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OBJECTIVE To establish the characteristic chromatogram of the volatile oil in the standard decoction of Qingshang juantong decoction， and preliminarily infer the main active components of volatile oil that affect the clinical therapeutic effect. METHODS The volatile oil in the standard decoction of Qingshang juantong decoction was extracted by steam distillation. The ultra-high performance liquid chromatography （UPLC） characteristic chromatograms of 15 batches of samples were established by the Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）， and the similarity evaluation was carried out. The volatile oil of standard decoction was identified by UPLC coupled with quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF/MS）. Then the volatile oil components were analyzed by GC-MS. RESULTS The similarities of UPLC characteristic chromatograms for volatile oil of 15 batches of Qingshang juantong decoction were between 0.949 and 0.997. A total of 12 common peaks were obtained. According to the UPLC-Q-TOF/MS， the main components were methyl eugenol， E-ligustilide， E-butylidenephthalide and so on. A total of 23 components were identified by GC-MS， which were mainly 3，4，5-trimethoxy- methylbenzene， patchouli alcohol， Z-ligustilide and so on. CONCLUSIONS The characteristic chromatograms of the volatile oil in the standard decoction of Qingshang juantong decoction is established， and it is inferred that methyl eugenol， ligustilide， E- butylidenephthalide， patchouli alcohol， 3，4，5-trimethoxy-methylbenzene might be the main active components affecting the clinical therapeutic effect of the volatile oil of Qingshang juantong decoction.
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Objective To investigate the role of KAT7 in cartilage cell and tissue ageing by establishing an over-replicating-induced primary mouse cartilage cell ageing model and a mouse natural ageing model.Methods Chon-drocytes of the mouse knee joint were obtained by type Ⅱ collagenase digestion and identified by toluidine blue stai-ning and Col Ⅱ staining.The age-related proteins and KAT7 expression levels in cartilage cells from different gener-ations of mice were discovered using Western blot and cellular immunofluorescence techniques,and the aging of the cells was assessed by SA-β-Gal coloring.The pathological alterations were examined in the joints of 22-month-old mice compared to 2-month-old mice using HE staining and safranin O-solid green staining.Additionally,immuno-histochemical analysis was done to observe the expression of KAT7 and p53 in mouse joint tissue.Results Com-pared with the control group,the expression levels of KAT7 protein and p21 and p53 in aged mouse chondrocytes significantly increased.WM-3835,a commonly inhibitor of KAT7 that possess the capacity on halting the protein expression procedure of gene KAT7 as well as p21 in ageing chondrocytes.SA-β-Gal staining showed a significant increase in positive staining of chondrocytes in the eighth generation(P8)compared to the first generation(P1).Compared with the cartilage tissue of young mice,the cartilage tissue of elderly mice presents a near-bone distribu-tion,with a decrease in cartilage surface integrity,a significant increase in the number of hypertrophic chondro-cytes,and more KAT7 and p53 cells that were positive.Conclusion The expression of KAT7 increases in the ageing chondrocytes and the cartilage tissue of ageing mice,reveales the potential significance of KAT7 correlated to cellular aging process in cartilage.
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Bisphenol A (BPA) is widely used to produce epoxy resin and polycarbonate plastic products. In severe cases, these plastics may release BPA, which then infiltrates into the environment. Various concentrations of BPA have been found in most biological fluid. Its presence has been well shown to be closely related to many chronic diseases, including chronic kidney disease (CKD). However, little is known regarding the adverse effects of BPA exposure and its succedent cellular events on CKD. Hence, in the current in vivo study, we aimed to assess the effects of chronic exposure to BPA on animal nephrotoxicity through investigating oxidative stress and apoptosis. Upon exposure to BPA at 0.01, 0.1, and 1 mg/L via drinking water for four weeks, the mated and pregnant females were continuously exposed to BPA until weaning. Subsequently, three weeks old F1-male neonates were also orally challenged with the same three doses of BPA for ten weeks. The results showed that the kidneys of 0.1 and 1 mg/L BPA-treated mice were seriously damaged; the contents of serum renal function indexes and lipid peroxidation products were significantly increased, including urea nitrogen, creatinine, uric acid, and thiobarbituric acid reactive substances; the morphological structure of mouse kidneys was impaired; the expressions of antioxidant-related genes at mRNA and protein levels from mouse kidneys were markedly diminished, including glutathione-S-transferase, superoxide dismutase, and catalase; the expressions of genes and proteins related to apoptosis index (ratio of Bax/Bcl-1 and Caspase-3) were significantly enhanced. The data manifested that cumulative oxidative stress and apoptosis might play an essential role in the animal nephrotoxicity induced by chronic exposure to BPA.
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Female , Male , Mice , Animals , Oxidative Stress , Antioxidants , Apoptosis , Renal Insufficiency, ChronicABSTRACT
Objective To study the chemical constituents from the herbs of Dendrobium crepidatum and identify its antitumor bioactive compounds.Methods The constituents were extracted by methyl alcohol and isolated by CC and Sephadex LH-20.Their structures were identified by spectroscopic analysis(1H NMR,13CNMR and EIMS).The antitumor activity of the constituents was determined by MTT assay in vitro.Results 9 compouds were obtained and identified as p-hydroxybenzaldehyde(1),p-methoxyphenol(2),p-Hydroxybenzyl alcohol(3),hydroquinone(4),(24R)-ethylcholest-5-en-3-ol-7-one(5),sinalexin(6),bis(2-ethylhexyl)benzene-1,2-dicarboxylate(7),pinoresinol(8),Chaenomin B(9).The antitumor activity of compounds 5～9 was tested,and it was found that compound 9 had good inhibitory activity against A549 cell line.Conclusion Compounds 2～5,7～8 were isolated from the herbs for the first time and compounds 6,9 were isolated from this genus for the first time.IC50 of 9 on A549 cell line is 29.35 μM.
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Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.
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Objective:To retrieve, evaluate and summarize the best evidence of exercise reversal intervention in the elderly with cognitive frailty, and to provide evidence for guiding exercise in elderly patients.Methods:This study was a summary of evidence-based nursing evidence. Based on the PIPOST (P: Population; I: Intervention; P: Professional; O: Outcome; S: Setting; T: Type of evidence) mode, the evidence of exercise reversal intervention in the elderly with cognitive frailty in 25 relevant guideline network and association websites, Chinese and foreign language comprehensive databases such as PubMed, CINAHL, Web of Science, Embase, Chinese Biomedical Database, China National Knowledge Internet and others were searched, extracted and integrated. The retrieval time was from January 1, 2013 to February 14, 2022.Results:A total of 22 articles were included, including 3 guidelines, 2 expert consensuses, 1 clinical decision-making, 1 evidence summary, 9 Meta analysis, and 6 randomized controlled trials. Finally, 28 pieces of the best evidence including 7 dimensions were namely formulate principles,overall assessment, exercise mode, exercise intensity, exercise time and frequency, exercise management, health guidance.Conclusions:This study summarized the best evidence of exercise intervention in the elderly with cognitive frailty, which are systematic, comprehensive, rigorous, and reliable. It can provide references for healthcare administrators to dynamically evaluate patients′cognitive frailty status, formulate personalized exercise programs, and standardize exercise guidance for patients, so as to delay or even reverse cognitive frailty.
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Objective:To develop and validate a nomogram model for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on preoperative enhanced computed tomography imaging features and clinical data.Methods:The clinical data of 210 patients with HCC undergoing surgery in the Second Affiliated Hospital of Anhui Medical University from May 2018 to May 2022 were retrospectively analyzed, including 172 males and 38 females, aged (59±10) years old. Patients were randomly divided into the training group ( n=147) and validation group ( n=63) by systematic sampling at a ratio of 7∶3. Preoperative enhanced computed tomography imaging features and clinical data of the patients were collected. Logistic regression was conducted to analyze the risk factors for HCC with MVI, and a nomogram model containing the risk factors was established and validated. The diagnostic efficacy of predicting MVI status in patients with HCC was assessed by receiver operating characteristic (ROC) curve, calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC) of the subjects in the training and validation groups. Results:The results of multifactorial analysis showed that alpha fetoprotein ≥400 μg/ml, intra-tumor necrosis, tumor length diameter ≥3 cm, unclear tumor border, and subfoci around the tumor were independent risk factors predicting MVI in HCC. A nomogram model was established based on the above factors, in which the area under the curve (AUC) of ROC were 0.866 (95% CI: 0.807-0.924) and 0.834 (95% CI: 0.729-0.939) in the training and validation groups, respectively. The DCA results showed that the predictive model thresholds when the net return is >0 ranging from 7% to 93% and 12% to 87% in the training and validation groups, respectively. The CIC results showed that the group of patients with predictive MVI by the nomogram model are highly matched with the group of patients with confirmed MVI. Conclusion:The nomogram model based on the imaging features and clinical data could predict the MVI in HCC patients prior to surgery.
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This study aims to explore the impact of Rehmannioside D (RD) on ovarian functions of rats with diminished ovarian reserve (DOR) and its underlying mechanisms of action. A single injection of cyclophosphamide was performed to establish a DOR rat model, and fourteen days after the injection, the rats were intragastrically administrated with RD for two weeks. Rat estrus cycles were tested using vaginal smears. Ovarian tissues were histologically evaluated, the number of primordial, mature, and atretic follicles was calculated, and the apoptotic rate of granulosa cells. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2 ) levels were determined by ELISA assays. Protein levels of Forkhead Box O1 (FOXO1), KLOTHO, Bcl-2, and Bax were investigated in ovarian tissues of DOR rats. The binding between FOXO1 and KLOTHO was verified by ChIP assay. High-dose administration of RD into DOR rats improved their estrus cycles, increased ovarian index, enhanced the number of primordial and mature follicles, reduced the number of atretic follicle number, and ovarian granulosa cell apoptosis in addition to inhibiting FSH and LH levels and upregulating E2 expression. FOXO1 and KLOTHO were significantly suppressed in DOR rats. FOXO1 knockdown partially suppressed the protective effects of RD on DOR rats, and KLOTHO overexpression could restore RD-induced blockade of DOR development despite knocking down FOXO1. FOXO1 antibody enriched KLOTHO promoter, and the binding between them was reduced in DOR group compared to that in sham group. RD improved ovarian functions in DOR rats and diminished granulosa cell apoptosis via the FOXO1/KLOTHO axis.
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Objective To analyze the characteristics of work-related musculoskeletal disorders (WMSDs) among sonographers in Guangdong Province, and to explore the disease pattern of the cases. Methods A total of 512 sonographers from 31 hospitals in Guangdong Province were selected as the research subjects using stratified cluster sampling method. The prevalence of WMSDs in the past year was investigated using the Musculoskeletal Disorders Questionnaire, and the characteristics of WMSDs were analyzed. Latent class analysis was used to identify the disease pattern of WMSDs. Results The overall prevalence of WMSDs was 94.3%. The top five affected body parts were right shoulder, neck, right hand/wrist, lower back and right forearm/elbow, with the prevalence of 80.3%, 75.4%, 61.1%, 55.5% and 45.3%, respectively. The prevalence of WMSDs was higher on the right side for the shoulder, hand/wrist, forearm/elbow, hip/leg and knee compared with the left side (80.3% vs 31.3%, 61.1% vs 13.9%, 45.3% vs 10.0%, 17.4% vs 8.6%, 13.1% vs 8.4%, all P<0.05). The prevalence of WMSDs increased with work years, as well the prevalence of WMSDs in the top five affected body parts among the sonographers (all P<0.05). However, there were no statistical differences in prevalence of WMSDs between general hospitals and maternal and child health hospitals, tertiary hospitals and non-tertiary hospitals, Pearl River Delta hospitals and non-Pearl River Delta hospitals; there was also no statistical difference between different genders and age groups of the sonographers (all P>0.05). The best-fit latent disease pattern for sonographers WMSDs comprised three categories： symptom of neck-right shoulder, symptom of neck-lower back-right shoulder-right elbow-right hand/wrist, and symptom of multi-parts above the knees, with the latent probabilities of 0.438, 0.427 and 0.135, respectively. Conclusion The prevalence of WMSDs in sonographers is extremely high, with a dose-effect relationship with work years. The most common affected parts are neck, lower back and right shoulder, right hand/wrist, and right forearm/elbow. The prevalence of WMSDs in the right side of limb was higher than that in the left. WMSDs primarily occur in multiple parts simultaneously. The most common symptoms occur in the neck-right shoulder and neck-lower back-right shoulder-right elbow-right hand/wrist.
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Background As a group of environmental pollutants, polycyclic aromatic hydrocarbons (PAHs) are neurotoxic and may cause mild cognitive impairment (MCI) by inducing inflammation. Whether neutrophil-lymphocyte ratio (NLR), an inflammatory indicator, plays a mediating role in the relationship between PAHs exposure and MCI is unclear yet. Objective To investigate a potential mediating role of NLR in the association between exposure to PAHs and MCI in coke oven plant workers. Methods Eleven urine hydroxylated PAHs (OH-PAHs) of 530 coke oven plant workers were determined by high performance liquid chromatography tandem mass spectrometry. NLR was derived from participants' routine blood examination results using a fully automated haematology analyser. The associations between urinary OH-PAHs and MCI were analyzed by binary logistic regression, the associations between urinary OH-PAHs and NLR were analyzed by multiple linear regression, and the role of NLR in the relationship between urinary OH-PAHs and MCI was evaluated by mediating effect analysis. Results After controlling for confounding factors and other OH-PAHs, the results of binary logistic regression showed that for every e-fold (e is the base of the natural logarithm) increase in the concentration of 2-hydroxynaphthalene (2-OHNap) and 1-hydroxyphenanthrene (1-OHPhe), the OR (95%CI) values of reporting MCI positive were 1.21 (1.02, 1.43) and 1.25 (1.04, 1.51) respectively. For each unit increase of NLR, the OR (95%CI) of reporting MCI positive was 1.56 (1.12, 2.18). The results of multiple linear regression showed that each unit increase in natural log-transformed levels of 1-OHPhe was associated with 0.05 (95%CI: 0.01, 0.10) increase of NLR. The results of mediating effect analysis showed that the association between urinary 1-OHPhe and MCI was partially mediated by peripheral blood NLR, with a mediation ratio of 9.8%. Conclusion Exposure to PAHs in coke oven plant workers may increase the risk of reporting MCI positive partially through increased NLR in peripheral blood.
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Objective:To investigate the effect of ultrasound-guided lumbar quadratus muscle plane block combined with general anesthesia on the analgesic effect during and after laparoscopic colon cancer radical surgery in elderly patients.Methods:A prospective study was conducted on 61 elderly patients who underwent radical colon cancer surgery at the Changsha Central Hospital Affiliated to South China University from May 2022 to February 2023, with American Society of Anesthesiologist (ASA) grades Ⅱ to Ⅲ. They were randomly divided into SA and GA groups using a random number table method, with 31 patients in the SA group and 30 patients in the GA group. The SA group received ultrasound-guided plane block of the upper lumbar quadratus muscle in the arcuate ligament combined with general anesthesia, while the GA group received simple general anesthesia. Record the mean artery pressure (MAP) and heart rate (HR) of two groups of patients at the time of entering the operating room (T 0), 5 minutes before skin incision (T 1), at skin incision (T 2), 30 minutes after surgery (T 3), at surgery end (T 4), and during anesthesia resuscitation and extubation (T 5); The Visual Analogue Scale (VAS) of two groups of patients at T 5, upon returning to the ward (T 6), 6 hours (T 7), 12 hours (T 8), 24 hours (T 9), and 48 hours (T 10) after surgery were recorded; The dosage of sufentanil, remifentanil, and propofol used during surgery, anesthesia recovery time, total number of analgesic pump presses within 48 hours after surgery, Lovett muscle strength score, early postoperative recovery, and adverse reactions within 48 hours after surgery were also recorded. Resultsl:The MAP and HR of the SA group were lower than those of the GA group at T 1-5 (all P<0.05); The VAS score of the SA group was lower than that of the GA group at T 5-10 (all P<0.05); The intraoperative dosage of propofol, remifentanil, and sufentanil in the SA group was lower than that in the GA group (all P<0.05); The anesthesia recovery time and first time out of bed in the SA group were earlier than those in the GA group (all P<0.05); The total number of times the analgesic pump was pressed within 48 hours after surgery was less than that of the GA group ( P<0.05); The incidence of nausea and vomiting within 48 hours after surgery in the SA group was lower than that in the GA group ( P<0.05). There was no statistically significant difference in postoperative Lovett muscle strength score, hospital stay, and dizziness incidence between the two groups of patients (all P>0.05). Conclusions:Ultrasound-guided lumbar quadratus muscle plane block on the arcuate ligament can significantly reduce the dosage of intraoperative general anesthesia drugs and postoperative analgesics in elderly patients undergoing laparoscopic colon cancer surgery, reduce postoperative pain scores, effectively alleviate postoperative pain, and thus advance the patient′s first time out of bed activity, reduce postoperative complications, and promote rapid recovery.
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The blood flow in the aortic arch and branch vessels in vitro is simulated,and the blood model is optimized with a non-Newtonian model.A numerical simulation analysis is conducted based on bidirectional fluid-solid coupling to analyze the hemodynamic characteristics(blood flow velocity,vascular wall pressure and vascular wall stress)in a cardiac cycle,and discuss their relationships with the formation of aortic dissection.It is concluded that the long-term existence of"chaotic"blood flow distribution in the blood vessel and the sudden changes of wall pressure and wall stress are liable to cause changes in the structure and function of the cells of the arterial wall,and ultimately induce the formation of aortic dissection.The study provides a more reliable basis for medical diagnosis,and further protects the life,health and safety of patients.
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Objective @# To study the protective effect and mechanism of iPSC⁃MSCs on cartilage matrix in knee oste⁃ oarthritis (KOA) patients in vitro. @*Methods @#Cartilage tissues removed from KOA patients with joint replacement surgery were collected and subjected to tissue and cellular experiments , respectively. Cartilage tissue was cut into small pieces and randomly divided into a control group , an IL⁃1β ( 10 ng/ml) induction group , and iPSC⁃MSCs 96 h and then co⁃cultured with different amounts of iPSC⁃MSCs ( 1 × 104 , 1 × 105 , 1 × 106 ) cells for 72 h. For in tissues , the pathological changes of isolated cartilage tissues were examined by HE staining. The levels of ADAMTS⁃4 , ADAMTS⁃5 , and type II collagen expression were analyzed by immunohistochemistry , while the levels of MMP13 , IL⁃6 , and IL⁃10 in culture supernatants were detected by ELISA kits. The 2 to 5 generations of chondrocytes , which were extracted from cartilage tissue of KOA patients , were stimulated with IL⁃1β ( 10 ng/ml) for 48 h and then co⁃cultured with different concentrations of iPSC⁃MSCs ( 1 × 104 , 1 × 105 , 1 × 106 ) cells for 72 h. Immunofluorescence and Western blot detected the expression of RUNX2 , ADAMTS⁃4 , and ADAMTS⁃5 in chondrocytes. @*Results @#Comparison with the control group , in the IL⁃1β⁃induced group , the levels of RUNX2 , ADAMTS⁃4 , and ADAMTS⁃5 increased , the level of type II collagen decreased , the levels of MMP⁃13 and IL⁃6 in the culture supernatant increased ( P < 0. 05) , and the level of IL⁃10 decreased ( P < 0. 05) ; Compared with the IL⁃1β⁃induced decreased the expression of RUNX2 , ADAMTS⁃4 , and ADAMTS⁃5 , promoted type II collagen expression and elevated IL⁃10 levels. @*Conclusion @#iPSC⁃MSCs inhibited ADAMTS⁃4 and ADAMTS⁃5 expression in vitro , reduced cartilage extracellular matrix degradation , and played a role in articular cartilage protection.
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Objective:To investigate the outcome of asthma in young children after 3 years and the factors associated with the outcome.Methods:A total of 494 children aged 2 to 5 years with asthma diagnosed in 5 hospitals in Beijing from 2016 to 2017 were followed up by telephone using questionnaire survey.Information on the asthma attack, the disease control level, and the comorbidities of allergic diseases in the past 3 years was collected and analyzed.Results:Questionnaires were conducted in 387 children, including 261 males(67.4%)and 126 females(32.6%). Two hundred and forty-six patients(63.6%)had no any asthma symptom(remission) within 3 years, while 141 patients(36.4%)were found with asthma symptom(without remission). The main symptoms were as follows: wheezing in 116 cases(82.3%), recurrent cough in 59 cases(41.8%), shortness of breath in 45 cases(31.9%), chest tightness or waking up at night due to wheezing in 22 cases(15.6%). The causes of asthma attack were respiratory tract infection in 80 cases(56.7%), allergen exposure in 46 cases(32.6%), climate change or cold air stimulation in 59 cases(41.8%), strenuous exercise in 36 cases(25.5%), and irritating odor in 3 cases(2.1%). One-way anova analysis showed that significant difference( P<0.05)was respectively observed in age at follow-up, postnatal tobacco smoke exposure history, repeated respiratory tract infection before asthma onset, personal allergy history, snoring, allergic rhinitis, allergic rhinitis within 1 year, allergic conjunctivitis within 1 year between the remission group and without remission group.Multivariate unconditional logistic regression analysis showed that tobacco exposure after birth, allergic rhinitis and allergic conjunctivitis within 1 year were independent risk factors for the continuation of asthma symptoms to school age( P<0.05). Conclusion:Till the school age, more than 1/3 children still had asthma symptom and the risk factors for the unalleviated symptom were postnatal tobacco exposure, allergic rhinitis within 1 year and allergic conjunctivitis within 1 year.
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Objective:To investigate the analgesic effect of ultrasound-guided pericapsular nerve group (PENG) block combined with laryngeal mask general anesthesia and internal fixation of proximal femoral nail antirotation (PFNA) under ERAS concept in elderly patients.Methods:A total of 50 elderly patients with femoral trochanteric fractures treated with PFNA internal fixation who were admitted to Changsha Central Hospital from January 2021 to March 2022 were selected and according to the random number table method, they were divided into groups P and F, with 26 cases in group P (ultrasound-guided PENG block combined with laryngeal mask general anesthesia group) and 24 cases in group F [ultrasound-guided fascia iliaca compartment block (FICB)] combined with laryngeal mask general anesthesia group]. The bispectral index (BIS) of the two groups of patients was maintained within the range of 40-60, and the dosage of cyclopofol and remifentanil was adjusted according to the BIS and hemodynamic changes. Postoperative oxycodone was used for patient controlled intravenous analgesia (PCIA). When the Visual Analogue Scale (VAS) score ≥4, 1 mg intravenous oxycodone was administered as rescue analgesia. The VAS score was observed and recorded before nerve block (T 0), 10 minutes after nerve block (T 1), 20 minutes after nerve block (T 2), when the patients were placed in body position after bed (T 3), after laryngeal mask removal (T 4), 12 h after operation (T 5), 24 h after operation (T 6) and 48 h after operation (T 7). The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO 2) at each time point from T 0 to T 4 were observed and recorded; the intraoperative dose of remifentanil, the rescue dose of oxycodone at postoperative T 6 and T 7, Lovett muscle strength score, anesthesia operation time, anesthesia recovery time and postoperative anesthesia-related complications were recorded. Results:There was no significant difference between the two groups in VAS scores at T 0, T 4, T 5 and T 6, MAP, HR and SpO 2 at T 0, T 1, T 2 and T 4, the dosage of remifentanil during operation, the remedial dosage of oxycodone at T 6 after operation, anesthesia operation time and anesthesia recovery time (all P>0.05). Compared with group F, the VAS scores of group P at T 1, T 2, T 3 and T 7 were lower than those of group F (all P<0.05); At T 3, there was no significant difference in SpO 2 between the two groups ( P>0.05), but the MAP and HR in group P was lower than that in group F (all P<0.05); The remedial dose of oxycodone at T 7 in group P was lower than that in group F ( P<0.05), and the analgesic effect was longer; Lovett muscle strength score at T 6 and T 7 in group P was better than that in group F (all P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusions:Compared with FICB, ultrasound-guided PENG block used in PFNA internal fixation in elderly patients has faster effect, lower dosage of opioid analgesics, longer duration of analgesia, and less impact on postoperative lower limb muscle strength.
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Undifferentiated connective tissue disease (UCTD) has clinical and laboratory characteristics of connective tissue disorders, but it can not meet the diagnostic criteria of any specific disease. Pregnancy complicated with UCTD is one of the most common rheumatic diseases in women of childbearing age. UCTD will increase the risk of adverse events of pregnancy, such as spontaneous abortion, preeclampsia, fetal growth restriction, small for gestational age,recurrent implantation failure and so on. Pregnancy may lead to recurrence, aggravation and even serious complications of UCTD; multidisciplinary monitoring and appropriate treatment can improve the pregnancy outcome.
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Objective:To investigate the relationship between the concentration of soluble platelet-derived growth factor receptor β (sPDGFRβ) in the cerebrospinal fluid (CSF) of patients with Alzheimer′s disease (AD) and the degree of cognitive impairment and cerebrospinal fluid biomarkers.Methods:A total of 50 patients with AD in the Department of Neurology of Provincial Hospital Affiliated to Anhui Medical University from September 2018 to August 2020 were selected as AD group, and 33 patients with normal cognition who had no significant difference in age and gender in the same period served as control group. The neuropsychological evaluation was conducted. According to the Clinical Dementia Rating scale scores, the AD patients were divided into mild AD group and moderate to severe AD group.The clinical data and cognitive function of the three groups were compared. And the level of CSF sPDGFRβ, CSF amyloid-β (Aβ) 1-40, CSF Aβ 1-42, CSF total tau protein (T-tau), CSF phosphorylated tau protein (P-tau) were measured by enzyme linked immunosorbent assay in each group. According to whether apolipoprotein E4 (ApoE4) gene was carried, the patients with AD were divided into ApoE4 + group and ApoE4 - group. Differences among the three groups were compared and the correlation analysis was carried out. Results:The levels of sPDGFRβ in the CSF of the mild AD group [(219.301±69.711) pg/ml] and the moderate to severe AD group [(235.358±86.187) pg/ml] were significantly higher than that of the control group [(184.878±52.944) pg/ml, F=3.90, P=0.024], while there was no significant difference in the level of CSF sPDGFRβ between the ApoE4 + group [(219.493±76.745) pg/ml] and the ApoE4 - group [(222.802±81.665) pg/ml, t=-0.13, P=0.900]. And the level of sPDGFRβ in the CSF in the mild AD group was positively correlated with the level of CSF P-tau ( r=0.43, P=0.019), but not correlated with Aβ 1-42, T-tau, Mini-Mental State Examination scores or Montreal Cognitive Assessment scores, whereas no significant correlation was found in the control group and the moderate to severe AD group. Conclusions:Expression of sPDGFRβ in CSF of AD patients is increased, and may relate to P-tau. Pericyte injury may be involved in the phosphorylation of tau protein in the brain of AD patients.
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Objective:To explore the clinical value of peripheral remnant lipoproteins (RLP), low density lipoprotein cholesterol particle (LDL-P) and sdLDL particle (sdLDL-P) measurement in the diagnosis of carotid plaque, so as to provide practical basis for the accurate diagnosis of carotid plaque and the control of carotid plaque related cardiovascular and cerebrovascular diseases.Methods:People who underwent carotid plaque ultrasound examination in Xingtai Third Hospital , from January 2020 to June 2021 were selected as the research object. According to the ultrasound results, they were divided into carotid plaque group ( n=146) and control group without carotid plaque ( n=149). The fasting RLP, LDL-P and sdLDL-P of the two groups were measured by vertical auto profile (VAP) centrifugal separation phase, and the fasting TG and LDL-C were detected by routine mixed phase method. The indexes were compared between the two groups and the true positive rate, true negative rate, false positive rate and false negative rate of the diagnosis of carotid plaque were analyzed. The receiver operating characteristic curve of each test index was drawn, and AUC was used to evaluate the clinical diagnostic value of each test index for carotid plaque. Results:The levels of RLP, LDL-P and sdLDL-P in carotid plaque group were significantly higher than those in non-carotid plaque group ([1.07±0.36] mmol/L vs [0.59±0.17] mmol/L,[1 300±370] nmol/L vs [781±215] nmol/L,[435±139] nmol/L vs [156±59] nmol/L, all P<0.01). The true positive rate (78.08% [114/146],81.51% [119/146]) and true negative rate (84.56% [126/149], 86.58%[129/149]) of serum RLP and LDL-P for the diagnosis of carotid plaque were significantly higher than TG (58.90%[86/146], 43.62%[65/149]) and LDL-C (59.59% [87/146], 46.98% [70/149]), and the false positive rate (15.44% [23/149], 13.42% [20/149]) and false negative rate (21.92% [32/146], 18.49% [27/146]) were significantly lower than TG (56.38% [84/149], 41.10% [60/146]) and LDL-C (53.02% [79/149], 40.41% [59/146], all P<0.01). The AUC of the ROC curve of RLP (0.890), LDL-P (0.902) and sdLDL-P (0.973) for the diagnosis of carotid plaque was higher than TG (0.682) and LDL-C (0.712). The AUC of ROC curve of the RLP combined with sdLDL-P (0.977) for the diagnosis of carotid plaque was higher than the RLP and sdLDL-P (all P<0.01). Conclusion:The serum RLP, LDL-P and sdLDL-P can be used as indicators of carotid plaque, and their clinical diagnostic value are superior to TG and LDL-C; the combined diagnostic effect of lipoprotein subclass is better than that of single index alone.
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Background As a complex organic pollutant, polycyclic aromatic hydrocarbons (PAHs) exposure shares the common exposure characteristics of multiple hydroxyl metabolites. Most studies have analyzed independent effect of each PAHs metabolite and have adjusted for the potential confounding effects induced by other metabolites concomitantly, without considering possible interactions among them. Proper statistical methods are needed to study their toxic effects. Objective To explore the applicability of logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) in evaluating the correlation between mixed exposures to exogenous chemicals and health outcomes, compare the advantages and limitations of the three models, and propose analytical strategies for evaluating the health effects of mixed chemical exposure for application in the analysis of the association between PAHs exposure and cognition. Methods Urine samples were collected of workers from a coke oven plant and a water treatment plant in Shanxi Province, who participated in their routine employee healthexamination. Mono-hydroxylated PAHs were detected by high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS), cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). A cut-off value of MoCA less than 26 was considered mild cognitive impairment (MCI). According to a predetermined inclusion and exclusion criteria, 1 051 cases were included in the final data analysis. Logistic regression, WQS regression, and BKMR were used to analyze the relationship between PAHs metabolites and MCI. Results The prevalence rate of reporting MCI among the 1 051 workers was 21.7% (228/1 051). The concentration of 2-hydroxynathalene (2-OHNAP) was the highest among the 11 PAHs metabolites with a median concentration of 0.30 μg·L−1, followed by 9-hydroxyphenanthrene (9-OHPHE) (0.26 μg·L−1). There were significant differences between the two groups in 2-OHNAP, 1-hydroxynaphthalene (1-OHNAP), 2-hydroxyfluorene (2-OHFLU), 9-OHPHE, 1-hydroxyphenanthrene (1-OHPHE), and 1-hydroxypyrene (1-OHPYR) (all Ps<0.05). In the logistic regression, 2-OHNAP and 2-OHPHE were associated with MCI, and the OR (95%CI) for reporting MCI was 1.28 (1.01-1.67) and 1.27 (1.00-1.72) for each 10-fold increase in 2-OHNAP and 2-OHPHE concentrations, respectively. In the WQS regression analysis, the WQS index was positively correlated with the prevalence rate of reporting MCI (OR=1.37, 95%CI: 1.10-1.72). In the BKMR analysis, compared with the median exposure levels of all chemicals, the overall effect was statistically significant when all PAHs metabolites concentrations were at or above their 30th percentile; when all exposures were at the 75th percentile, the risk of reporting MCI increased by 6%. Conclusion Based on the results of these three models, 2-OHNAP and 2-OHPHE are the most important factors related to cognitive. It is recommended to use a combination of traditional logistic regression and either WQS or BKMR to study the association between PAHs and MCI.
ABSTRACT
Objective:To evaluate the diagnostic value of multiparametric cardiac magnetic resonance(CMR)or detecting the occurrence of acute rejection(AR)after heart transplantation(HT).Methods:From 2019 to 2021, 44 HT recipients are prospectively recruited from Guangdong Provincial People's Hospital.Another 51 healthy volunteers are recruited from a local community as healthy controls.CMR studies are performed for obtaining baseline parameters.According to the clinicopathological diagnostic criteria of AR by the consensus of International Society for Heart and Lung Transplantation, 81 CMR studies of 44 HT recipients are further divided into two groups of AR (18 cases)and non-AR(71 cases). CMR parameters includ global ventricular structure/function, T2, T1, extracellular volume(ECV)and late gadolinium enhancement(LGE). A combined model is established by binary Logistic regression and receiver operator characteristic curve(ROC)constructed.Results:The age range is(41.8±16.8)years in 44 HT recipients and(41.8±9.7)years in 51 healthy controls.T1 mapping indicated that myocardial global ECV of left ventricle is significantly higher in AR patients than non-AR controls(32.4%±6.0% vs 28.5%±2.4%; P<0.001 9). Global native T1 is higher in AR group than that in non-AR group(49.8±3.1 vs 47.5±2.8 ms, P=0.009)and the difference is statistically significant.The cutoff value of global ECV is 30.62% with a sensitivity of 61% and a specificity of 86% for detecting AR.And T2 mapping reveale that T2 value of global left ventricle is significantly higher in AR group than that in non-AR group(49.8±3.1 vs 47.5±2.8 ms, P=0.009). LGE extent is significantly higher in AR group than those in non-AR group( P=0.004). Through including global native T1 and ECV into a logistic regression model, multiparametric CMR can yield an area under curve(AUC)of 0.794.It hints at the potential of CMR for detecting AR. Conclusions:Multiparametric cardiac magnetic resonance offers an excellent predictive capacity for a noninvasive detection of AR.