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By consulting ancient herbal books and modern literature， this paper systematically sorted out and researched the processing history， relevant processing norms in recent years， modern processing technology， chemical composition changes of processed products and their pharmacological mechanism of Scutellariae Radix， in order to provide a basis for the further development of Scutellariae Radix decoction pieces. According to the textual research of ancient books， there were many kinds of processing auxiliary materials of Scutellariae Radix， such as wine， vinegar， salt， honey， pig bile and so on， among which the wine processing was the most diverse and detailed， and the processed products such as raw products， stir-fried products， wine-processed products， fried charcoal products were still in use. The modern processing techniques of Scutellariae Radix mainly focus on the processing aspects of softening and slicing， wine processing and charcoal frying， and the research methods are relatively unified. At present， it is found that the changed chemical constituents of Scutellariae Radix after processing are flavonoids， polysaccharides， volatile oils and trace elements， etc. Pharmacological effects of processed products are hemostasis， antibacterial， anti-inflammatory， antioxidant， analgesic and antipyretic， treatment of lung diseases， treatment of colitis， etc. However， in the studies of Scutellariae Radix processing， there is a lack of research on the structural changes of chemical components caused by processing and a comprehensive comparative study on the pharmacological effects of various processed products. Based on this， it is suggested to carry out systematic research on the processing technology to processing mechanism， further explore the relationship between the change rule of material basis and pharmacological action before and after processing of Scutellariae Radix， and deepen the exploration of molecular mechanism and clinical application of processed products of Scutellariae Radix， in order to clarify the scientific connotation of the processing mechanism of Scutellariae Radix， and lay a foundation for the subsequent expansion of the application of Scutellariae Radix decoction pieces and the formulation of processing standards.
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The pathological manifestations of neurodegenerative diseases， such as Alzheimer's disease， Parkinson's disease， and multiple sclerosis， are abnormal protein aggregation and accumulation， microglia activation， and mitochondrial dysfunction， which eventually lead to the gradual loss of neuronal structure or function and deteriorate over time. These pathological processes are related to the production of reactive oxygen species （ROS）， which can cause oxidative stress and damage proteins， lipids， and DNA， leading to cell and tissue injuries. The Kelch-like ECH-associated protein 1 （Keap1）/nuclear factor E2-related factor 2 （Nrf2）/antioxidant response element （ARE） signaling pathway is the main mechanism to maintain the redox balance of the body and defend against oxidative stress injury. Nrf2 activates the expression of a series of antioxidant genes related to ARE through the dissociation of Keap1 and nuclear transfer in the cytoplasm to protect the body from oxidative damage. Therefore， the discovery and study of the Keap1/Nrf2/ARE signaling pathway activator is of great significance for the prevention and treatment of neurodegenerative diseases. Because of the remarkable biological activity and slight side effects， natural products are a treasure trove for new drug research and development. Studies have shown that a variety of natural products can activate the Keap1/Nrf2/ARE signaling pathway and play a neuroprotective role. According to the structural characteristics， natural products can be divided into flavonoids， terpenoids， volatile oils， polyphenols， and phenylpropanoids. This study summarized the underlying mechanism of the Keap1/Nrf2/ARE signaling pathway in regulating diseases and reviewed the research progress on natural products based on this signaling pathway in neuroprotection to provide references for the development of clinical drugs for the prevention and treatment of neurodegenerative diseases.
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OBJECTIVES@#There is less clinical data on multiple myeloma (MM) in China, and the aim of this study was to collect and analyze the clinical data of newly diagnosed multiple myeloma (NDMM) patients in Hunan Province during 1 year, to understand the real clinical features and treatment outcome for Hunan Province patients with MM, and to strengthen the understanding of the standardized diagnosis process and treatment plan of MM.@*METHODS@#The clinical data of 529 patients with NDMM in 12 large-scale general hospitals in Hunan Province from January 1 to December 31, 2019 were collected and analyzed, including baseline data, treatment regimens, duration of treatment, and adverse reactions. The clinical characteristics, treatment, and safety of patients were analyzed by SPSS 21.0.@*RESULTS@#Among the 529 NDMM patients, the age was 33-90 (median 64) years and the male-female ratio was 1.38꞉1. The clinical features ranged from high to low were as follows: Bone pain (77.7%), anemia (66.8%), renal insufficiency (40.6%), hypercalcemia (15.1%). Typing: IgG 46.5%, IgA 24.6%, IgD 2.6%, IgM 0.8%, light chain 15.7%, double clone 3.0%, no secretion 0.6%, absence 6.2%. Staging: Durie-Salmon stage I, II, and III were 4.5%, 10.6%, 77.3%, respectively, and 40 cases (7.6%) missed this data. International Staging System (ISS) stage I, II, and III were 10.4%, 24.4%, and 47.6%, respectively, and 93 cases (17.6%) were missing. Revised International Staging System (R-ISS) stage I, II, and III were 5.5%, 27.0%, 23.1%, respectively, and 235 cases (44.4%) missed this data. Among the 98 NDMM patients in the Third Xiangya Hospital, Central South University, Durie-Salmon (DS) stage missing 2.0%, ISS stage missing 12.3%, and R-ISS stage missing 12.3%.Treatment: Among the 529 patients,475 received treatment, the rate of treatment was 89.8%; 67.4% of the patients were able to complete four courses of chemotherapy at induction phase, 90.3% of the patients received proteasome inhibitor based combination chemotherapy regimen more than once, 67.2% received immunomodulator based regimen more than once, and 59.8% of the patients received proteasome inhibitor and immunomodulator based combination chemotherapy regimen more than once. Curative: Overall response rate (ORR) and high quality response rate (HQR) of the 4-course group were better than those of the 2-course group (ORR: 85% vs 65%, P=0.006; HQR: 68.3% vs 24.0%, P<0.001). The HQR of the standard chemotherapy group was better than that of the non-standard chemotherapy group (65.1% vs 48.2%, P=0.035). Adverse reactions during treatment included hematologic toxicity (17.5%), peripheral neuropathy (24.8%), gastrointestinal adverse events (23.8%), pulmonary infection (25.9%), herpes zoster (4.6%), and venous thrombotic events (1.7%).@*CONCLUSIONS@#In 2019, the missed diagnosis rate of MM patients was high, the medium age of diagnosis was older, and the accuracy of patient diagnosis was not high. There is a great difference among medical centers, especially in the stage and risk stratified, nearly half of NDMM patients are not diagnosed with R-ISS stage; the lack of cytogenetic data needs to be supplemented by follow-up studies. A high proportion of patients with NDMM present with bone pain and anemia.Patients received treatment have higher use of chemotherapy regimens containing proteasome inhibitors and/or immunomodulators, but there is a significant gap among different medical centers, and standardized treatment needs to be strengthened. The safety during chemotherapy is controllable.
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Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Immunologic Factors/therapeutic use , Multiple Myeloma/therapy , Neoplasm Staging , Pain , Prognosis , Proteasome Inhibitors/therapeutic useABSTRACT
Vaccination is an effective way to reduce the morbidity and mortality of infectious diseases. As a needle-free transcutaneous immunization (NF-TCI) vaccination technology, microneedles (MNs), composed of multiple micro-needles orderly attached to a substrate, can overcome the problems of low immune efficiency, poor compliance and waste of resources that exists in the conventional vaccination by injection, thus becoming a research hotspot in biomedicine. The microneedle vaccine can directly break through the stratum corneum barrier of the skin without touching nerves and blood vessels in the dermis, and effectively delivers the vaccine to the immune cells in the skin tissue to initiate the immune response of the body, thus triggering strong humoral and cellular immune processes. Vaccine delivery via the MNs system possesses the advantages of high safety, satisfying immune effect and practical economy, and shows great prospect in the prevention and treatment of infectious diseases and antineoplastic therapy. This article reviews the development background of MNs in transcutaneous immunization, the types of vaccine delivery, the factors affecting the immune effect, the problems to be solved and development direction in the future.
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Objective:To examine the influencing factors of endothelial injury using the structural equation model (SEM).Methods:A total of 6 861 asymptomatic individuals free of cardiovascular disease underwent health examinations at the health management center of the third Xiangya hospital, Central South University from May 2015 to August 2020. And collected their questionnaire and checkup data. Spearman′s rank correlation coefficient was used to analyze metabolic factors and brachial artery flow-mediated dilatation (FMD). Exploratory factor analysis (3 430/6 861) and confirmatory factor analysis (3 431/6 861) were conducted on the diet items. An SEM was constructed using the diet pattern data, cardiovascular risk factors and FMD, and using multi-path regression analysis to determine the correlation between the indicators.Results:Based on the factor analysis, diet items were divided into three patterns: healthy food, meat, and supplementary food. The SEM indicated that age ( β=0.27) and blood pressure ( β=0.12) had obvious effects on low FMD. Triglyceride ( β=0.03), fasting blood glucose ( β=0.04), and body mass index ( β=0.08) were positively correlated with low FMD. On the upstream, healthy food was negatively correlated with blood pressure ( β=-0.04) and body mass index ( β=-0.04), meat was positively correlated with triglyceride ( β=0.33), blood pressure ( β=0.06), fasting blood glucose ( β=0.20), and body mass index ( β=0.16), and supplementary food was negatively correlated with fasting blood glucose ( β=-0.30). This was the only pattern that was directly correlated with FMD ( β=0.05). Conclusions:SEM is an effective method to analyze the influence of various risk factors on the population and the relationship between individual indicators. This study revealed direct and indirect correlations between age, diet pattern, cardiovascular-metabolic risk, and FMD impairment. Comprehensive control of dietary patterns and metabolic indicators could prevent and improve early cardiovascular injury.
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Objective The mechanism of autophagy-related gene mTOR signaling pathway is less studied in its pathogenesis of systemic lupus erythematosus. The aim of this study was to investigate the role of autophagy-related gene mTOR signaling pathway in the pathogenesis of SLE. Methods 72 patients with systemic lupus erythematosus in the Department of Rheumatism and Immunity in the Second Affiliated Hospital of Hainan Medical College from February 2018 to March 2019 were selected as observation group. 67 healthy subjects in the same period were used as control group. The ENA antibody profiles were determined by immunoblotting, including anti-SSA, anti-SSB, anti-Sm, anti-nRNP antibodies, and ds-DNA antibodies. IgG, IgA, IgM, and complement C3, C4 were determined using an IMMAGE protein analyzer. Fluorescence PCR was used to detect the autophagy-related gene mTOR signaling pathway. SPSS Pearson correlation analysis software was used to analyze the correlation between autophagy-related gene mTOR signaling pathway(pI3K mRNA, Akt mRNA, mTOR mRNA) and humoral immunity level in the two groups. Results The level of IgG, IgA, and IgM in the observation group was significantly higher than that of the control group (P<0.05). The levels of complement C3 and C4 in the observation group were lower than those in the control group (P<0.05). The expression levels of PI3K mRNA, Akt mRNA and mTOR mRNA in SLE group (0.52±0.06, 0.61±0.08, 0.48±0.05) were significantly lower than those in control group (1.00±0.09, 0.89± 0.07, 0.95±0.08), with statistically significant differences (P<0.05). The results of SPSS Pearson correlation analysis showed that Akt and mTOR signals expression were negatively correlated with IgG, IgA, IgM level,and ds-DNA, anti-SSA, anti-SSB, anti-Sm, anti-nRNP expression leve(P<0.05). On the contrary, they were positively correlated with complement C3, C 4 levels(P<0.05). Conclusion The expression of PI3K mRNA, Akt mRNA and mTOR mRNA in mTOR signaling pathway of autophagy related genes in SLE patients is inhibited, which is closely related to immunoglobulin and complement level. Therefore, detection of the autophagy related gene mTOR signaling pathway will be helpful in assessing the status of SLE patients.
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OBJECTIVE@#To analyze how governments, hospitals and information technology(IT) companies use Internet technology to provide online health services during the early stage of corona virus disease 2019 (COVID-19) epidemic in January 2020 in China, and then provide suggestions and coping strategies for the later stage and post-epidemic time.@*METHODS@#We searched for information on ehealth services related to the outbreak of COVID-19 in China. The sources of information were mainstream search engines such as Baidu and the popular interactive social platforms such as Webchat. The keywords were "Internet+pneumonia", "Internet clinic", "pneumonia online clinic" and so on. The time of information was from January 20 to February 3, 2020. The key information was extracted and encoded by two persons back-to-back. The coding information included: name of organization provider, launching time, location of provider, service items, user, health workers engaging in the service, and so on. The coded information was entered and analyzed with SPSS 24.0 and Excel.@*RESULTS@#There were totally 57 projects launched by local governments, hospitals and IT companies. Most of them were launched from January 24th to 27th, the hospital and government projects services regionally, especially in eastern provinces. In this study, 90.48% of the enterprises and 100.00% of the hospitals had online fever clinic and consultation services for COVID-19, 66.67% of the enterprises and 37.04% of the hospitals serviced derivative health problems. Only a few projects provided tele-medical consultation. There were individual projects that provided online health management for home quarantine people. Physicians were the main force of various projects. In some hospital projects, there were also nurses, pharmacists and professional technicians to provide featured consultation.@*CONCLUSION@#Ehealth is useful and helpful for the health care system to rapidly cope with health demand during instantaneous and post epidemic time. Regional distribution of ehealth is unbalanced. There are institutional and technical feasibilities for the emergency application of Internet technology. However, community health centers seldom provide ehealth or connect with tertiary hospitals with Internet. Therefore, all kinds of providers within healthcare system should promote emergence ehealth. Tele-medical diagnosis and referral should be developed by local governments during COVID-19. The application of "Internet+medical treatment" in community medical institutions and synergy among various institutions should be promoted.
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Humans , Betacoronavirus , COVID-19 , China , Coronavirus Infections , Pandemics , Pneumonia, Viral , SARS-CoV-2 , TelemedicineABSTRACT
Objective Studies are rarely reported on the effect of short peptides of the pigment epithelium derived factor (PEDF) on the proliferation of human cutaneous squamous (SCL-1) cells. The purpose of this study is to investigate segmented cloning and expression of the PEDF protein and observe its effect on the proliferation of human SCL-1 cells. Methods The target genes of PEDF1, PEDF2 and PEDF3 were amplified by PCR and the recovered fragments subjected to double digestion of NheⅠ and Hind Ⅲ and inserted into the pET28a(+) plasmid. The product was transformed into human E coli BL21 and induced to express, followed by isolation and purification of the fusion protein. CCK-8 assay was used to detect the proliferation of the SCL-1 cells with PEDF1, PEDF2 and PEDF3 at 100, 400, 800 and 1000 nmol/L at 24, 48 and 72 hours. Results The prokaryotic expression vectors of PEDF1, PEDF2 and PEDF3 were successfully constructed, and their fusion proteins prepared, with the molecular weight of 18 000, 17 000 and 13 000, respectively. The proliferation of the SCL-1 cells was significantly decreased in the 800 and 1000 nmol/L PEDF3 groups compared with that in the 0 nmol/L PEDF3 group at 24 hours (0.16 ± 0.03 and 0.78 ± 0.07 vs 1.00 ± 0.00, P < 0.05), inhibited in a concentration-dependent manner in the 400, 800 and 1000 nmol/L PEDF3 groups at 48 hours (P < 0.05), markedly lower in the 800 and 1000 nmol/L PEDF3 groups at 72 hours (0.53 ± 0.05 and 0.51 ± 0.05) than in the in the 400 and 0 nmol/L PEDF3 groups (0.60 ± 0.05 and 1.00 ± 0.00) (P < 0.05). Conclusion The PEDF fusion proteins were successfully segmentally cloned and expressed and PEDF3 inhibited the proliferation of SCL-1 cells, which has paved the ground for further screening of active functional short peptides of PEDF.
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Complication with twins or hypoproteinemia and long-term use of fetal protection drugs and other factors in preeclampsia pregnant women significantly increase the risk of heart failure.Combining typical clinical manifestations with auxiliary examinations can diagnose preeclampsia complicated with cardiac insufficiency.The early symptoms of cardiac insufficiency are easy to be neglected.We should pay attention to the manifestations of early heart failure.Active control of preeclampsia and timely termination of pregnancy are the main measures to prevent cardiac insufficiency.Preeclampsia is also a major risk factor for long-term cardiovascular complications.It is necessary to synthesize multidisciplinary diagnosis and treatment and strengthen long-term follow-up.
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Liver cancer is the second leading cause of cancer-related death worldwide,so early detection and prediction for response to treatment is of great benefit to hepatocellular carcinoma (HCC) patients.Currently,needle biopsy and conventional medical imaging play a significant and basic role in HCC patients' management,while those two approaches are limited in sample error and observerdependence.Radiomics can make up for this deficiency because it is an emerging non-invasive technic that is capable of getting comprehensive information relevant to tumor situation across spatial-temporal limitation.The basic procedure for radiomics includes image acquisition,region of interest segmentation and reconstruction,feature extraction,selection and classification,and model building and performance evaluation.The current advances and potential prospect of radiomics in HCC studies are involved in diagnosis,prediction for response to treatment,prognosis evaluation and radiogenomics.
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Aim To explore the optimal way of breeding and genotype identification of Arrb2 knockout mice, and to find a simple and quick polymerase chain reaction ( PCR) method for the genotyping of Arrb2 knockout mice. Methods Breeding homozygote genotype of Arrb2 gene knockout mice were copula-ted with wild-type C57BL/6J mice, and then the heterozygous mating were used for mating. The growth and development of off-spring were observed. The genomic DNA was extracted from the tail of two-week-old mice. PCR was employed to amplify the Arrb2 gene fragment, and electrophoresis was used to present the gene type. Results The breeding and reproducing were successful and three genotype offspring, including wild-type,heterozygous and homozygous knockout mice were obtained. Agarose gel electrophoresis results showed the size of PCR prod-ucts was about 186 bp and 224 bp, which was consistent with the expected target gene fragment, and identified Arrb2 gene knockout mice of different genotypes successfully. Western blot analysis demonstrated the lack ofβ-arrestin2 protein in the major organs from Arrb2 -/ - mice compared with Arrb2 +/ + and Arrb2 +/ - mice. Conclusions It is feasible to obtain the homo-zygous Arrb2 knockout mice by inbreeding heterozygotes. It is simple, rapid and reliable to identify mouse genetype by PCR.
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<p><b>Background</b>Remote ischemic postconditioning (RIPostC) appears to protect distant organs from ischemia-reperfusion injury (IRI). However, cerebral protection results have remained inconclusive. In the present study, a meta-analysis was performed to compare stroke patients with and without RIPostC.</p><p><b>Methods</b>CNKI, WanFang, VIP, CBM, PubMed, and Cochrane Library databases were searched up to July 2016. Data were analyzed using both fixed-effects and random-effects models by Review Manager. For each outcome, risk ratio (RR) and mean difference (MD) with 95% confidence interval (CI) were calculated.</p><p><b>Results</b>A total of 13 randomized controlled trials that enrolled a total of 794 study participants who suffered from or are at risk for brain IRI were selected. Compared with controls, RIPostC significantly reduced the recurrence of stroke or transient ischemic attacks (RR = 0.37; 95% CI: 0.26-0.55; P < 0.00001). Moreover, it can reduce the levels of the National Institutes of Health Stroke Scale score (MD: 1.96; 95% CI: 2.18-1.75; P < 0.00001), modified Rankin Scale score (MD: 0.73; 95% CI: 1.20-0.25; P = 0.00300), and high-sensitivity C-reactive protein (MD: 4.17; 95% CI: 4.71-3.62; P < 0.00001) between the two groups. There was no side effect of RIPostC using tourniquet cuff around the limb on ischemic stroke treating based on different intervention duration.</p><p><b>Conclusion</b>The present meta-analysis suggests that RIPostC might offer cerebral protection for stroke patients suffering from or are at risk of brain IRI.</p>
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Humans , Brain Ischemia , Ischemic Attack, Transient , Therapeutics , Ischemic Postconditioning , Methods , Randomized Controlled Trials as Topic , StrokeABSTRACT
Objective To investigate the relationship between the expression of Wnt induced secreted protein-1 (WISP-1) and the fibrosis of renal biopsy tissue in IgA nephropathy (IgAN) patients.Methods Fifty-three patients firstly diagnosed as IgA nephropathy by renal biopsy were included and classified according to Oxford and Lee's classification.Sixteen patients with MCD entered the fibrosis negative control group,and fourteen healthy adults entered the normal control group.The expression of WISP-1 in renal tissues and serum of all subjects were detected by immunohistochemistry and ELISA respectively.Results Immunohistochemistry results showed that WISP-1 was not expressed in MCD patients and normal human kidney tissues,which was abundantly deposited in renal tissue of patients with focal proliferative IgAN with renal interstitial fibrosis.The serum level of WISP-1 in IgAN patients was significantly higher than that in normal subjects (P=0.015) and MCD patients (P=0.030).In the subgroup analysis of IgAN renal fibrosis,the serum concentration of WISP-1 of fibrosis grade between 0-10％ (F1 group) and fibrosis ＞ 25％ (F3 group) were significantly higher than that in the normal group and the MCD group (all P ＜ 0.05).There was no significant difference between F2 group (10％ ＜ fibrosis≤25％) and normal group or MCD group (P ＞ 0.05).Conclusions The expression of WISP-1 in serum and renal tissue of renal interstitial fibrosis IgAN patients is higher than that of normal and MCD patients without renal fibrosis,and the IgAN patients' serum level of WISP-1 is significantly increased in fibrosis lower score group.The expressions of WISP-1 in serum and renal tissue are related to the occurrence of IgAN renal interstitial fibrosis,in which WISP-1 may play an important role as an early precursor factor in the pathogenesis of IgAN renal interstitial fibrosis.
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Objective To explore the related factors on sore throat and pharyngeal xeransis during thyroid surgery.Methods Twenty-nine female patients, aged 24-67 years, BMI 18-30 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were scheduled for thyroid surgery.After anesthesia induction and tracheal intubation, the endotracheal intracuff was inflated to 20 mm Hg.Intracuff pressure was monitored every 5 minutes by a pressure transducer.At the time of 24 hours after tracheal intubation, the patients were asked about their throat complaints such as sore throat and pharyngeal xeransis.Results Endotracheal intracuff pressure during thyroid surgery was in a discrete distribution.Multiple linear regression model analysis found that age, BMI, anesthesia time and intracuff pressure had no obvious effects on sore throat.Decision tree model analysis found that patients undergoing thyroid surgery had higher probability of pharyngeal xeransis grade Ⅳ, when the average intracuff pressure was higher than 29 mm Hg.Conclusion Excessive endotracheal intracuff pressure during thyroid surgery due to operation causes pharyngeal xeransis.
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Objective To investigate the relationship between the expression of Wnt induced secreted protein-1 (WISP-1) and the fibrosis of renal biopsy tissue in IgA nephropathy (IgAN) patients.Methods Fifty-three patients firstly diagnosed as IgA nephropathy by renal biopsy were included and classified according to Oxford and Lee's classification.Sixteen patients with MCD entered the fibrosis negative control group,and fourteen healthy adults entered the normal control group.The expression of WISP-1 in renal tissues and serum of all subjects were detected by immunohistochemistry and ELISA respectively.Results Immunohistochemistry results showed that WISP-1 was not expressed in MCD patients and normal human kidney tissues,which was abundantly deposited in renal tissue of patients with focal proliferative IgAN with renal interstitial fibrosis.The serum level of WISP-1 in IgAN patients was significantly higher than that in normal subjects (P=0.015) and MCD patients (P=0.030).In the subgroup analysis of IgAN renal fibrosis,the serum concentration of WISP-1 of fibrosis grade between 0-10％ (F1 group) and fibrosis ＞ 25％ (F3 group) were significantly higher than that in the normal group and the MCD group (all P ＜ 0.05).There was no significant difference between F2 group (10％ ＜ fibrosis≤25％) and normal group or MCD group (P ＞ 0.05).Conclusions The expression of WISP-1 in serum and renal tissue of renal interstitial fibrosis IgAN patients is higher than that of normal and MCD patients without renal fibrosis,and the IgAN patients' serum level of WISP-1 is significantly increased in fibrosis lower score group.The expressions of WISP-1 in serum and renal tissue are related to the occurrence of IgAN renal interstitial fibrosis,in which WISP-1 may play an important role as an early precursor factor in the pathogenesis of IgAN renal interstitial fibrosis.
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Objective To compare left ventricular (LV)synchronization of direct His-bundle pacing (DHBP)and right ventricular apical pacing (RVAP)with two-dimensional speckle tracking imaging (2D-STI)and tissue Doppler imaging (TDI),and discuss the diagnostic value of 2D-STI and TDI in evaluation of left ventricular systolic synchronicity.Methods Twenty-four patients implanted with DHBP and RVAP were observed.Conventional echocardiography examination were undergone both at the mode of DHBP or RVAP respectively.The time to peak radial strain of LV 1 8 segments were derived from the parasternal short-axis views by 2D-STI,then calculated the standard deviations (SD ) and the maximal temporal difference of LV 1 8 segments (Trs-SD and Trs-Dif),and the interval of time to peak radial strain between the anteroseptal wall and the posterior wall (Tas-post).The time to peak systolic velocity of LV 12 segments were derived from the apical axis views by TDI.The SD and the maximal temporal difference of 1 2 segments (Ts-SD and Ts-Dif)were calculated as the LV dyssynchrony index.Results All the systolic synchrony parameters derived from 2D-STI and TDI were more significantly shortened in DHBP than in RVAP (all P <0.01).For DHBP,the detection rate of LV synchronization was higher by 2D-STI than by TDI.For RVAP the detection rate of LV dyssynchronization was also higher by 2D-STI than by TDI with RVAP lead (all P <0.05).Conclusions DHBP is more beneficial than RVAP in LV syschronization and LV function,RVAP may induce left ventricular systolic asynchrony.Both 2D-STI and TDI can assess the LV synchronization quantitatively,but 2D-STI may be more superior on the detection rate than TDI.
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Objective To explore whether the PDA patients in the early stage of Eisenmenger syndrome can accept interventional surgery. Methods Three patients were choose from the “National Multicenter Prospective Registration Study on Pulmonary Artery Hypertension”, Clinical assessment, as well as examinations and registrations associated with PAH, was conducted in accordance with relevant provisions of the registration study within 1 wk prior to surgery. The way of the interventional treatment were right heart catheterization and pulmonary vasodilator testing (a capsule of iloprost solution for inhalation), and measurement of the pulmonary arterial pressure, descending aortic pressure, ratio of pulmonary to systemic blood flow, ratio of pulmonary to systemic blood pressure, pulmonary capillary wedge pressure [mean≤15 mmHg(1 mmHg=0.133 kPa)], before and after testing. After clear the results of pulmonary vasodilator test all patients underwent transcatheter closure testing, if it was positive,the amplatzer was released if her family members’ approved;Conversely, the amplatzer was quickly withdrawn with negative results, and symptomatic treatment was conducted based on the patient’s clinical symptoms. Results The first cases pulmonary vasodilator test was negative, but positive in transcatheter closure testing. Satisfaction immediate effect of surgery, and the occluder was released with her family members’ approval. patients of Example 2 and Example 3 were negative in pulmonary vasodilator testing and transcatheter closure testing, can not released the occluder. Conclusions Some Patents Ductus Arteriosus (PDA) patients in early stage of Eisenmenger syndrome is feasible to accept interventional therapy , try plugging test is may be an important indicator of prognostic assessment.
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Objective To investigate the safety and effectiveness of percutaneous balloon pulmonary valvuloplasty (PBPV) in the treatment of pulmonary stenosis (PS). Methods The subjects were 52 patients with PS from 2007 to 2012, including 24 male and 28 female. Their age ranged from 1 year old to 56 year old and mean age was 9.2±7.6 years old. Their body weight ranged from 10 kg to 60 kg and mean weight was 17.3±8.9 kg. All patients were assessed with electrocardiogram (ECG), chest X-ray, right heart catheterization and right ventricular angiagraphy before the procedure. Results All 52 patients received PBPV successfully. Comparing the transvalvular pressure gradient before and after the operation, it decreased from 86.3±27.6 mmHg (1 mmHg=0.133 kPa) to13.8±7.7 mmHg, and statistically difference (P<0.01). Among these patients, one patient occurred ventricular fibrillation and Aspen syndrome (hypoxie-ischemic encephalopathy), one patient occurred respiratory and cardiac arrest, 24 patients occurred transient arrhythmia, one patient had hypotension, one patient had bradycardia and one patient showed desaturation. All these symptoms resolved after appropriate treatment during the PBPV. Two patients had hematoma in the puncture point and 2 patients had reactive infundibular stenosis after PBPV. Conclusions Performing the percutaneous balloon pulmonary valvoplasty on the patients with pulmonary stenosis is safe and effective. PBPV causes less pain and can be used as the preferred treatment for pulmonary stenosis.
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<p><b>OBJECTIVE</b>To rationalize the clinical use and safety are some of the key issues in the surveillance of traditional Chinese medicine injections (TCMIs).</p><p><b>METHOD</b>In this 2011 study, 240 medical records of patients who had been discharged following treatment with TCMIs between 1 and 12 month previously were randomly selected from hospital records. Consistency between clinical use and the description of TCMIs was evaluated. Research on drug use and adverse drug reactions/events using logistic regression analysis was carried out.</p><p><b>RESULT</b>There was poor consistency between clinical use and best practice advised in manuals on TCMIs. Over-dosage and overly concentrated administration of TCMIs occurred, with the outcome of modifying properties of the blood. Logistic regression analysis showed that, drug concentration was a valid predictor for both adverse drug reactions/events and benefits associated with TCMIs.</p><p><b>CONCLUSION</b>Surveillance of rational clinical use and safety of TCMIs finds that clinical use should be consistent with technical drug manual specifications, and drug use should draw on multi-layered logistic regression analysis research to help avoid adverse drug reactions/events.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , Clinical Trials as Topic , Drug-Related Side Effects and Adverse Reactions , Epidemiology , Drugs, Chinese Herbal , Logistic Models , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate nutritional risk and its relationship with clinical outcome in children hospitalized in the surgical department, and to provide a scientific basis for clinical nutrition management.</p><p><b>METHODS</b>Nutritional risk screening was performed on 706 children hospitalized in the surgical department using the Screening Tool for Risk on Nutritional Status and Growth. The data on nutritional support during hospitalization, incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses were recorded.</p><p><b>RESULTS</b>Of the 706 cases, 11.5% had high nutritional risk, 46.0% had moderate nutritional risk, and 42.5% had low nutritional risk. Congenital hypertrophic pyloric stenosis, intestinal obstruction and congenital heart disease were the three most common types of high nutritional risk. The incidence of high nutritional risk was significantly higher in infants than in other age groups (P<0.01). Fifty-two (64.2%) of the eighty-one children with high nutritional risk received parenteral nutrition. Children with high nutritional risk were significantly more likely to have weight loss than children with low nutritional risk (P<0.05). Children with high nutritional risk had significantly increased incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses compared with those with moderate or low nutritional risk (P<0.01).</p><p><b>CONCLUSIONS</b>Moderate or high nutritional risk is seen in children hospitalized in the surgical department. Nutritional risk score is correlated with clinical outcome. Nutritional support for these children is not yet properly provided. Nutritional risk screening and standard nutritional support should be widely applied among hospitalized children.</p>