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Acute kidney injury (AKI) is a devastating complications of end-stage of liver disease (ESLD), seriously affecting the prognosis of patients. With the deepening understanding of the pathogenesis, the definition, staging, diagnosis and treatment of ESLD with AKI have been gradually optimized. This article reviews the evolution of definition, pathogenesis, diagnosis and treatment of ESLD with AKI, to provide reference for early recognition, precise diagnosis and standardized treatment of this condition.
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ObjectiveTo investigate the effect of respiratory training based on core stability training on feedforward control in patients with chronic nonspecific low back pain (CNLBP). MethodsA total of 60 patients with CNLBP in Jiaxing Second Hospital from January, 2022 to March, 2023 were randomly divided into control group (n = 30) and experimental group (n = 30). Both groups received health education, physical factor therapy and core stability training, while the experimental group received respiratory training in addition, for four weeks. Visual Analogue Scale (VAS) score, Japanese Orthopaedic Association low back pain (JOA) score and Oswestry Dysfunction Index (ODI) were compared between two groups before and after treatment, while surface electromyography was used to detect the root mean square (RMS) and integrated electromyography (iEMG) of transversus abdominis, multifidus and triceps (movement muscles), and the activation sequence and relative activation time of transversus abdominis, multifidus and triceps were calculated. ResultsAfter treatment, the scores of VAS, JOA and ODI improved significantly in both groups (|t| > 8.515, P < 0.001), and the scores were better in the experimental group than in the control group (|t| > 2.089, P < 0.05). RMS and iEMG of transversus abdominis and multifidus improved significantly after treatment in both groups (|t| > 18.831, P < 0.001), and were significantly better in the experimental group (|t| > 3.481, P < 0.05). The transversus abdominis and multifidus in both groups were activated before the movement muscles, and the relative activation time of transversus abdominis and multifidus increased in negative (|t| > 48.115, P < 0.001), the experimental group being better (|t| > 3.229, P < 0.05). ConclusionCombination of core stability training and respiratory training is beneficial in reducing the pain of patients with CNLBP, reducing the lumbar dysfunction, improving the order of muscle activation, and strengthening feedforward control.
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Increasing evidence suggests that atrial fibrillation is associated with an increased risk of cognitive impairment and dementia beyond its association with stroke and mortality. The association is independent of stroke. However, the association between atrial fibrillation and cognitive function has often been overlooked in the management and treatment in clinical practice. There is a lack of consensus on the relationship and its mechanisms between atrial fibrillation and brain dysfunction. Whether treatments targeted atrial fibrillation are effective for brain function remains unknown. Through reviewing relevant literatures, this article analyzed the association between atrial fibrillation and its underlying mechanisms. Furthermore, this article further discussed the effectiveness of atrial fibrillation treatments to cognitive function and brain health.
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Objective:To explore any effect of kinesio taping on the head and neck mobility of children with congenital muscular torticollis.Methods:A total of 52 children with congenital muscular torticollis were randomly divided into a treatment group and a control group, each of 26. All were given 20 minutes of routine rehabilitation training daily, 5 days a week for 4 weeks. The treatment group was additionally taped up with kinesio tape for no more than 48 hours once every 3 days for 4 weeks. Before and after the treatment the angles of head tilt and neck lateral flexion and the gaps in left and right neck rotation were measured for both groups.Results:Significant improvement was observed in both groups but there was significantly more improvement among the treatment group. The treatment had a cure rate (46.15%) and an improvement rate (50.00%) significantly superior to those of the control group and a significantly lower rate of ineffectiveness.Conclusion:Kinesio taping along with routine rehabilitation training can better improve the head and neck mobility of children with congenital muscular torticollis.
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ObjectiveTo investigate the effect of robot-assisted bilateral task-oriented upper limb training on upper limb function of patients with stroke. MethodsFrom January, 2021 to June, 2022, 52 patients with stroke in the Second Hospital of Jiaxing were enrolled and randomized into control group (n = 26) and experimental group (n = 26). Both groups received routine treatment. The control group added conventional bilateral upper limb training, while the experimental group added robot-assisted bilateral task-oriented upper limb training, for six weeks. Before and after treatment, the upper limb motor function and activities of daily living were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and modified Barthel Index (MBI). The upper limb proprioception test system was used to measure the average trace error (ATE) and test execution time of the upper limb. ResultsBefore treatment, there was no significant difference in the scores of FMA-UE and MBI, and ATE and test execution time between two groups (P > 0.05). After treatment, all the indexes improved significantly in both groups (|t| > 5.400, P < 0.001), and were better in the experimental group than in the control group (|t| > 2.123, P < 0.05). ConclusionRobot-assisted bilateral task-oriented upper limb training could facilitate to improve the upper limb motor function and activities of daily living of stroke patients.
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Objective To establish a novel rat model of chronic skeletal muscle composite injury in the lumbar region,to explore its mechanism and treatment method in depth.Methods Twenty-eight SD rats were randomly divided into control group(n = 10),Hitting injury model(HIM)group(n = 9),Composite damage model(CDM)group(n = 9)(vertical blow combined with forced prolonged sitting).Open field test,HE staining and PCR sequencing were performed 3 days after modeling.Results The open field distance of rats in HIM group was significantly shorter than that in the CDM group,and both groups had shorter distances than the control group.HE staining showed multiple muscle fiber breaks,significant widening of muscle gaps,uneven distribution of muscle nuclei,and visible congestion in the model group of simple blow injury;In the CDM group,muscle fibers were ruptured,the muscle gaps were slightly widened,and inflammatory cell infiltration was observed between the muscles,especially around the muscle fiber breakage,with muscle fiber nuclei gathering.A volcano plot of the sequencing result suggested significant differences in the Pf4 gene.GO analysis of muscle tissue in model group rats showed upregulation of oxygen binding and carrier activity pathways.Conclusions This study attempted to establish a composite skeletal muscle injury model to study the pathological changes of chronic skeletal muscle injury in the low back pain and evaluate the efficacy of treatment method.It has practical application value in animal experiments for chronic non-specific low back pain.
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Objective:To explore the effect of alcohol consumption on the severity of coronary atherosclerotic heart disease (CHD) in male patients with type 2 diabetes mellitus (T2DM).Methods:A total of 155 male T2DM patients with CHD were enrolled in the study and admitted at the Third Hospital of Hebei Medical University. Clinical and serum biochemical parameters were collected. The effect of alcohol consumption on the severity of CHD was assessed using the Gensini scoring system. Multiple linear regression was performed to analyze the risk factors of CHD in T2DM patients.Results:About 63% of male T2DM patients with CHD were regular (moderate) alcohol consumers and among them, about 60% were classified as excessive drinkers. Compared to patients who did not consume alcohol, the following parameters were all significantly increased (all P<0.05): body mass index [(26.1±3.6) vs (24.9±3.1) kg/m 2]; systolic blood pressure [(142.0±17.6) vs (131.2±17.8) mmHg (1 mmHg=0.133 kPa); diastolic blood pressure (88.6±12.1) vs (83.8±8.9) mmHg)]; total cholesterol [(4.8±1.3) vs (4.3±1.3) mmol/L]; uric acid [(370.9±89.6) vs (349.6±84.3) mmol/L]; smoking rate (76.0% vs 13.3%); and prevalence of hypertension (76.0% vs 13.3%). Compared with patients in the moderate drinking subgroup, the level of low-density lipoprotein cholesterol [LDL-C, (3.2±0.9) vs (2.8±0.9) mmol/L] and plasma fibrinogen [(3.5±0.5) vs (3.9±0.4) mmol/L] were significantly higher ( P<0.05). In addition, the smoking rate and the prevalence of hypertension in the excessive drinking subgroup were significantly higher than those in the moderate drinking subgroup ( P<0.05). Excessive alcohol consumption was the risk factor ( OR=0.259,95% CI: 0.074-0.904, P<0.05), but not the severity factor ( t=-0.58, P=0.565) for CHD in male patients with T2DM, hemoglobinA 1c ( t=3.11, P=0.019), triglycerides ( t=2.30, P=0.039) and LDL-C ( t=4.24, P<0.001) were the risk factors for the severity of CHD. Conclusions:Excessive alcohol consumption may be a risk factor for CHD in male patients with T2DM, but its effect on the severity of CHD still needs further exploration.
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The negative effects of low temperature can readily induce a variety of diseases. We sought to understand the reasons why cold stress induces disease by studying the mechanisms of fine-tuning in macrophages following cold exposure. We found that cold stress triggers increased macrophage activation accompanied by metabolic reprogramming of aerobic glycolysis. The discovery, by genome-wide RNA sequencing, of defective mitochondria in mice macrophages following cold exposure indicated that mitochondrial defects may contribute to this process. In addition, changes in metabolism drive the differentiation of macrophages by affecting histone modifications. Finally, we showed that histone acetylation and lactylation are modulators of macrophage differentiation following cold exposure. Collectively, metabolism-related epigenetic modifications are essential for the differentiation of macrophages in cold-stressed mice, and the regulation of metabolism may be crucial for alleviating the harm induced by cold stress.
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Animals , Mice , Acetylation , Cold-Shock Response , Epigenesis, Genetic , Macrophages/metabolism , Mitochondria/metabolismABSTRACT
Objective:To explore the effect of a pelvis-assisting rehabilitation robot on lower limb function and knee proprioception after cerebral infarction.Methods:Forty hemiplegic cerebral infarction survivors were randomly divided into an experimental group and a control group, each of 20. Both groups were given routine neurological medication and rehabilitation training, while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily, five times a week for four weeks. Before and after the intervention, motor function, balance, walking function and knee joint proprioception were assessed using the simplified Fugl-Meyer lower limb assessment, the Berg balance scale, functional ambulation categorization and the Humac Norm isokinetic tester.Results:After the treatment, significant improvement was observed in all of the above measurements in both groups, but the improvements were significantly greater in the experimental group.Conclusions:Robotic pelvic assistance can effectively improve lower limb motor function, balance, knee proprioception and walking after cerebral infarction.
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Objective:To evaluate the clinical value of the holographic image and navigation in robotic assisted laparoscopic radical prostatectomy (RARP) .Methods:From Sept. 2020 to Dec. 2020, 5 patients diagnosed with prostate cancer in Beijing United Family Hospital were included in this study. The mean age was 57 years(38-69 years). Before the operation, the engineers established the holographic image based on the enhanced MRI images. The holographic images were used in pre-surgery planning. During the operation, the navigation was achieved by real time fusing holographic images with the robotic surgery endoscopic views. Some important structure such as prostate, bladder neck and the tumor could be observed and monitored in real time. The No.1 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection; The No.2 patient had low-risk prostate cancer, underwent RARP, and the right side neurovascular bundle (NVB) was preserved; The No.3 patient had low-risk prostate cancer, underwent RARP, and the bilateral side NVB was preserved; The No.4 patient had low-risk prostate cancer, underwent RARP, and the right side NVB was preserved; The No.5 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection, and the bilateral side NVB was preserved.Results:All the 5 cases surgeries were successful, no conversion to open surgery, the mean operation time was 161.7min (160-250min), the mean blood loss was 426.7 ml(60-1000 ml). The pathological results were pT 3bN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0 and pT 3aN 1 cM 0, respectively. There was no over Clavien Dindo Ⅱ perioperative complications. 4 patient achieved continence when catheter removal. The PSA level and erectile function were monitored in the follow up. Conclusions:Holographic image navigation might have clinical value in RARP.