ABSTRACT
【Objective】 To investigate the role of LIF/LIFR/STAT3 pathway in endometrial receptivity in rats with polycystic ovary syndrome (PCOS). 【Methods】 Forty 21-day-old SD female rats were divided into normal (control) group, model group, sham-operation group, and LIF group with 10 rats in each. The rat model of PCOS was constructed by subcutaneous injection of prasterone sodium sulfate at the back of the neck. The serum levels of testosterone (T), glucose and insulin in each group were detected. The morphological changes of the uterus in each group were observed by HE staining, and the morphological changes of endometrium were measured. Immunohistochemistry, Western blotting, and Real-time fluorescence quantitative PCR(qRT-PCR) were used to determine the protein expression and mRNA expression of LIF and STAT3 in rat endometrium. 【Results】 Compared with control group, the levels of integrin avb3, serum T, insulin and glucose in PCOS rats were significantly increased (P=0.000, P=0.000, P=0.001). Supplementation of exogenous LIF could significantly reduce the levels of integrin avb3, serum T, glucose and insulin in PCOS rats (P=0.000, P=0.002, P=0.003, P=0.007). HE results showed that exogenous LIF could reduce uterine cavity and glandular morphology in PCOS rats and increase the equivalent diameter (P=0.000, P=0.000) and area (P=0.000, P=0.000) of uterine glands and glandular cavity, the ratio of glandular interstitial area (P=0.000), and the average endometrial thickness (P=0.006), with statistically significant differences. Immunohistochemistry, Western blotting, and qRT-PCR results showed that the expression levels of LIF and p-STAT3 protein and mRNA in model group were significantly decreased compared with control group. Compared with model group, the protein and mRNA expressions of LIF and p-STAT3 in LIF group were significantly increased (P<0.05). 【Conclusion】 Exogenous LIF supplementation can improve endometrial receptivity in PCOS rats, and its mechanism is related to the LIF/LIFR/STAT3 pathway.
ABSTRACT
Objective To investigate the efficacy and safety of ketogenic diet (KD) and antiepileptic drugs (AEDs) in the children with drug refractory Dravet syndrome (DS).Methods Thirty-two cases of drug refractory DS were enrolled into the Department of Neurology,Shenzhen Children's Hospital Affiliated to Shantou University Medical School from July 2016 to December 2017,and they were divided into 2 groups:KD group and AEDs group (16 cases for each group),respectively.KD was added to as an additional therapy for KD group,and oral AEDs were administered only in AEDs group.In KD group,oral AEDs were not adjusted for the first 3 months.AEDs could be adjusted within a limited range in 2 groups after 3 months.The clinical efficacy,improvement of cognitive function,retention rate and side effects were observed and compared after 3,6,12 months of treatment.The average monthly seizure frequency within 3 months before enrollment was recorded as the baseline.The clinical efficacy was assessed by comparing the seizure frequency of each observation period with the baseline.Results In KD group,after 3,6,12 months' follow-up,KD therapy was maintained in 15,14,12 patients.The number of patients whose seizure reduction over 50％ was 10,12,11 cases,respectively.The number of patients whose seizure reduction over 90％ was 7,9,10 cases,respectively.The number of patients who were seizure free was 3,6,8 cases,respectively.In AEDs group,after 3,6,12 months' therapy,the number of patients whose seizure reduction over 50％ was 6,7,8 cases,respectively,the number of patients whose seizure reduction over 90％ was 3,3,4 cases,respectively.The number of patients who were seizure-free was 2,1,2 cases,respectively.There was a significant difference in the seizure reduction between 2 groups after 6,12 months (P ＜ 0.05).Furthermore,the incidence of status epilepticus (SE) was significantly reduced in KD group,and non-fever related status epilepticus (NFSE) was preferentially improved.There was a significant difference in the incidence of SE between before and after treatment in the KD group (P ＜ 0.05).After 12 months,there was a significant difference in the incidence of SE between 2 groups (P ＜ 0.05).After 6,12 months of treatment,the patients in KD group had significant improvements in adaption,gross motor and language quotients by Gesell Developmental Scale compared to the AEDs group (all P ＜ 0.05).Eleven of 12 children who adhered to the therapy for 1 year in KD group had improvement of developmental quotient ≥ 1 grade,however,7 cases of 16 children in AEDs group had this improvement.The incidence of adverse effect in the KD group and the AEDs group was 37.5％ (6/16 cases) and 56.3％ (9/16 cases),respectively,and the difference was not significant (P ＞ 0.05).Conclusions KD can not only reduce seizure frequency and relieve SE,but also improve the cognitive function of drug refractory DS.The adverse reaction ratio of KD does not increase significantly compared to AEDs.Therefore,KD is effective and safe therapy for children with drug-resistant DS.
ABSTRACT
Objective@#To investigate the efficacy and safety of ketogenic diet (KD) and antiepileptic drugs(AEDs) in the children with drug refractory Dravet syndrome (DS).@*Methods@#Thirty-two cases of drug refractory DS were enrolled into the Department of Neurology, Shenzhen Children′s Hospital Affiliated to Shantou University Medical School from July 2016 to December 2017, and they were divided into 2 groups: KD group and AEDs group (16 cases for each group), respectively.KD was added to as an additional therapy for KD group, and oral AEDs were administered only in AEDs group.In KD group, oral AEDs were not adjusted for the first 3 months.AEDs could be adjusted within a limited range in 2 groups after 3 months.The clinical efficacy, improvement of cognitive function, retention rate and side effects were observed and compared after 3, 6, 12 months of treatment.The average monthly seizure frequency within 3 months before enrollment was recorded as the baseline.The clinical efficacy was assessed by comparing the seizure frequency of each observation period with the baseline.@*Results@#In KD group, after 3, 6, 12 months′ follow-up, KD the-rapy was maintained in 15, 14, 12 patients.The number of patients whose seizure reduction over 50% was 10, 12, 11 cases, respectively.The number of patients whose seizure reduction over 90% was 7, 9, 10 cases, respectively.The number of patients who were seizure free was 3, 6, 8 cases, respectively.In AEDs group, after 3, 6, 12 months′ therapy, the number of patients whose seizure reduction over 50% was 6, 7, 8 cases, respectively, the number of patients whose seizure reduction over 90% was 3, 3, 4 cases, respectively.The number of patients who were seizure-free was 2, 1, 2 cases, respectively.There was a significant difference in the seizure reduction between 2 groups after 6, 12 months (P<0.05). Furthermore, the incidence of status epilepticus (SE) was significantly reduced in KD group, and non-fever related status epilepticus (NFSE) was preferentially improved.There was a significant difference in the incidence of SE between before and after treatment in the KD group (P<0.05). After 12 months, there was a significant difference in the incidence of SE between 2 groups (P<0.05). After 6, 12 months of treatment, the patients in KD group had significant improvements in adaption, gross motor and language quotients by Gesell Developmental Scale compared to the AEDs group (all P<0.05). Eleven of 12 children who adhered to the therapy for 1 year in KD group had improvement of developmental quotient ≥ 1 grade, however, 7 cases of 16 children in AEDs group had this improvement.The incidence of adverse effect in the KD group and the AEDs group was 37.5%(6/16 cases) and 56.3%(9/16 cases), respectively, and the difference was not significant (P>0.05).@*Conclusions@#KD can not only reduce seizure frequency and relieve SE, but also improve the cognitive function of drug refractory DS.The adverse reaction ratio of KD does not increase significantly compared to AEDs.Therefore, KD is effective and safe therapy for children with drug-resistant DS.
ABSTRACT
Objective To investigate the prevalence and risk factors of age-related macular degeneration (AMD) in southern Xinjiang Uyghur residents aged≥ 50 years.Methods A cross-sectional study was carried out.Randomized cluster sampling was used in this survey of Uyghur residents aged 50 or above in Kuche and Kashi County of Xinjiang from January to May 2017.A total of 1 202 individuals received questionnaire survey,visual acuity test and eye examination.The AMD was diagnosed according to the Consensus of the 2012 International Beckmann AMD Classification Study Group,and the prevalence rate and risk factors of AMD in the population was analyzed.Results In 1490 Uyghur residents,a total of 1 202 subjects were included,with the response rate 80.67％.The 113 eyes of 73 patients were diagnosed as AMD,with the prevalence rate 6.07％.The prevalence of early-and mid-term AMD was 3.99％,and dry AMD was 1.00％ and wet AMD was 1.08％.The prevalence rate of AMD in 50-59 years group,60-69 years group,70-79 years group and more than 80-year group was 4.35％,5.85％,11.38％ and 14.81％,respectively.The prevalence of AMD was elevated with aging (x2 =15.008,P =0.002).Aging and region are the risk factors of AMD (Age:OR=1.000,P=0.001;region:OR=0.515,P=0022).Conclusions The prevalence rate of AMD among Uyghur residents aged 50 or above in southern Xinjiang is significantly lower than that in Europe and United States.Aging is an uncontrollable risk factor for AMD.
ABSTRACT
Dravet syndrome (DS) is an epileptic (developmental) encephalopathy which onsets in infancy,most DS children are drug resistant.However,the emergence of new antiepileptic drugs is providing more options to treat DS.In the recent years,the efficacy of nonpharmacologic therapies (such as neurostimulation and ketogenic diet) had been also confirmed in DS.Now,the latest progress on clinical treatment of DS was elaborated.Besides that,the therapies on neuropsychological damages and how to prevent and deal with the status epilepticus and sudden unexpected death in children with DS were briefly introduced.
ABSTRACT
Objective To study the relationship of early postoperative CRP and PCT with pancreatic fistula after pancreaticoduodenectomy (PD);to study whether the combination of CRP and PCT can be used as an early predictor of pancreatic fistula;and to determine the optimal cut-off values of CRP and PCT for early diagnosis of pancreatic fistula after PD.Methods Postoperative pancreatic fistula and other complications were recorded in 82 patients after PD carried out at the Anshan Iron and Steel Group General Hospital from January 2013 to May 2017.PCT and CRP were measured on the 1st to the 5th postoperative day (POD).CRP and PCT were compared between the pancreatic fistula group and the non-complication group on pancreatic fistula prediction.The sensitivity,specificity,and combined sensitivity,combined specificity,negative predictive value,positive predictive value and optimal cut-off value were calculated.Results 56 patients developed postoperative complications,including 17 patients with pancreatic fistula,and 39 patients with non-pancreatic fistula.The postoperative CRP and PCT were correlated with postoperative pancreatic fistula and with other complications.The higher the CRP and PCT,the higher the risk of postoperative pancreatic fistula.The ROC curves suggested that CRP and PCT had a high predictive value for pancreatic fistula,especially on POD 2.The optimal cut-off value of CRP was 189.05 mg/L,the sensitivity was 94.1％,the specificity was 81.5％,the positive predictive value was 94.7％,and the negative predictive value was 24.4％.The optimal cut-off value of PCT was 0.89 mg/dl,the sensitivity was 88.2％,the specificity was 84.6％,the positive predictive value was 91.3％,and the negative predictive value was 20.5％.The sensitivity and specificity of combined CRP with PCT on POD 2 in predicting pancreatic fistula after operations were 100％ and 69.1％,respectively.Conclusion Combined CRP and PCT had a high early predictive rate in the identification of pancreatic fistula after PD.
ABSTRACT
Objective: To study the pharmacokinetics and brain/plasma concentration ratio of nortriptyline at multiple doses in mice which were pre-treated with physiological saline, piperine and verapamil. Methods: A total of 216 male Kun Ming mice[(25±3) g] were equally divided into 4 groups randomly. Each group was intragastrically administered physiological saline (B), piperine (170 μg/kg), piperine (5 mg/kg) and verapamil (5 mg/kg) for 8 days. On the 8th day, 1 h atfer giving the above drugs, each mice was intraperitoneally injected nortriptyline (13 mg/kg). The mice were sacriifced by picking off eyeballs at the time intervals of 5, 15, 30 min, and 1, 2, 4, 6, 8 and 12 h, andthe cerebra were collected and weighted. Nortriptyline in mouse plasma and brain was determined by HPLC-MS/MS. The pharmacokinetic properties of the plasma, brain and brain/plasma were calculated. Results: hTe AUC0-12 h of brain/plasma concentration ratio in the 170 μg/kg piperine group was significantly lower than that in the other groups (P<0.05), while the AUC0-12 h of brain/plasma concentration ratios in the 5 mg/kg piperine group and the verapamil group were not signiifcantly different from those of untreated mice. Conclusion: Piperine (170 μg/kg) may induce P-glycoprotein expression in the blood-brain barrier, while piperines at 5 mg/kg has no influence on P-glycoprotein expression in the blood-brain barrier.