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Objective:To construct a case management index for acute myocardial infarction based on multidisciplinary collaboration, and to provide guidance for the case management of patients with acute myocardial infarction.Methods:From October 2021 to April 2022, a research group with clinical experience was established to initially formulate an index system for acute myocardial infarction case management based on multidisciplinary collaboration after a literature review. After 2 rounds of Delphi expert correspondence, the items of the case management index system were revised according to the opinions of the expert correspondence.Results:Twenty-two experts were interviewed in the first round, and the effective recovery rate of the questionnaire was 95.45%(21/22); in the second round, 21 experts were interviewed, the effective recovery rate of the questionnaire was 100.00%(21/21). The first and the second round of the expert authority coefficient was 0.896 and 0.912, respectively, the coefficient of variation of each item was 0-0.17, Kendall′s coefficient of concordance was 0.20 ( P<0.01), the average importance value of indexes were 4.43-5.00, and the rate of full marks was 38.1%-100.0%. Finally, an acute myocardial infarction case management index system based on multidisciplinary collaboration was established, including 3 primary indexes and 51 secondary indexes. Conclusions:The case management index constructed in this study is scientific and reliable, closely integrated with clinical practice, and has strong clinical practical value.
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Two skeletally undescribed polyketide-indole hybrids (PIHs), named indolchromins A and B, were generated from indole-3-carbinol (I3C) in the fungal culture (). The indolchromin structures were elucidated mainly by their 1D and 2D NMR spectra with the former confirmed by the single-crystal X-ray crystallographic analysis. Each indolchromin alkaloid was chirally separated into four isomers, whose absolute configurations were assigned by comparing the recorded circular dichroism (CD) spectra with the electronic CD (ECD) curves computed for all optional stereoisomers. Furthermore, the indolchromin construction pathways in fungal culture were clarified through enzyme inhibition, precursor feeding experiment, and energy calculation. The cascade reactions, including decarboxylative Claisen condensation catalyzed by 8-amino-7-oxononanoate synthase (AONS), C()-H activation, double bond migration, and Michael addition, all undergone compatibly during the fungal cultivation. In an MIC range of 1.3-8.6 μmol/L, (2,4)- and (2,4)-indolchromin A and (2,4)-indolchromin B are inhibitory against , , sp., , and . (2,4)-Indolchromin A and (2,4)-indolchromin B were cytotoxic against the human breast cancer cell line MDA-MB-231 with IC values of 27.9 and 131.2 nmol/L, respectively, with the former additionally active against another human breast cancer cell line MCF-7 (IC 94.4 nmol/L).
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Objective To describe the status of anxiety and depression in patients with uveitis, and to explore the related factors of quality of life. Methods A total of 126 uveitis patients from September 2015 to March 2016 were investigated with the General Social Population Questionnaire, Life Quality for Diseases with Visual Impairment Scale, Self-rating Anxiety Scale and Beck Depression Inventory. Results There were 126 valid questionnaires, and the effective recovery rate was 96.9％(126/130). The score of Self-rating Anxiety Scale in uveitis patients was (43.49±7.20) points which lower than the standard mark standardized score, and 14.3％ (18/126)of patients were diagnosed with anxiety. The score of Beck Depression Inventory in uveitis patients was (7.50 ± 6.60) points which lower than the standard mark standardized score, 28.6％ (36/126)of patients were diagnosed with depression. The Self-rating Anxiety Scale scores and psychological dimensions of quality of life was negatively correlated (r=-0.310, P<0.01), and the Beck Depression Inventory scores and the average score of the quality of life, the 4 dimensions and total score of quality of life was negatively correlated(r=-0.534--0.240, all P<0.01). The multiple linear regression analysis showed that the related factors of quality of life were score of depression, vision loss, education and gender(P<0.05). Conclusions The incidence of depression and anxiety are both lower in patients with uveitis than general population. The status of quality of life is related to the score of depression, vision loss, education and gender.
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Background Blepharitis caused by Demodex infestation is very common in clinical practice.There are various methods mentioned in the study of Demodex infestation in China,but a unified introduction and evaluation of the operating procedures is lacked.A quick and accurate clinical diagnostic method for Demodex infestation needs to be further studied.Objective This study aimed to establish operation procedures for the clinical examination of eyelid Demodex infestation,which were applied to evaluate the conditions of eyelid Demodex infestation in ocular patients with discomfort.Methods One thousand and fifty-two patients with eye dryness,eye itchiness or other symptoms were selected for slit lamp examination and photographing of the eyelid margin area.Three eyelashes with associated scurf from each superior eyelid were plucked out for examination of Demodex under the microscope.Positive findings included observation of Demodex mites or eggs.Their amounts were recorded individually for all eyelash samples.Results A procedure for observing,recording and reporting eyelid Demodex infestations in patients was successfully established.By using this procedure,1 052 patients were investigated for the examination of Demodex infestations.Demodex mites or eggs were found in 582 cases (55.3％).The positive rate of Demodex infestation increased with age,and the population over 60 years group had the highest positive rate,showing a significant difference among the different age groups (x2=10.547,P=0.001).There was no significant difference in positive rate between male patients and female patients (P =0.352).The test turnaround time (TAT) for one examination was (11.4±5.2) seconds.Conclusions The operational procedure for examining the palpebral margin Demodex infestation by the slit-lamp,optical microscope,photographing and laboratory reports is established.It is simple and quick in the appliation for the clinical diagnosis of eyelid Demodex infestation.
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@#Objective To explore the relationship between corticospinal tract (CST) repairment and motor function recovery after rehabilitation in stroke patients by diffusion tensor imaging (DTI). Methods 15 stroke patients with internal capsule lesions and injured CST, 4-8 weeks after onset were included. They were scanned with DTI and assessed with the simple Fugl-Meyer Assessment (FMA) before and after 3-month rehabilitation. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The correlation of differences of FA, rFA and FAasy of CST with FMA was analyzed. Results The scores of FMA increased after treatment (P<0.01). The FA of the ipsilesional CST were significantly less than that of contralesional ones before and after rehabilitation. There was statistical differences in FA, rFA and FAasy in the corona radiate section of CST after treatment (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant correlation of FA, rFA and FAasy of corona radiate section to scores of FMA. Conclusion DTI can respond to the repairment of corticospinal tract after stroke, especially in the corona radiate section.
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@#Objective To explore brain plasticity of upper extremities motor function recovery after stroke with diffusion tensor imaging (DTI). Methods 25 stroke patients with internal capsule lesions and affected corticospinal tract (CST), 4-8 weeks after onset, were divided randomly into rehabilitation group (n=13) and control group (n=12). Both groups received routine medication and the rehabilitation group also received rehabilitation. All the patients were scanned with DTI and assessed with upper extremity Fugl-Myer Assessment (UE-FMA) before and 3 months after treatment. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The bilateral corticospinal tracts were reconstructed with diffusion tensor tractography. Results The scores of UE-FMA increased in both groups after treatment (P<0.05), and increased more in the rehabilitation group than in the control group (P<0.05). There was significant difference in FA, rFA and FAasy in the corona radiate section of CST after treatment in the rehabilitation group (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant differences in FA, rFA and FAasy in the control group. The ipsilesional CST fibers were more compact after treatment in the rehabilitation group. Conclusion Rehabilitation can improve the upper extremities function recovery after stroke, which may associated with the repairment of CST in the corona radiate section.
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Objective To explore brain plasticity of upper extremities motor function recovery after stroke with diffusion tensor imaging (DTI). Methods 25 stroke patients with internal capsule lesions and affected corticospinal tract (CST), 4-8 weeks after onset, were divided randomly into rehabilitation group (n=13) and control group (n=12). Both groups received routine medication and the rehabilitation group al-so received rehabilitation. All the patients were scanned with DTI and assessed with upper extremity Fugl-Myer Assessment (UE-FMA) be-fore and 3 months after treatment. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The bilateral corticospinal tracts were reconstructed with diffusion tensor tractography. Results The scores of UE-FMA increased in both groups after treatment (P<0.05), and increased more in the rehabilitation group than in the control group (P<0.05). There was significant difference in FA, rFA and FAasy in the corona radiate section of CST after treatment in the rehabilitation group (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant dif-ferences in FA, rFA and FAasy in the control group. The ipsilesional CST fibers were more compact after treatment in the rehabilitation group. Conclusion Rehabilitation can improve the upper extremities function recovery after stroke, which may associated with the repair-ment of CST in the corona radiate section.
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Objective To explore the relationship between corticospinal tract (CST) repairment and motor function recovery after reha-bilitation in stroke patients by diffusion tensor imaging (DTI). Methods 15 stroke patients with internal capsule lesions and injured CST, 4-8 weeks after onset were included. They were scanned with DTI and assessed with the simple Fugl-Meyer Assessment (FMA) before and after 3-month rehabilitation. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of in-ternal capsule (PLIC) and corona radiate were obtained. The correlation of differences of FA, rFA and FAasy of CST with FMA was ana-lyzed. Results The scores of FMA increased after treatment (P<0.01). The FA of the ipsilesional CST were significantly less than that of con-tralesional ones before and after rehabilitation. There was statistical differences in FA, rFA and FAasy in the corona radiate section of CST after treatment (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant correlation of FA, rFA and FAasy of corona radiate section to scores of FMA. Conclusion DTI can respond to the repairment of corticospinal tract after stroke, es-pecially in the corona radiate section.
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<p><b>BACKGROUND AND OBJECTIVE</b>How to prolong progression free survival (PFS) and overall survival (OS) of patients with small cell lung cancer (SCLC) has been one of the hottest issues. We retrospectively reviewed our data to compare the survival of immediate with delayed topotecan after first-line therapy in SCLC.</p><p><b>METHODS</b>In our retrospective study, 53 patients with SCLC were divided into two groups as follow: patients receiving topotecan-containing regimen as maintenance/consolidation (maintenance/consolidation chemotherapy group) and salvage chemotherapy (salvage chemotherapy group). The Log-rank test was used to assess the difference in OS between two groups. Cox regression model was used for the multivariable analysis of independent prognostic factors.</p><p><b>RESULTS</b>Twenty-nine patients received topotecan as maintenance/consolidation treatment, whereas 24 patients salvage chemotherapy. The response rates were 51.7% and 41.7%, respectively. The median survival time were 20 months and 27 months respectively (P = 0.89). Multivariate Cox regression analyses identified sex and stage as independent prognostic factors.</p><p><b>CONCLUSION</b>Efficacy of first-line therapy was improved by topotecan maintenance/ consolidation treatment, which did not result in any significant survival benefits in SCLC.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Agents , Therapeutic Uses , Lung Neoplasms , Drug Therapy , Mortality , Retrospective Studies , Small Cell Lung Carcinoma , Drug Therapy , Mortality , Topotecan , Therapeutic Uses , Treatment OutcomeABSTRACT
BACKGROUND: Previous research has demonstrated that dermal tissue has mesenchymal stem cells, which have a possibility of autologous transplantation. If the mesenchymal stem cells derived from the skin differentiate into lymphocytes under a certain condition, the immune system disease can be solved generally.OBJECTIVE: To investigate the possibility of differentiation of human skin-derived mesenchymal stem cells into lymphocytes. METHODS: Surface marker expression was detected in the 14th passage human skin-derived mesenchymal stem cells using flow cytometry. Transdifferentiation medium of human skin-derived mesenchymal stem cells consisted of human lymphocyte supernatant and fresh human skin-derived mesenchymal stem cells based on the ratio of 7:3. Inverted microscope was employed to observe morphological changes, and flow cytometry was used to detect surface marker expression in the lymphocytes at 1-8 days after induction. Self-marker expression of human skin-derived mesenchymal stem cells was then detected at 3,6, and 9 days after induction.RESULTS AND CONCLUSION: Human skin-derived mesenchymal stem cells stably expressed self-specific marker CD73, Vimentin and so on, but did not express specific markers of hematopoietic system, I.e., CD34, CD45 and so on, lowly expressed HLA-I, but did not express HLA-DR at all. At 3 days after induction, the cell volume significantly increased, cell proliferation rate was significantly lower than before induction, and a lot of cystic-like particles with strong refraction were observed in or between cells. The CD45 lymphocyte expression was not significantly changed, but CD3, CD19, CD16, CD4, and CD8 expression rates of human skin-derived mesenchymal stem cells were linearly increased at 1-4 days after induction and stabilized at 5-8 days after induction. In addition, CD37, CD34, Vimentin, and HLA-DR expressions were not changed at 3, 6, and 9 days after induction, but HLA-I expression rate was gradually increased with the prolongation time of induction. This suggested that human skin-derived mesenchymal stem cells can differentiate into lymphocyte and potentially participate in repairing immune system injury.
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<p><b>BACKGROUND</b>Gefitinib, a selective inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase, has been approved effective in local advanced or metastatic non-small cell lung cancer (NSCLC), with the equivalent response rate to that of chemotherapy in Asian patients. Asian ethnicity, gender, smoking history, adenocarcinoma histology were remarkably associated with gefitinib response and survival. However, predictive factors of gefitinib response and survival are still unclear in Asian population. In this study, we retrospectively reviewed the data of 153 Chinese NSCLC patients who received a single agent of gefitinib with the purpose of identifying the potential predictive factors of gefitinib response and survival.</p><p><b>METHODS</b>Tumor response, survival and the clinicopathologic factors of 153 NSCLC patients treated between November of 2003 and June of 2004 were collected retrospectively from the multicenter clinical trial in China. Pearson Chi-square test and Logistic regression test were performed respectively as univariate and multivariate analyses of gefitinib response. Overall survivals between groups with different predictive factors were compared by log-rank tests. Multivariate analysis was performed to identify factors that independently predict for survival.</p><p><b>RESULTS</b>A total of 153 patients were included in this analysis. Objective response rate was statistically significant higher in patients with younger age (≤65 years) and longer interval from diagnosis to gefitinib treatment (≥6 months) in multivariate analysis (P < 0.05). The median follow-up duration was 10.0 months (0.5-16.8). The median survival was 10.3 months (95% CI: 8.1-12.6) and 1-year survival was 44.1%. Significant independent predictive factors associated with longer survival in multivariate analysis were good performance status (score 0-1), controlled disease (CR+PR+SD) to most recent chemotherapy and controlled disease to gefitinib (P < 0.05).</p><p><b>CONCLUSIONS</b>Gefitinib is effective in local advanced or metastatic NSCLC patients who failed to chemotherapy in Chinese population. In Chinese NSCLC population, younger age (≤65 years) and longer interval from diagnosis to gefitinib treatment (≥6 months) were predictive factors in multivariate analysis for gefitinib response; good performance status (score 0-1), controlled disease to most recent chemotherapy and controlled disease to gefitinib were independent prognostic factors for survival.</p>
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With well understanding of the ethical problems in ophthalmic clinical treatment, strategies were developed to help establish a credible relationship with children and then to avoid causing psychological harm to them. The informed consent given prior to treatment can effectively minimize potential medical risks.
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Object To study the effects of artemisinin and its analogue artemisunate on the proliferation of human breast cancer MCF-7 cell line, as well as their mechanism comparatively. Methods The inhibition of cell proliferation was determined by SRB method. Cell cycle was determined by flow cytometry (FCM) analysis. Apoptosis was confirmed by sub-G 1 cells content and DAPI method. Results The cell cycle of MCF-7 was changed greatly when treated 24 h with either 10 ?mol/L artemisinin or 1 ?mol/L artemisunate, the distribution of MCF-7 cells among S phase was reduced greatly, while inereased during G 0+G 1. However, artemisinin had weaker effect on the proliferation of MCF-7 cell, while artemisunate effectively inhibited the proliferation of MCF-7, the IC 50 was 0.31 ?mol/L. Apoptosis induced by 1 ?mol/L artemisunate was stronger than that by 10 ?mol/L artemisinin, too. Conclusion The inhibitory effect of artemisunate on the proliferation of tumor cell is stronger than that of artemisinin in vitro.
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The effect of riboflavin deficiency on the fluidity of erythrocyte (RBC) membrane, the level of membrane MDA, the activity of RBC SOD and lipid peroxidation were studied. Growing male rats were fed with an experimental (riboflavin-deficient, RD) or a control (riboflavin-supplemented, RS, 22mg/ kg) diet for 7 weeks.The RBC membrane of RD rats contained higher level of MDA (0.6868?0.1732 nmol/mg protein) compared with the control (0.5548?0.0980 nmol/mg protein), while the activity of RBC SOD (7.745210.6101 nU/mg protein) of RD rats were significantly decreared compared with the control (8.2685?0.3010 nU/mg protein), which indicated the lipid peroxidation was elevated.Membrane fluidity was studied with fluorescence polarization (P) and mean microviscosity (?) using DPH as probe. The value of P and? of RD rats (0.2976 ? 0.0198, 3.9483? 0.3680, respectively) were significantly higher than the RS rats (0.2760 ? 0.0207, 2.875310.4634, respectively), which showed the membrane fluidity in RD rats was decreased according with the increase in lipid peroxidation. This study demonstrated that the RBC membrane fluidity was dicrcased in riboflovin deficient rats. It was relative to the increasing lipid peroxidation and decreasing RBC SOD activity.
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This paper was designed to study the effects of cellulose, pectin and ag-ar at 10% level on the concentration of serum total cholesterol (TC), trigly-ceride (TG) and high density lipoprotein cholesterol (HDL-C) in rats. Male adult Wistar rats were randomly divided into 5 groups and fed on basal diet, hypercholesterolemic diet (control diet) and 3 test diets (contain 10% cellulose, pectin or agar respectively) for 6 weeks. The results showed that all three fibrous diets were significantly lowered serum TC (P