ABSTRACT
OBJECTIVE@#To explore the protective effect of SBi4211 (heptamidine), an inhibitor of S100B, against central nervous system injury induced by HIV-1 envelope protein gp120.@*METHODS@#In an @*RESULTS@#In the cell co-culture system, SBi4211 treatment significantly inhibited gp120-induced expression of S100B, RAGE and GFAP in U251 cells (@*CONCLUSIONS@#SBi4211 can protect neurons from gp120-induced neurotoxicity possibly by inhibiting the S100B/ RAGE-mediated signaling pathway.
Subject(s)
Animals , Mice , Astrocytes , Blotting, Western , Central Nervous System , HIV Envelope Protein gp120 , Neurons , S100 Calcium Binding Protein beta Subunit , Signal TransductionABSTRACT
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a major outbreak in the world. SARS-CoV-2 infection can not only involve in the respiratory system, but also cause severe nervous system damage. Studies have shown that SRAS-CoV-2 can invade the nervous system through hematogenous and transneuronal pathways, and may cause nervous system damage in patients with COVID-19 by inhibiting cellular immunity, hypoxemia, inflammation, inducing neuronal degeneration and apoptosis, and angiotensin converting enzyme 2 (ACE2) mechanism. It can lead to intracranial infection, toxic encephalopathy, acute cerebrovascular disease, muscle damage, peripheral nervous system injury, acute myelitis, demyelination disease or other nervous system diseases.
Subject(s)
Humans , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Pandemics , Peptidyl-Dipeptidase A , Pneumonia, Viral/epidemiology , Research , SARS-CoV-2ABSTRACT
OBJECTIVES@#To analyze the clinical characteristics and prognosis of children with anti-N-methyl--aspartate receptor (NMDAR) encephalitis and to provide a basis for early clinical identification of this disease.@*METHODS@#The clinical data of 42 cases of anti-NMDAR encephalitis at Department of Pediatrics, Second Xiangya Hospital, Central South University from January 2015 to March 2018 were collected. The clinical features and followed-up outcomes were analyzed retrospectively.@*RESULTS@#There were 15 cases (35.7%) of males and 27 cases (64.3%) of females in 42 children, with a ratio of 1꞉1.8. They were aged from 4 months to 17 years, with an average of (9.20±4.66) years. The most common initial symptoms were seizures (47.6%, 20/42) and mental behavior disorder (35.7%, 15/42). During the course of the disease, 85.7% patients(36/42) had mental and behavior disorder, 85.7% patients (36/42) had epilepsy, 76.2% (32/42) had speech disorder, 66.7% patients (28/42) had dyskinesia, 66.7% patients (28/42) had the decreased level of consciousness, 61.9% patients (26/42) had autonomic instability, and 57.1% (24/42) patients had sleep disorder. All the children had positive antibody against NMDA receptor resistance encephalitis in cerebrospinal fluid. Head MRI showed the abnormal incidence was 50.0% (21/42), and the lesions involved in parietal lobe, frontal lobe, temporal lobe, occipital lobe, midbrain, thalamus, basal ganglia and optic nerve. There was a patient with optic nerve damage combined with myelin oligodendrocyte glycoprotein (MOG) antibody positive. Forty cases were examined by electroencephalogram (EEG), 92.5% cases (37/40) were abnormal, mainly showing diffuse slow waves, and δ brushes could be seen in severe cases. And there was 1 patient (2.4%) complicated with mesenteric teratoma. The mRS score (2.14±1.46) at discharge was significantly lower than the highest mRS score (3.88±1.38) during hospitalization (<0.05). After 3-39 months of follow-up, mRS score at 3 months after discharge was only 0.81±1.29, which was still improved compared with that at discharge, 76.2% cases (32/42) experienced complete or near-complete recovery (mRS score≤2), and 4.8% (2/42) cases relapsed. There was no mortality; the initial time of immunotherapy and the highest mRS score in the course of the disease were the factors affecting the prognosis. The earlier the starting time for immunotherapy and the lower mRS score in the course of the disease were, the better the prognosis was.@*CONCLUSIONS@#Seizures, mental and behavior disorder, dyskinesias, speech disorder and autonomic instability are common clinical manifestations of anti-NMDAR encephalitis in children. The effect of immunotherapy is significant, and the time to start immunotherapy and the severity of the disease are important factors affecting the prognosis. Anti-NMDAR encephalitis can be combined with other autoantibodies, but its clinical significance and mechanism need further study.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Anti-N-Methyl-D-Aspartate Receptor Encephalitis , Autoantibodies , Electroencephalography , Magnetic Resonance Imaging , Receptors, N-Methyl-D-Aspartate , Retrospective StudiesABSTRACT
OBJECTIVE To evaluate the anti-vertigo effect of phencynonate hydrochloride. METHODS To detect the improvement of phencynonate hydrochloride on cerebral blood flow, a rat model wa s es?tablished with bilateral common carotid arteries occlusion. Phencynonate hydrochloride 0.1-4.0 mg·kg-1 was ig given, twice a day for three consecutive days and the alteration of cerebral blood flow was measured with laser Doppler flowmetry. Rotating acceleration equipment was used to provocate mouse vertigo for 30 min, and the spontaneous locomotor activities were tested for occurrence of vertigo in mice. Phencynonate hydrochloride 1.4-5.6 mg·kg-1 was ig given before rotating acceleration. Gastric phenol red emptying rate was used to determine the anti-nausea effect of the test drug in mice 30 min after phencynonate hydrochloride 1.4-8.4 mg·kg-1 was ig given. RESULTS The cerebral blood flow of the rat model with bilateral common carotid arteries occlusion was reduced significantly after 24 h (P<0.01). Compared with the model group, phencynonate hydrochloride (0.5, 2.0 and 4.0 mg · kg-1) increased the cerebral blood flow in a dose-dependent manner in rats with cerebral ischemia (P<0.01). The spontaneous locomotor activities were significantly reduced after vertigo stimulation in mice (P<0.05). Compared with the model group, phencynonate hydrochloride (2.8 and 5.6 mg · kg-1) increased the movement distance and speed of vertigo mice (P<0.05). Phencynonate hydrochloride (2.8, 5.6 and 8.4 mg·kg-1) inhibited the gastric emptying of mice (P<0.05). CONCLUSION Phecynonate hydrochloride can improve the cerebral blood flow and locomotor activities in vertigo rats, while inhibiting gastric emptying, which points to the therapeutic potential of phencynonate hydrochloride for vertigo in clinic.
ABSTRACT
[Objective] To investigate the relationship of different types of gestational diabetes mellitus (GDM) and thyroid function.[Methods] A Total of 3846 cases,which received prenatal examination,delivered in the Eastern Hospital of the First Affiliated Hospital,Sun Yat-sen University and performed a 75 g oral glucose tolerance test (75 g 0GTT) at 24-28 gestational weeks,from Jan 1st,2014 to Dec 31st,2015,were divided into 2 groups.Normal blood glucose group:the result of OGTT (fasting plasma glucose,1 hour glucose and 2 hour glucose) was normal;Gestational diabetes mellitus group (GDM group):the result of 0GTT was abnormal.GDM group were divided into Ⅰ,Ⅱ,and lⅢ.GDM Ⅰ defined as one abnormal blood glucose of result.GDM Ⅱ:two abnormal blood glucose.GDM Ⅲ:three abnormal blood glucose.1868 cases of healthy pregnant women were reselected as the control group.TSH,FT4 and TPO Ab were detected in two groups.Analysis of Variance,Mann-Whitney U test,Kruskal Wallis rank test or Fisher's test was used for statistical analysis.[Result] There were statistically significant difference in TSH,FT4 between GDM subgroup and control group (P =0.012,P =0.002).TSH median trend to increase in GDM Ⅱ,and FT4 median trend to decrease in GDM Ⅱ.The Prevalence of hypothyroidism in GDM Ⅱ and GDM Ⅲ were higher than those in control group.[Conclusion] The GDM group with two or three abnormal blood glucose had a higher incidence thyroid gland dysfunction,especial with subclinical hypothyroidism.We should fully test the thyroid function,treat diabetes as early as possible and improve the pregnancy outcome as we could.
ABSTRACT
Syncope and epilepsy are common pediatric clinical symptoms and causes of paroxysmal loss of consciousness.They can be manifested as a sudden attack,transient and reversible loss of consciousness,easily leading to misdiagnosis in clinics.The etiology and pathogenesis of syncope and epilepsy are completely different,and the principle of treatment is also different.Therefore,in clinics,making an early diagnosis and differential diagnosis between syncope and epilepsy has an important significance to improve the treatment and the prognosis of the patients.
ABSTRACT
Objective:To study the chronic disease management’s key factors in community health service insti-tution based on the Innovative Care for Chronic Conditions Framework ( ICCC ) . Methods: The purposive sampling method was adopted. Twelve community health service centers were selected as the field survey sites in Beijing, Shanghai, Zhengzhou and Chengdu. During the key factors description at macro-, meso-and micro-level in the IC-CC framework, thematic framework analysis was used to describe the key factors at maro-, meso-and micro level in the ICCC framework. Results:From the community health institutions’ perspective, the key factors at meso level in the ICCC framework played a better role in the management of chronic conditions while the key factors in both macro and micro level still lacked. Conclusion:Based on the ICCC framework, the management of chronic diseases needs to emphasize the cooperation with relevant departments outside the health area and legislative strategies at macro level, the ability of community supporters to mobilize and coordinate resources at meso level and the improvement of self-management skills for the patients with chronic diseases.
ABSTRACT
Objective To observe the therapeutic effect of Wenyang Huayu Sanjie Decoction ( WHSD) for the treatment of adenomyosis with the syndrome of blood deficiency and cold stagnation. Methods Seventy qualified patients were evenly randomized into observation group and control group. The control group was treated with Mirena intrauterine contraceptive device, and the observation group was treated with WHSD ( composed of Danggui Sini San, Wuzhuyu Shengjiang Tang, Shixiao San and Rhizoma Sparganii, Rhizoma Curcumae). The clinical outcomes included the menstrual blood volume, menstrual cycle, menstruation, degrees of dysmenorrhea, uterine volume, and serum CA125 level in the two groups before treatment and 3, 6 months after treatment. Results ( 1) After treatment for 6 months, the total effective rate of the observation group was 94.29%, significantly higher than 85.71% in the control group ( P<0.05). ( 2) After treatment, dysmenorrheal degrees, menstrual blood volume, menstrual cycle, menstruation, uterine volume, and serum CA125 level were improved in both groups ( P<0.05) , and the observation group had better effect on relieving dysmenorrhea, improving menstruation, and decreasing CA125 level than the control group ( P<0.05). ( 3) No obvious adverse reaction was found in the observation group, but most of the cases in the control group had menstrual disorder such as vaginal irregular bleeding and prolongation of menstruation. Conclusion WHSD has certain therapeutic effect on adenomyosis with the syndrome of blood deficiency and cold stagnation, and can also obviously improve the quality of life of the patients.
ABSTRACT
Objective:To analyze the progress of the contracting service model in community health centers in the typical areas in China, and provide empirical evidence for the hierarchical system targeted to make first contact and orderly dual transfer. Methods: Purposive sampling was adopted. Twelve community health centers in Beijing, Shanghai , Zhengzhou and Chengdu areas where the general practitioner model was conducted earlier and set to be the representative one, were selected as the field survey sites. A thematic framework analysis was used to describe the key factors around the contacting service model. Results:This model was developed around the following key factors:using the general practice team as the main service provider, taking the patients with chronic diseases as the main contracting groups and extending to their family members with the number of contracted ranging around 1500~2000 , freely providing both essential public health and medical services, fully using the family physician room as the con-tracting service platform and highlighting the actively serving concept, building the financial and non-financial incen-tives, health insurance benefits and green transfer mechanisms in order to efficiently guarantee the contracting service development. Conclusions: Based on the information platform, the contracting service model in the sample sites played a great role in the appointment and referral services development as well as the self-health management among residents, improving the relationship between physicians and patients, and promoting the formation of orderly health service pursuing pattern.
ABSTRACT
<p><b>BACKGROUND</b>It is unclear whether the effect of video-assisted thoracoscopic surgery ablation is better than catheter ablation on paroxysmal atrial fibrillation (PAF) or not. This study aimed to compare the effects of catheter ablation and video-assisted thoracoscopic surgery ablation on PAF.</p><p><b>METHODS</b>From March 2008 to March 2012, 138 consecutive patients with PAF were randomly assigned to receive either video-assisted thoracoscopic surgery ablation (thoracoscopy group, n = 66) or the traditional catheter ablation (catheter group, n = 72).</p><p><b>RESULTS</b>No patient died during the study and all were successfully followed and included in analysis. There were no significant differences in clinical and echocardiographic characteristics between the two groups. All patients were evaluated at 1 week, 1 month, 3 months, 6 months, and 12 months after discharge by physical examination and related laboratory tests. Preoperative left atrium dimensions (LADs) of the recurrent AF were (47 ± 4) mm in the thoracoscopy group and (46 ± 8) mm in the catheter group, whereas the LADs were (40 ± 5) and (39 ± 9) mm, respectively, in non-recurrent PAF.</p><p><b>CONCLUSIONS</b>The short-term outcome of video-assisted thoracoscopic surgery ablation is safe and effective; and the indications are wider than those for catheter ablation. The larger left atrium diameter is related to the recurrence of atrial fibrillation.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Atrial Fibrillation , General Surgery , Therapeutics , Catheter Ablation , Methods , Thoracic Surgery, Video-Assisted , Methods , Treatment OutcomeABSTRACT
Objective:To analyze the structure modes of general practice teams in community health care cen-ters in order to provide empirical evidence for the transformation of the community health service mode. Method:Pur-posive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou and Cheng-du, where the transformation of the community health service mode was piloted earlier and representative, were se-lected as the field survey sites. The qualitative method was used to collect the data accompanied by the quantitative method. Results:The structure models of general practice teams could be divided into four types:1) general practi-tioner+nurse+nurse assistant+pharmacist, 2) physician (general practitioner, herbalist physician) +nurse+com-munity volunteers, 3 ) physician ( general practitioner/herbalist physician ) +nurse +assistant +community volun-teers, and 4) general practitioner+nurse+assisting team (professionals of public health and maternal care, etc) +supportive team ( pharmacists, health technician, etc) . Conclusion:The paper verified the common sense conclusion that general practitioners should play an essential role in general practice teamwork. The four general practice team models analyzed above positively contributed to the improvement of efficiency and quality, the relationship between health professionals and patients, the promotion of community participation, and the combination between preventive care and clinical care.
ABSTRACT
Objective:To analyze the concerning guarantee mechanisms during the transformation of the com-munity health service mode. Method:Purposive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou, and Chengdu, where the transformation of the community health service mode was pi-loted earlier and representative, were selected as the field survey sites. The qualitative method was used to collect da-ta accompanied by the quantitative method. Results: The guarantee mechanisms related to the transformation of the community health service mode could be concluded into four main types:collaboration mechanism, health profession-al training mechanism, incentive mechanism, and policy guarantee mechanism. All of the four mechanisms contribu-ted to the improvement of general teamwork, dual referral systems, and the development of contract and appointment services. Conclusion:During the transformation of the community health service mode, priority strategies include top-down design, health professional training mechanisms, and performance-based incentive mechanism, all of which should be implemented in the future.
ABSTRACT
Objective: To explore the utilization and effects of informatization in perfecting the community health service mode. Method:Through purposive sampling, 12 community health service centers in Beijing, Shang-hai, Chengdu, and Zhengzhou were selected for site investigation. The heads of the health administrative department and community health service centers were interviewed, with a focus on the construction and utilization of the local community health informatization and a discussion of the role of informatization in perfecting the community health service mode. Results:The information systems can be divided into core systems, core auxiliary systems, and periph-eral support systems. Informatization provides strong support to perfecting the community health service mode in opti-mizing the service process, improving work efficiency, strengthening institutional cooperation, promoting quality regu-lation, optimizing performance appraisal, and strengthening doctor-patient interaction. Conclusion: Informatization plays a key role in perfecting the community health service mode. Recommendations were proposed to strengthen community health informatization construction and utilization:optimizing service processes, promoting the efficient co-ordination of safe health services, optimizing performance appraisals, and strengthening doctor-patient interaction.
ABSTRACT
In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.
ABSTRACT
ObjectiveTo evaluate the feasibility of constructing tissue engineering cardiac patch with photooxidationfixed acellular bovine pericardium.MethodsFresh bovine pericardia were treated by dye-mediated photooxidation after decellularization.Some of them were seeded with bone marrow stromal cells(MSCs) isolated from male SD rats to construct cardiac patches.Myocardial infarction(MI) model was made in female SD rats by left anterior descending coronary ligation(LAD).One week later, the confirmed MI rats were divided into three groups randomly, group MI (n = 15)without any treatment; group P (n = 18) with photooxidated pericardia implantation ; group P + C (n = 18) with seeded pericardia implantation.A sham group (n = 10) was also performed with opening and closing chest twice only.The heart were explanted at 2 or 4 weeks after implantation, and examined histologically and immunohistochemically.The heart function was evaluated by echocardiography at 4 weeks before excising the rats.ResultsThere were no cells or cell debris remained in bovine pericardium tissue.The fiber structure became condensed after photooxidation.The seeded cells formed a continuous layer on the surface of the tissue.The pericardial degradation level and newly formed microvessel density were larger in group P + C than in group P after 2 [ (13.7 ±5.2)个/mm2 vs (7.1 ±3.1)个/mm2, P＜0.05]and4 [(22.6 ±4.9)个/mrn2 vs (14.1 ±5.3)个/mm2, P＜0.05]weeks.Four weeks after transplantation, cardiac echocardiography showed left ventricular ejection fraction(LVEF) was lower in group MI (44.8 ± 4.4) ％ and group P (48.4 ± 5.0) ％ compared with group P + C (49.3 ± 4.8) ％, left ventricular fractional shorterning(LVFS) was lower in group MI (18.0 ± 2.2) ％ and group P (19.8 ± 2.5) ％ compared with group P + C (20.4 ±2.5) ％, the difference between P + C and MI was significant.ConclusionTransplantation of the tissue engineered bovine pericardial patches with dye-mediated photooxidation can improve heart function in MI rats.This kind of patches demonstrates a promising prospect in the future.
ABSTRACT
5 cases diagnosed with Dandy-Walker Syndrome from May 2006 to November 2009 were investigated and relevant literature reviewed. Dandy-Walker Syndrome was characterized by retarded motordevelopment and cerebellar signs. The latter was observed in 3 cases in our series. The disorder, mostly influencing childhood, typically causes the fourth ventricle enlarged, and the cauda cerebelli atrophic or even absent. MRI is the most optimal radiological method to diagnose it.
ABSTRACT
The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city community health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms of IB allocation quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.
ABSTRACT
Objective To investigate the expression of caspase-3 and FasL in the hippocampus of the infantile rats with recurrent sei-zures. Methods 72 of 20-day-old Sprague-Dawley rats were randomly divided into two groups, control group and seizure group. Seizures in rats were induced by inhalant flurothyl daily in six consecutive days. Brain tissue was sampled at different time points (the 1st day, 3rd day and 7th day) after last seizure. The expressions of caspase-3 and FasL proteins in the hippocampus were detected by immunohistochemistry, and the expression of caspase-3 mRNA was measured by reverse transcription- polymerase chain reaction (RT-PCR). Results The caspase-3 protein, FasL protein and caspnse-3 mRNA levels were obviously increased at the 1st, 3rd and 7th day after recurrent seizure in the hippocampus of the rat(P<0.01). Conclusions Caspase-3 and FasL are participated in the infantile brain injury after recurrent seizures.
ABSTRACT
The practice operation is an important method of clinical pediatric teaching during internship.We should fully consider the application occasions and select the most appropriate teaching cases when using this method on the clinical application teaching.The preparation before the intern should be emphasized because it is one of keys for students to learn much in the application.In order to correctly evaluate the effects of practice operation,we must focus on testing the working ability of students and standardizing the examination.
ABSTRACT
Objective To investigate the effects of Ginkgo biloba(银杏叶) extract on the expression of caspase-3 in the hippocampus of the rats following recurrent seizures,the role of caspase-3 in the brain injury induced by seizures and the possible protective mechanism of Ginkgo biloba extract against brain injury.Methods One hundred and eight Sprague-Dawley(SD) rats,twenty-day-old,were divided randomly into three groups: the control group,the seizure group and the Ginkgo biloba extract treatment group.Seizures models in rats were produced by consecutive inhalation of flurothyl daily for six days.The rats in the Ginkgo biloba extract treatment group received 50 mg/kg of the Ginkgo biloba extract through intra-abdominal injection immediately after every seizure,and after 12 hours another injection was repeated,while the rats in seizure group and control group received volume-matched saline through intra-abdominal injections.Brain tissue was sampled at different time points(1 day,3 days,7 days) after last seizure.The expression of caspase-3 protein in the hippocampus was detected by immunohistochemistry,and the expression of caspase-3 mRNA was measured by reverse transcription-polymerase chain reaction(RT-PCR).Results The caspase-3 protein and caspase-3 mRNA levels at the time points of postseizure 1,3,7 days in the hippocampus of the rat pups in seizure group were much higher than those in control group,while they were highest on the post-seizure 3rd day(all P