone and joint diseases, and its widely used in clinical practice. In recent years, many scholars have conducted a large number of basic studies on the delay of intervertebral disc degeneration by herbal compound and monomeric components from different perspectives. In order to further elucidate its mechanism of action, this paper summarizes the in vivo and in vitro experimental studies conducted at the level of both herbal compound and single components, respectively, in order to provide references for the basic research on the treatment of lumbar intervertebral disc degeneration by Chinese medicine. A summary shows that commonly used herbal compound prescriptions include both classical prescriptions such as Duhuo Jisheng Decoction, as well as clinical experience prescriptions such as Yiqi Huoxue Recipe. Angelicae Sinensis Radix, Chuanxiong Rhizoma, Rehmanniae Radix Praeparata, Achyranthis Bidentatae Radix, and Eucommiae Cortex were used most frequently. Tonic for deficiency and blood stasis activators were used most frequently. The most utilized monomeric components include icariin, ginsenoside Re, salvianolic acid B and aucubin. The main molecular mechanisms by which herbal compound and monomeric components delay of lumbar intervertebral disc degeneration include improving the intervertebral disc microenvironment, promoting the synthesis of aggregated proteoglycans and type Ⅱ collagen in the intervertebral disc, reducing the degradation of the extracellular matrix, and inhibiting apoptosis in the nucleus pulposus cells, etc. The main signaling pathways involved include Wnt/β-catenin signaling pathway, MAPK-related signaling pathway, mTOR signaling pathway, Fas/FasL signaling pathway, PI3 K/Akt signaling pathway, NF-κB signaling pathway, JAK/STAT signaling pathway, and hedgehog signaling pathway, etc.
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Humans , China , Drugs, Chinese Herbal/therapeutic use , Hedgehog Proteins/metabolism , Intervertebral Disc Degeneration/metabolism , Nucleus Pulposus/metabolism , Wnt Signaling PathwayABSTRACT
ObjectiveTo assess the curative effects of Fangji Huangqi detumescence prescription (FHDP) on synovitis and polarization of synovial macrophages of knee osteoarthritis (KOA) model in rats induced by Hulth method. MethodThirty-six rats were randomly divided into sham operation group, model group, high-dose, medium-dose, and low-dose (29.16, 14.58, and 7.29 g·kg-1) FHDP groups, and loxoprofen sodium (16.2 mg·kg-1) group. KOA model in rats was induced by modified Hulth method. Six weeks after the operation, rats were given high, medium, and low concentrations of FHDP, normal saline (NS), and loxoprofen sodium according to the group to intervene, and sacrificed after 2-week administration. Synovium and cartilage histopathological changes were observed after hematoxylin-eosin (HE) staining. Flow cytometry (FCM) and immunofluorescence (IF) test were used to evaluate the polarization of M1/M2 macrophages. Immunohistochemistry (IMC) and enzyme-linked immunosorbent assay (ELISA) were used to detect the related protein expression levels of macrophage polarization, such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and matrix metalloproteinase-13 (MMP-13) in joint tissues and serum. ResultCompared with the sham operation group, Krenn and Mankin scores in the model group were significantly increased (P<0.01). Compared with the model group, Krenn score was decreased in all administration groups (P<0.05, P<0.01), but there was no significant difference in Mankin score in any administration groups. Compared with the sham operation group, M1/mø (CD38+) ratio in the model group was significantly increased (P<0.01), and M2/mø (CD206+) ratio in the model group was decreased (P<0.05). Compared with the model group, M1/mø ratio in the high, medium, and low-dose FHDP groups was decreased (P<0.05, P<0.01), but M2/mø ratio was increased in all administration groups (the difference had no statistical significance). Compared with the sham operation group, M1/M2 ratio in the model group was significantly increased (P<0.01). Compared with the model group, M1/M2 ratio in all FHDP groups was significantly decreased (P<0.01), and M1/M2 ratio in the high and medium-dose FHDP groups was lower than that in the loxoprofen sodium group (P<0.05). Compared with the sham operation group, the levels of TNF-α, IL-1β, and MMP-13 in synovium and cartilage of the model group were significantly increased (P<0.01), the level of IL-10 was significantly decreased (P<0.01). Compared with the model group, the levels of TNF-α and IL-1β in synovium were decreased in all administration groups (P<0.05), but the difference of the levels of MMP-13 and IL-10 in synovium had no statistical significance. The level of inflammatory mediators in cartilage was not affected in all administration groups. Compared with the sham operation group, the levels of TNF-α and IL-β in serum of the model group were significantly increased (P<0.01), the level of IL-10 was decreased (P<0.05). Compared with the model group, the level of TNF-α in the high-dose FHDP group was decreased (P<0.05), and the level of IL-10 was increased in all administration groups (P<0.05, P<0.01). The difference of the level of IL-β in all administration groups had no statistical significance. ConclusionFHDP attenuated the synovitis of KOA rats. FHDP exert the effect on the releasing of proinflammatory cytokines and MMP by inhibiting the polarization of M1 macrophages in synovium, and had no significant effect on the polarization of M2 macrophages. Modulating the imbalanced polarization of synovial macrophages was a possible mechanism of FHDP on attenuating synovitis and treating KOA.
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OBJECTIVE@#To evaluate the effect of degenerative scoliosis on the difficulty and efficacy of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) in the treatment of lumbar spinal stenosis.@*METHODS@#From September 2016 to September 2019, 52 patients with lumbar spinal stenosis treated by MIS-TLIF were retrospectively analyzed, including 16 males and 36 females, aged from 42 to 71(63.44±5.96) years old, the course of disease from 1.5 to 6.5 years, with an average of (3.69±1.10) years. All patients had lower extremity root pain or numbness, 41 patients had intermittent claudication. There were 31 cases of L@*RESULTS@#All patients were followed up for 12 to 36 months, with an average of (19.58±5.33) months. The operation time and intraoperative bleeding in stenosis group were better than those in scoliosis group (@*CONCLUSION@#For patients with lumbar spinal stenosis undergoing MIS-TLIF, degenerative scoliosis can lead to prolonged operation time and increased bleeding. However, it has no significant effect on therelief of postoperative symptoms, postoperative complications and the recovery of lumbar function.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Lumbar Vertebrae/surgery , Minimally Invasive Surgical Procedures , Retrospective Studies , Scoliosis/surgery , Spinal Fusion , Spinal Stenosis/surgery , Treatment OutcomeABSTRACT
To evaluate the clinical efficacy and safety of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation, in order to provide evidence for its clinical application. PubMed, Cochrane Library, EMbase, CNKI, WanFang, VIP, CBM and Clinical Trials.gov databases were sysmatically retrieved. Two researchers independently searched, screened and extracted data. Randomized controlled trials in line with the inclusion criteria were included in the study. The article quality was assessed with the bias risk tool in the Cochrane Handbook. Meta-analysis was performed using RevMan 5.3. A total of 604 articles were obtained from the retrieval, and 824 patients in 9 studies were finally selected through screening. The course of treatment was about 1 month, and all of the studies were completed in China. Meta-analysis showed that the efficacy of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation was better than that of the control group(RR=1.19, 95%CI[1.12, 1.26], P<0.000 01), including the comparison with Yaotongning Capsules(RR=1.10, 95%CI[1.02, 1.19], P=0.01) and diclofenac sodium tablets(RR=1.26, 95%CI[1.11, 1.44], P=0.000 4). In VAS pain score, Shentong Zhuyu Decoction had also obvious advantages(MD=-3.70, 95%CI[-6.31,-1.09], P=0.005). In addition, the number of adverse events in the Shentong Zhuyu Decoction group was lower than that in the control group. Shentong Zhuyu Decoction can effectively alleviate discomfort symptoms of patients with LDH. It has an obvious clinical efficacy and less adverse reactions. However, restricted by the quality of the included literatures, prospective, multi-center, large-sample-size randomized controlled trials are still needed to further improve the clinical evidence of the effect of Shentong Zhuyu Decoction in the treatment of LDH.
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Humans , China , Drugs, Chinese Herbal/therapeutic use , Intervertebral Disc Displacement/drug therapy , Randomized Controlled Trials as TopicABSTRACT
The aim of this paper was to investigate the key targets and mechanism of "Epimedii Folium-Paeoniae Radix Alba" in the treatment of lumbar disc herniation by means of network pharmacology. The currently recognized databases and analysis software at home and abroad were used to construct the network from drugs and diseases. The chemical components of Epimedii Folium and Paeo-niae Radix Alba were collected by using databases such as TCMSP, while their active components were determined and the action targets were predicted according to threshold screening and literature reports. The genes for lumbar disc herniation were collected by using GeneCards, OMIM, and DisGeNET databases. The drug targets were mapped to disease targets, and protein interaction network analysis for key targets, GO function enrichment analysis and KEGG signaling pathway enrichment analysis were performed. Finally, 23 active components of Epimedium Folium and 13 active components of Paeoniae Radix Alba were determined, and a total of 624 drug targets were obtained. After standardization, 214 drug targets were obtained. In addition, 306, 2 and 5 related targets of lumbar disc herniation were collected from GeneCards, OMIM, and DisGeNET database, respectively, and a total of 293 disease targets were obtained after deduplication. After the mapping of drug target and disease target, 44 common targets were obtained. PPI protein interaction network analysis showed that IL-6, TNF, AKT1, MAPK1, and VEGFA may be the core targets for the treatment of lumbar disc herniation. GO enrichment analysis identified 56 items(P<0.05), among which biological processes mainly included immune response, apoptosis, etc.; cell components mainly included extracellular space, extracellular region, etc.; molecular functions mainly included cytokine activity, metallopeptidase activity and so on. Through KEGG pathway enrichment analysis, 91 signaling pathways related to inflammation, metabolism, and senescence were identified, mainly including IL-17 signaling pathway and TNF signaling pathway and so on. "Epimedii Folium-Paeoniae Radix Alba" showed the characteristics of multi-channel and multi-target for the treatment of lumbar disc herniation. This study preliminarily explored the key targets for its role and the biological processes and signaling pathways involved. It was found that it may play a therapeutic role by affecting inflammation and immune regulation, which laid the foundation for further experimental verification.
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Humans , Drugs, Chinese Herbal/therapeutic use , Epimedium/chemistry , Intervertebral Disc Displacement/drug therapy , Lumbar Vertebrae , Medicine, Chinese Traditional , Paeonia/chemistry , Plant Leaves/chemistry , Plant Roots/chemistry , Signal TransductionABSTRACT
OBJECTIVE@#To explore the influence of individual characteristics of patients on the kinematics parameters of sitting lumbar spine manipulation.@*METHODS@#From January 2016 to December 2016, 30 patients with degenerative lumbar spondylolisthesis were treatede, including 18 males and 12 females, aged from 45 to 61(52.33±2.34) years old, with a course of 2 to 72(29.13±3.23) months. Motion capture technique was used to measure the kinematics parameters of the same manipulator in sitting lumbar spine manipulation for 30 patients, including rotation time, maximum speed and maximum acceleration. The parameters of the left and right hands of the operator were different. The effects of individual characteristics on the kinematics parameters of sitting lumbar spine manipulation were analyzed.@*RESULTS@#The kinematic and mechanical parameters of manipulation were as follows:spin time, maximum speed, maximum acceleration, the manipulation done by right or left hand showed the similar parameters(>0.05). According to multivariate linear regression, there was a significant correlation between the age of the patient and the rotation time of the operator(<0.01); the height of patient had a significant correlation with the maximum speed and maximum acceleration of the operator(<0.01).@*CONCLUSIONS@#There is no difference between the manipulation of left and right hand in clinical application. Age and height are important influencing factors of sitting lumbar rotation manipulation.
Subject(s)
Female , Humans , Male , Middle Aged , Biomechanical Phenomena , Lumbar Vertebrae , Manipulation, Spinal , Range of Motion, Articular , Sitting PositionABSTRACT
Objective: Analyze the clinical application rule of Chinese patent medicine in cervical radiculopathy (CR) .Method: The clinical real-world data of CR were extracted by using information sharing system of traditional Chinese medicine and clinical research. Six hundred and twenty-eight inpatients and out patients with CR were enrolled from December 2012 to July 2014 in the information system database of Wangjing Hospital. The correlation analyses and mutual information value were recorded for Chinese patent medicine therapy application of all patients by using liquorice software. Complex network diagrams were generated. Result: Yuxuebi capsule and Jingshu granule is the highest frequency in application of Chinese patent medicine. Jingshu granule and Cobamamide for injection were the highest frequency in combined application of Chinese patent medicine and western medicine. Association frequency was 822, mutual information value was 268.07. Biqi capsule and Daiwenjiu cream were the highest frequency in combined application of Chinese patent medicine and topical drugs. Association frequency was 384, mutual information value was1754.76. Conclusion: The basic treating principle for CR was promoting blood circulation and removing blood stasis. The efficacy and safety of combined Chinese patent medicine with other medicine need further research
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BACKGROUND: As a reliable biomechanical model, human fresh isolated cervical specimens provide the basis for studying the pathogenesis of cervical vertigo from the perspective of blood flow of vertebral artery.There is a lack of an in vitro cervical model that can simulate the physiological state of the cervical vertebrae and achieve complex posture, as well as can measure the blood flow of vertebral artery. OBJECTIVE:To study the influence of variant position of human fresh isolated cervical vertebrae on the blood flow of vertebral artery in vitro through constructing the fresh specimen of cervical vertebral artery determination model. METHODS: Six human fresh isolated cervical specimens were selected for constructing the vertebral artery determination model. The pressure of human vertebra artery was simulated by pressure pump. The change of normal saline height was measured by digital motion capture system dynamically under different positions. RESULTS AND CONCLUSION: (1) Eight vertebral arteries in the six models were in good condition. (2) The vertebral artery flow under neutral position was significantly richer than that under contralateral rotation-anteflexion and ipsilateral/contralateral rotation-postexion (P <0.05). (3) The vertebral artery flow under contralateral rotation-anteflexion and rotation-postexion was significantly poorer than that under natural position, ipsilateral rotation and ipsilateral rotation-anteflexion (P < 0.05). (4) In summary, the cervical vertebral artery determination model is constructed successfully that can simulate the influence of the position on vertebral artery flow. Additionally, different positions of rotation make a different effect on vertebral artery flow.
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To explore the clinical medication rules in the patients with limb fractures, and provide guidance for clinical practice. Data of 48 398 patients with limb fractures from 2001 to 2011 was extracted from the hospital information system(HIS) established by the institute of basic research in clinical medicine, China academy of Chinese medical sciences. The gender and age distribution of patients and clinical medication characteristics were described. Apriori algorithm was adopted to analyze the common drug combinations of Chinese medicine(CM) and western medicine(WM). The study results showed that the ratio of included males and females was 1.83∶1. There was a high peak of incidence for the patients from 18 to 44 years. Apriori algorithm showed that the usage of WM was more frequent than that of CM. The most commonly used CM was Lugua polypeptide and sodium aescinate injection. Blood-activating and stasis-resolving medicines, as well as tendons and bones-strengthening medicines were the commonly used CM types. In addition, WM antibiotics plus blood-activating and stasis-resolving CM, or antibiotics plus tendons and bones-strengthening CM was the most commonly used drug combination. Based on the analysis of available data, the prevalence of limb fracture was higher in men than in women; more in young and middle-aged patients; the common drug combination was antibiotics plus blood-activating and stasis-resolving CM, or antibiotics plus tendons and bones-strengthening CM. More prospective and high-quality clinical trials are necessary to evaluate the effect of CM or integrative medicine treatment for limb fracture in the future research.
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Objective To investigate the clinical efficacy of two different single orifice laparoscopic surgeries for patent processus vaginalis in children. Methods From August 2013 to June 2015,there were 84 children with patent processus vaginalis in the First Affiliated Hospital of Guangxi University of Science and Technolgy. They were divided into two groups ( A and B ) randomly according to different laparoscopic surgeries. Group A:used ordinary micro?laparoscope, single orifice, and double channel. Group B:used Li Xun nephroscope,single orifice,single channel. Both two groups′ the high ligation of the sheath was performed with the aid of the auxiliary forceps in the mirror under surveillance. The mean unilateral operation time, mean postoperative hospitalization duration,complications and recurrences of two groups were compared. Results All children underwent successful laparoscopic surgery,without transfering to open surgery,and unilateral operation time was (12. 53±3. 22) min for group A,(10. 16±2. 79) min for group B,the difference was significant(P=0. 037). The mean postoperative hospitalization duration was (2. 29±0. 57) d in group A,(2. 25±0. 55) d in group B, the difference was not significant ( P= 0. 671 ) . There was no complication and recurrence in two groups. Conclusion laparoscopic percutaneous extraperitoneal closure use Li Xun nephroscope,single orifice, single channel for children is safe and effective,and it is more convenient and less invasive than the conventional micro?laparoscope.
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Objective To investigate the correlation between HLA-DRB71 allele and primary biliary cirrhosis(PBC)of Han pop-ulation in Qinghai plateau.Methods 95 PBC patients from March 2011 to March 2013 in the hospital were enrolled in the study (PBC group),203 cases of healthy individuals were recruited as control group.By using a sequence specific primer PCR method,the HLA-DRB71 alleles in the two groups were analyzed.Results HLA-DRB71*07 gene frequencies in PBC group and control group were 36.84% and 13.79% respectively,the difference was statistically significant(P <0.05).In PBC group,the other HLA-DRB71 alleles′frequency were lower than that in control group(P <0.05).There was a higher positive rate of HLA-DRB71 * 07 in PBC group than control group,and the OR value is 2.67(P <0.05).All the PCB patients carring HLA-DRB71 *07 alleles were HLA-DRB71*0701,but other subtypes such as HLA-DRB71 *0703,HLA-DRB71 *0704,HLA-DRB71 *0705,HLA-DRB71 *0706 were not found.Conclusion PBC Susceptibility might associated with HLA-DRB71 *0701 alleles,but is not an independent risk factor.
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<p><b>OBJECTIVE</b>To explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension (PAH) in patients of chronic obstructive pulmonary disease (COPD) associated with chronic cor pulmonale (CCP) during exacerbation.</p><p><b>METHODS</b>Seventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group. The control group received standard treatment with antibiotics, antiasthmatic and expectorant medications, and oxygenation; and the ligustrazine treatment group received ligustrazine treatment (80 mg/d; i.v.; for 2 weeks) in addition to the standard treatment. Before and at the end of 2 week treatment, the clinic responses of the two regimens were evaluated, plasma levels of endothelin-1 (ET-1) and nitric oxide (NO) were determined; arterial oxygen partial pressure (PaO2, mean pulmonary arterial pressure (mPAP), outflow tract of right ventricle (RVOT), and internal diameter of right ventricle (RV) were measured.</p><p><b>RESULTS</b>Good clinic benefits were achieved in both the standard and ligustrazine regimens, plasma level of ET-1, values of mPAP, RV and RVOT decreased significantly, plasma level of NO and PaO2 values decreased (all P < 0.01 vs pre-treatment to all parameters). Compared with the control group, ligustrazine greatly enhanced the clinic efficacy from 77.1% to 97.1% (P < 0.05), and also resulted in more significant changes of all these parameters (P < 0.01 vs control group for all parameters). For both groups, the levels of plasma ET-1 were positively correlated with values of mPAP, RVOT, and RV (r = 0.710, 0.853, and 0.766, respectively, all P = 0.000), and negatively correlated with plasma NO and PaO2 (r = - 0.823, and - 0.752, respectively, all P = 0.000).</p><p><b>CONCLUSION</b>Ligustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area. The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells, thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.</p>
Subject(s)
Humans , Altitude , Blood Gas Analysis , Chronic Disease , Endothelin-1 , Blood , Hypertension, Pulmonary , Drug Therapy , Nitric Oxide , Blood , Pulmonary Artery , Pulmonary Disease, Chronic Obstructive , Drug Therapy , Pyrazines , Therapeutic Uses , RespirationABSTRACT
<p><b>OBJECTIVE</b>To assess the relationship of high altitude de-adaptation response (HADAR) with acute high altitude response (AHAR) and cardiac function.</p><p><b>METHODS</b>Ninety-six military personnel of rapid entering into high altitude (3 700 to 4 800 m) with strong physical work were analyzed, all subjects were male, aged 18 - 35 years. According to the symptomatic scores of AHAR were divided into 3 groups: sever AHAR (group A, 24), mild to moderate AHAR (group B, 47) and non-AHAR (group C, 25) at high altitude. According to the symptomatic scores of HADAR were divided into 3 groups: severe HADAR (group E, 19), mild to moderate HADAR (group F, 40) and non-HADAR (group G, 37) after return to lower altitude (1 500 m). Mean pulmonary arterial pressure (mPAP), right ventricular internal dimension (RVID), outflow tract of right ventricle (RVOT), left ventricular internal dimension (LVID), left ventricular ejection fraction (LVEF), cardiac muscle work index (Tei index), creatine kinase isoenzymes-MB (CK-MB), lactic dehydrogenase isoenzyme-1 (LDH-1) were measured at high altitude stayed 50 days and after return to lower altitude 12 h, 15 d, and 30 d. Fifty healthy volunteers (group D) at 1 500 m altitude served as control.</p><p><b>RESULTS</b>Level of mPAP, RVID, RVOT, RVID/LVID ratio, Tei index, CK-MB,and LDH-1 were higher, and LVEF was lower in group A than those in group B, C and D, there were significant differences between group B and C, C and D (all P < 0.01). AHAR scores were positively correlated with HADAR scores (r = 0.863, P < 0.01). Twelve hours after return to lower altitude, level of mPAP, RVID, RVOT, RVI/LVID ratio, Tei index, CK-MB, and LDH-1 were higher, and LVEF was lower in group E than those in group F, G and D, there were significant differences between group F and G, G and D (all P < 0.01). Fifteen days after return to lower altitude, level of mPAP, RVID, RVOT, RVID/LVID ratio were higher in group E than those in group F, G, and D, there were significant differences between group F and G, and D (P < 0.01 or P < 0.05), there were no significant differences between group G and D (all P > 0.05), LVEF, Tei index, CK-MB, LDH-1 showed no significant differences among groups (all P > 0.05). Thirty days after return to lower altitude, these parameters in group E, F, and G showed no significantly differences compared with those of group D (all P > 0.05).</p><p><b>CONCLUSION</b>The severity of HADAR is associated with severity of AHAR and cardiac injury, the more serious of AHAR and cardiac injury at high altitude, the more serious of HADAR and cardiac injury after return to lower altitude, the more long of restore of right cardiac morphologic injury.</p>
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Adolescent , Adult , Humans , Male , Young Adult , Adaptation, Physiological , Altitude , Altitude Sickness , Metabolism , Case-Control Studies , Heart , Heart Function Tests , MyocardiumABSTRACT
Background Haze formation is a key factor of vision reduce following corneal refractive surgery.Transforming growth factor-β1 (TGF-β1) and α-smooth muscle actin (α-SMA) are documented to participate in haze formation.Laboratory study showed that bevacizumab can not only inhibit corneal neovascularization,but also promote the healing of corneal epithelial basement membrane.However,the impact of bevacizumab on corneal healing after Off-flap epipolis laser in situkeratomileusis (Off-flap Epi-LASIK) is unclear.Objective The present study was to investigate the inhibition effect of bevacizumab on corneal haze after off-flap Epi-LASIK and its active mechanism.Methods Off-flap Epi-LASIK was performed in 24 adult pigmented rabbits and these rabbits were randomized into three groups.Bevacizumab of 0.1 ml (2.5 mg) was subconjunctivally injected 10 minutes after surgery in 16 rabbits and the same amount of bevacizumab was repeatedly injected 4 days after the initial injection in 8 eyes of 16 eyes.In addition,equivalent amount of normal saline solution was used in the same way in the other 8 rabbits.Another 2 health rabbits were used as the blank controls.Operative eyes were examined by slit lamp biomicroscope daily after surgery and haze was scored based on SundarRayde criteria.Corneas were obtained 4 weeks after operation for hematoxylin & eosin and periodic acid Schiff staining.Expressions of TGF-β1 and α-SMA in corneal tissue were detected by immunochemistry.Results Corneal epithelium healed completely in all eyes 4-5 days after operation.The haze scores were lower in the bevacizumab single injection group and repeat injection group than those in the normal saline solution group (P<0.05) in 1 week and 4 weeks after operation.However,no significant difference was seen in the haze scores between the bevacizumab single injection group and repeat injection group (P > 0.05).The hostopathological examination showed that the fibrosis response of cornea tissue was slight in the bevacizumab single injection group and repeat injection group comparison with the normal saline solution group.At 1 week after operation,the expression levels of TGF-β1 were (49.8 ± 2.1) PU and (38.6 ±4.4) PU in the bevacizumab single injection group and repeat injection group,and those of 4 weeks were (37.7 ±4.8) PU and (28.3 ± 3.5) PU,indicating significant decrease in the TGF-β1 expression compared with (65.1 ±5.3) PU and (51.6±2.2) PU of the normal saline solution group in both 1 week and 4 weeks (P<0.01).The expression levels of α-SMA in corneas were (67.2±10.0) PU and (32.7±3.1) PU at 1 week,and (34.2±5.7) PU and (22.8±3.0) PU at4 weeks after operation in the bevacizumab single injection group and repeat injection group,which were significantly lower than (87.8±7.7) PU and (59.4±5.6) PU in the normal saline solution group in both 1 week and 4 weeks (P<0.05).Meanwhile,the expression levels of TGF-β1 and α-SMA were declined in the bevacizumab repeat injection group compared with single injection group (P<0.01).Periodic acid Schiff staining exhibited that the basement membrane of cornea was intact and continued in bevacizumab injection group.But corneal basement membrane was discontinuous in the normal saline solution group.Conclusions Subconjunctival injection of bevacizumab downregulates the expressions of TGF-β1and α-SMA in cornea after Off-flap Epi-LASIK and thus prevents haze formation.
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Background The accuracy of biometric measurement is critical for precise diagnoses and prognosis evaluation of ocular diseases.Objective The present study was to evaluate the differences of Lenstar with A-scan ultrasound biometry or keratometer in ocular bio-measurement.Methods Written informed consent was obtained from each subject before examination.Total 43 eyes of 40 age-related cataract patients were enrolled in this study.Axial length,corneal curvature (K1,K2,Km) and intraocular lens (IOL) power were measured with Lenstar,A-scan ultrasound biometry and keratometer,separately.The differences of measuring outcomes were compared between these two methods according to a paired samples t test,and the agreement analysis of measuring outcomes between Lenstar and A-scan ultrasound biometry or keratometer was performed by Blant-Altman plots.Results Thirty-five eyes finished the clinical bio-measurement.The axial length was (23.341 ± 1.208) mm and (23.268 ±1.157)mm based on Lenstar method and A-scan ultrasound biometry method,respectively,with a insignificant difference between them(t =0.260,P=0.796).No significant differences were found in the K1,K2 and Km values between Lenstar and keratometer methods (t =0.526,P =0.601 ; t =0.927,P =0.357 ; t =0.213,P =0.832).The IOL power was (20.371 ±2.827) D and (20.729 ± 2.672) D,respectively in Lenstar method and keratometer method,without statistically significant difference between them (t =0.543,P =0.589).Bland-Altamn agreement analysis showed that the dots of 11% (4/35),0% (0/100),9%(3/35),9% (3/35),6% (2/35) were out of 95% confidence limit,and the absolute values of maximal difference value between Lenstar and A-scan ultrasound biometry or keratometer methods was 0.39 mm,1.31 D,1.30 D,0.77 D and 1.00 D in ocular axial length,K1,K2 and Km values and IOL power,respectively.Conclusions As a new bio-measuring method,Lenstar can offer multiple biometric parameters by single procedure.However,an inconsistent measuring outcome is seen between Lenstar and Ascan ultrasound biometry or keratometer.So whether Lenstar can replace A-scan ultrasound biometry or keratometer still need further large simple clinical trail.
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<p><b>OBJECTIVE</b>To discuss the method for repairing the circular scar in the forearm.</p><p><b>METHODS</b>Large expander (400-600 ml) were implanted subcutaneously at the rear flank of bottom-waist in the way of overlapping or continued expansion. After expansion was completed, the horizontal opened omega-shaped flap was formed by advancement of expanded skin with the two pedicles at the two sides. Then the forearm was tunneled under flap with the wound covered by flap. The pedicles were cut off at the third stage.</p><p><b>RESULTS</b>From April 1998 to June 2009, 8 cases were treated with no flap necrosis. The patients were followed up for 1 to 3 years with good flap color and thickness. Flap sensory was partially recovered. Linear atrophic scar was left in the donor sites.</p><p><b>CONCLUSIONS</b>It is feasible to repair forearm circular scar by expanded double-pedicle omega-shaped flap at the rear flank of bottom-waist.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Cicatrix , General Surgery , Follow-Up Studies , Forearm , General Surgery , Surgical Flaps , Tissue Expansion , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To assess the effect of oxidative stress in development of acute high altitude response (AHAR) during the process of strong physical work at high altitude and its change after return to lower altitude.</p><p><b>METHODS</b>Ninety-six officers and soldiers of rapid entering into high altitude (3 700 m) with strong physical work were analyzed, all subjects were male, aged 18-35 years. According to the symptomatic scores of AHAR were divided into 3 groups: severe AHAR (group A, n = 24), mild AHAR (group B, n = 47) and without AHAR (group C, n = 25). Levels in serum 8-iso prostaglandinF2alpha(8-iso-PGF2alpha), superoxide dismutase (SOD) and malonaldehyde (MDA) were measured at higher altitude stayed 50 d and after return to lower altitude (1 500 m) 12 h and 15 d, and 50 healthy volunteers (group D) at 1 500 m altitude served as controll.</p><p><b>RESULTS</b>Levels of serum 8-iso-PGF2alpha and MDA [(9.53 +/- 0.47) microg/L, (8.91 +/- 0.39) micromol/L] were significantly higher in group A than those in group B [(8.34 +/- 0.42) microg/L, (7.31 +/- 0.32) micromol/L] , group C [(7.02 +/- 0.48) microg/L, (6.41 +/- 0.23) micromol/L] and group D [(5.13 +/- 0.56) microg/L, (5.48 +/- 0.33) micromol/L], (all P < 0.01), and serum SOD [(52.08 +/- 3.44) micro/ml] was significantly lower in group A than that in group B [62.27 +/- 2.54) micro/ml], group C [(71.99 +/- 3.35) micro/ml] and group D [(80.78 +/- 3.44) micro/ ml] (all P < 0.01), there were significant differences between group B and C, C and D (all P < 0.01). At altitude 3 700 m 50 d, AHAR scores was positively correlated with serum 8-iso-PGF2alpha and MDA (all P < 0.01), negatively correlated with SOD (P < 0.01). Serum 8-iso-PGF2alpha and MDA were negatively correlated with SOD (all P < 0.01). Levels of serum 8-iso-PGF2alpha and MDA were significantly higher at altitude of 3 700 m 50 d than those at altitude of 1 500 m 12 h,15 d in group D (all P < 0.01), and serum SOD was significantly lower than that at 1 500 m 12 h,15 d in group D (all P < 0.01), there were significantly difference between at 1 500 m 12 h and 15 d (all P < 0.01), there were no difference between at 15 d in group D (all P > 0.05).</p><p><b>CONCLUSION</b>The more serious of oxidative stress and oxidative/antioxidative imbalance, the more serious of AHAR, oxidative stress and oxidative/antioxidative imbalance may be involved in the development of AHAR. The changes were obviously improved after return to lower altitude 12 h, and recovered to normal after 15 d.</p>
Subject(s)
Adolescent , Adult , Humans , Male , Young Adult , Altitude , Altitude Sickness , Oxidative Stress , Physiology , Physical Exertion , PhysiologyABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of removing dampness and promoting diuresis method on autoimmune and immuno-inflammatory response caused by nucleus pulposus of rats, in order to provide the basis for the treatment of lumbar disc herniation with Chinese medical immunotherapy.</p><p><b>METHODS</b>Forty male Wistar rats were divided into 4 groups randomly according to body weight layer:sham operation group (group A), model contrast group (group B), colchicine tablets group (group C), modified Qingyao decoction group (group D). There were 10 rats in each group. Nucleus pulposus of coccygeal vertebra was transplanted to the gluteal muscle by operation in groups B, C, D, which can lead to autoimmune and immuno-inflammatory response of rats; the rats of group A were only treated with sham operation. At the 3rd day after operation, the rats were fed through intragastric administration, the group A and B with distilled water (10 ml/kg), the group C and D respectively with suspension of colchicine tablets (10 ml/kg, 0.01 mg/ml) and water-decocted liquid of modified Qingyao decoction (10 ml/kg,1.035 g/ml), once a day and continuous medication for 18 days. All rats were killed at the 21th day after operation. The immunoglobulin G (IgG), immunoglobulin M (IgM) and interleukin-1beta (IL-1beta), interleukin-8 (IL-8) level in serum of different groups were detected by ELISA method. At the same time, surrounding tissues of the transplanted nucleus pulposus were observed by pathological section.</p><p><b>RESULTS</b>The level of IgG, IgM, IL-1beta, IL-8 in serum of group B was significantly higher than that of group A (P < 0.01), while the level of IgG, IgM, IL-1beta, IL-8 in serum of group C, D was significantly lower than that of group B (P < 0.05 or P < 0.01). Moreover, pathological section indicated that immuno-inflammatory response was hardly found in surgical site of group A, while local immuno-inflammatory response of surrounding tissues of the transplanted nucleus pulposus of group C and D was much lighter than that of group B.</p><p><b>CONCLUSION</b>Removing dampness and promoting diuresis method could inhibit autoimmune and immuno-inflammatory response caused by nucleus pulposus of rats.</p>