ABSTRACT
OBJECTIVE@#To determine the role of Tripterygium wilfordii multiglycoside (TGW) in the treatment of psoriatic dermatitis from a cellular immunological perspective.@*METHODS@#Mouse models of psoriatic dermatitis were established by imiquimod (IMQ). Twelve male BALB/c mice were assigned to IMQ or IMQ+TGW groups according to a random number table. Histopathological changes in vivo were assessed by hematoxylin and eosin staining. Ratios of immune cells and cytokines in mice, as well as PAM212 cell proliferation in vitro were assessed by flow cytometry. Pro-inflammatory cytokine expression was determined using reverse transcription quantitative polymerase chain reaction.@*RESULTS@#TGW significantly ameliorated the severity of IMQ-induced psoriasis-like mouse skin lesions and restrained the activation of CD45+ cells, neutrophils and T lymphocytes (all P<0.01). Moreover, TGW significantly attenuated keratinocytes (KCs) proliferation and downregulated the mRNA levels of inflammatory cytokines including interleukin (IL)-17A, IL-23, tumor necrosis factor α, and chemokine (C-X-C motif) ligand 1 (P<0.01 or P<0.05). Furthermore, it reduced the number of γ δ T17 cells in skin lesion of mice and draining lymph nodes (P<0.01).@*CONCLUSIONS@#TGW improved psoriasis-like inflammation by inhibiting KCs proliferation, as well as the associated immune cells and cytokine expression. It inhibited IL-17 secretion from γ δ T cells, which improved the immune-inflammatory microenvironment of psoriasis.
Subject(s)
Male , Animals , Mice , Tripterygium , Psoriasis/drug therapy , Keratinocytes , Skin Diseases/metabolism , Cytokines/metabolism , Imiquimod/metabolism , Dermatitis/pathology , Disease Models, Animal , Mice, Inbred BALB C , Skin/metabolismABSTRACT
Objective:To construct a predictive model of post-stroke delirium (PSD) in patients with acute ischemic stroke (AIS), and to verify its predictive value.Methods:Patients with AIS admitted to the Department of Neurology, Lianyungang Hospital Affiliated to Xuzhou Medical University from February to May 2022 were enrolled prospectively. They were divided into modeling group and validation group according to the order of enrollment. Depending on whether the patients had delirium or not, the patients in the modeling group were divided into delirium group and non-delirium group. The independent risk factors for PSD were determined by multivariable logistic regression analysis, and the prediction model of PSD was constructed accordingly. The predictive value of the model was verified by the receiver operating characteristic curve. Results:Three hundred and fifty patients with AIS were included in the modeling group, of which 71 (20.28%) had PSD. The validation group included 150 patients with AIS, and 36 of them (24.00%) had PSD. Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.036, 95% confidence interval [ CI] 1.000-1.074; P=0.050], National Institutes of Health Stroke Scale (NIHSS) score ( OR 1.607, 95% CI 1.438-1.797; P<0.001), neutrophil/lymphocyte ratio (NLR) ( OR 1.135, 95% CI 1.016-1.267; P=0.025), and atrial fibrillation ( OR 5.528, 95% CI 1.315-23.245; P=0.020) were the independent risk factors for PSD. The predictive model was Z=0.036×age+0.475×NIHSS score+0.127×NLR+1.710×assignment of atrial fibrillation - 10.160. The area under the curve of the model was 0.935, and the sensitivity and specificity were 97.2% and 82.5% respectively. Conclusion:This model can effectively predict the PSD risk of patients with AIS, with higher sensitivity and specificity, and can provide a basis for PSD screening of patients with AIS.
ABSTRACT
Objective:To investigate the effect of psychological support during perithrombotic period on post-stroke depression (PSD) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolysis in the Affiliated Lianyungang Hospital of Xuzhou Medical University from January 1, 2021 to July 31, 2021 were enrolled prospectively. The intervention group received one-to-one individual psychological support therapy in the perithrombolytic period on the basis of receiving standard intravenous thrombolytic therapy. At 30 d after onset, Hamilton Depression Scale was used to assess whether PSD occurred. Multivariate logistic regression analysis was used to evaluate the independent influencing factor of PSD. Results:A total of 126 patients with AIS were enrolled, and 86 of them were male (68.25%). Their age was 63.65±10.46 years; 65 were in the intervention group and 61 were in the control group. The incidence of PSD in the intervention group was significantly lower than that in the control group (20.00% vs. 36.07%; χ2=4.049, P=0.044). Multivariate logistic regression analysis showed that psychological intervention (odds ratio [ OR] 0.333, 95% confidence interval [ CI] 0.132-0.838; P=0.020] was an independent protective factor for PSD, while ischemic heart disease ( OR 4.510, 95% CI 1.181-17.217; P=0.028), alcohol consumption ( OR 3.421, 95% CI 1.317-8.888; P=0.012), anticoagulation therapy ( OR 3.145, 95% CI 1.155-8.567; P=0.025) and modified Rankin Scale score before thrombolysis ( OR 1.627, 95% CI 1.142-2.317; P=0.007) were the independent risk factors for PSD. Conclusion:Perithrombolytic psychological support may reduce the incidence of PSD.
ABSTRACT
Objective:To explore the influencing factors of frailty in elderly patients with coronary heart disease (CHD), and to compare and analyze the value of different frailty scales in screening elderly patients with coronary heart disease.Methods:Using cross-sectional research methods，elderly patients with coronary heart disease from November 2019 to January 2020 in the Department of Cardiology of a tertiary hospital in Zhenjiang City were selected as the research objects. The frailty status of the patients was evaluated by the frailty index scale, and the patients were divided into frailty group (54 cases) and non-frailty group (149 cases) according to the evaluation results. F-test was used for the comparison between measurement data groups conforming to normal distribution, and χ 2 test or exact probability method was used for the comparison of counting data. Multivariate Logistic regression was used to analyze the main influencing factors of elderly patients with coronary heart disease. The correlation and consistency of clinical frail scale, frail scale and frail index were compared and analyzed were analyzed by Spearman correlation and Kappa test. ROC curve was used to analyze the sensitivity, specificity and the area under the working characteristic curve. Results:The age ((78.96±6.78) years), the percentage of monocytes >10% (31.48% (17/54)), the specific index for coronary heart disease ≥4 points (57.41% (31/54)), Barthel index <100 points (85.19% (46/54)), the mini nutritional assessment scale <24 points (66.67% (36/54)) of the patients in the frail group was higher than these in non-frail group ((73.94±5.89) years old, 12.08%(18/149), 7.38%(11/149), 22.15%(33/149), 14.77%(22/149)), the differences were statistically significant (statistical values were t=5.15, χ 2=10.46, χ 2=60.45, χ 2=66.26, χ 2=52.32; P values were <0.001,0.001,<0.001,<0.001,<0.001,respectively). The results of multivariate Logistic regression analysis showed that the percentage of monocytes >10% ( OR=5.927, 95% CI:1.854-18.947), the mini nutritional assessment scale <24 ( OR=7.026, 95% CI:2.660-18.555),the specific index for coronary heart disease ≥4 points ( OR=3.333, 95% CI:1.889-26.850,) and Barthel index <100 points ( OR=15.649, 95% CI:5.403-45.321) are the main effects of frailty in elderly patients with coronary heart disease factors ( P values were 0.003,<0.001,<0.001, and <0.001, respectively). Taking the frailty index as the gold standard, the sensitivity of the clinical frailty scale and FRAIL scale were 85.19% and 85.19%, respectively, and the specificity was 90.60% and 94.63%, respectively, with no significant difference (χ 2 values were 0.000 and 1.767; all P>0.05). The Kappa of the clinical frailty scale scale was <0.75, while the Kappa of the FRAIL scale was >0.75. The consistency of the frail scale with the gold standard was better than that of the clinical frailty scale scale. Conclusion:The percentage of monocytes, the specific index for coronary heart disease, the mini nutritional assessment scale and Barthel index are the main factors affecting the frailty of elderly patients with coronary heart disease. Taking the frailty index score as the standard, the consistency between the screening results of frail scale and frailty index score is better than that of clinical frailty scale scale, which has clinical application value.
ABSTRACT
Delirium is a common complication after stroke. Post-stroke delirium is associated with the poor outcome and increased mortality. This article reviews the screening tools, predictive factors and predictive models of post-stroke delirium.
ABSTRACT
OBJECTIVE@#To explore the synergistic immunomodulatory mechanism of interferon alpha-1b, interleukin-2 and thalidomide (ITI) regimen on patients with acute myeloid leukemia (AML).@*METHODS@#Sixty eight untreated de novo or relapsed or refractory or maintenance therapy patients with AML admitted in the Affiliated Cancer Hospital of Zhengzhou University and the other 11 medical units from March 2016 to May 2019 were treated with ITI regimen. Peripheral blood specimen per patient was collected into EDTA-K3 anticoagulation vacuum tube before the administration of ITI and 3 months after the treatment; peripheral blood lymphocyte subsets and perforin and Granzyme B expression were analyzed by using flow cytometry; the levels of VEGF, IFN-γ, TNF-α and IL-6 in the plasma were detected by using a cytometric bead array. Thirty-five healthy subjects from the hospital physical examination centre were selected as normal controls.@*RESULTS@#The ratio of CD4@*CONCLUSION@#The ITI regimen can raise the ratio of CD4
Subject(s)
Humans , CD8-Positive T-Lymphocytes , Interferon-alpha , Interleukin-2 , Leukemia, Myeloid, Acute/drug therapy , Perforin , ThalidomideABSTRACT
To compare carbon nanoparticles with methylene blue for sentinel lymph nodes mapping in laparoscopic staging of early endometrial carcinoma.Forty five patients with stage I or stage Ⅱ endometrial carcinoma undergoing laparoscopic operation from January 2016 to January 2018 were randomly divided into two groups:methylene blue was applied in 20 cases and carbon nanoparticies were applied in 25 cases for sentinel lymph node (SLN) mapping in laparoscopic staging;and the images of two tracers were compared.The development time of nano-carbon group was shorter[(16.4±3.4) min vs.(21.0±5.9)min,t=3.26,P=0.02] and duration was longer [(73.1 ± 14.3) min vs.(54.6 ± 14.9)min,t=5.41,P=0.04] than those of methylene blue group.In lymphatic mapping,the detection rate of SLN in nano-carbon group was significantly higher than that of methylene blue group [95％ (21/22)vs.5/18].For detection of metastatic SLN,the sensitivity of methylene blue group was 1/2 and that of nano-carbon group was 4/4 (x2=66.70,P＜0.01).The results indicate that both methylene blue and Nano-carbon tracer can be used for SLN mapping in laparoscopic staging of early endometrial carcinoma,and nano-carbon tracer is recommended as the first choice to predict pelvic lymph node metastasis in endometrial carcinoma surgery.
ABSTRACT
The descriptive cross sectional surveys were carried out among the outstanding clinical physicians in the field of acupuncture and moxibustion by using the survey sampling. The fuzzy comprehensive evaluation techniques was applied to evaluate the opinions of clinical experts in the field of acupuncture and moxibustion in order to classify the spectrum of diseases related to the musculoskeletal and connective tissue. After the statistical analysis on sixty-four diseases with 104 subtypes, the spectrum of diseases were determined as grade I spectrum of diseases with 13 subtypes of diseases, grade II spectrum of diseases with 51 subtypes of diseases, grade III spectrum of diseases with 10 subtypes of diseases, and grade IV spectrum of diseases with 30 subtypes of diseases. The outcomes reveal that acupuncture and moxibustion therapy have been applied widely for musculoskeletal diseases and connective tissue related diseases.
Subject(s)
Humans , Acupuncture Therapy , Methods , Bone Diseases , Therapeutics , Connective Tissue Diseases , Therapeutics , Cross-Sectional Studies , Moxibustion , Methods , Muscular Diseases , Therapeutics , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical studies of acupuncture for treatment of depressive neurosis, collect the high quality evidence relative to clinical acupuncture practice for clinical decision-making reference.</p><p><b>METHODS</b>Around crucial common questions of acupuncture clinical practice, the documents of clinical study were comprehensively retrieved. According to 5-grade criterion of evidence-based medicine, the evidence from high to low level were selected to answer corresponding clincal questions and RevMan 5.0.20 was used to analyze the final indicator.</p><p><b>RESULTS</b>Nineteen documents of clinical study accord with the inclusive criterion were retrieved. Level-A evidence showed effectiveness of acupuncture. Acupuncture might be superior or equal to fluoxetine, with little adverse effect and high safety. Level-C evidence showed acupuncture might be superior or equal to Amitriptyline, with little adverse effect and high safety. And no relative clinicial evidence compared effect of acupuncture with that of psychotherapy or behavior therapy. Only one level-C evidence showed there was no effect difference between acupuncture combined with bloodletting therapy and bloodletting alone. Two level-C evidence showed the effect of acupuncture combined with western medicine was superior to that of medicine alone, eg. catgut embedding therapy combined with Fluoxetine, electroacupuncture combined with Seroxat.</p><p><b>CONCLUSION</b>Acupuncture for depressive nerosis has a positive effect. Acupuncture has an equal effect compared with western medicine, while strictly designed equivalent and non-inferior studies are demanded. The effect of acupuncture combined with medicine has some advantage, but need high quality studies to verify.</p>
Subject(s)
Humans , Acupuncture Therapy , Depressive Disorder , Therapeutics , Randomized Controlled Trials as TopicABSTRACT
<p><b>OBJECTIVE</b>To investigate the association of urinary albumin excretion rate (UAER) and hyperuricemia with macrovascular atherosclerosis in type 2 diabetic patients.</p><p><b>METHODS</b>Ninety-seven type 2 diabetic patients were divided into two groups according to the UAER, namely group A with UAER between 20 and 200 microg/min (n=63) and group B with UAER > or = 200 microg/min (n=34); the patients were also classified into hyperuricemia group (group C, n=59) and normal blood uric acid (BUA) group (group D, n=38). The disease course, BUA, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoproteins (HDL), UAER and arteria carotis intima-media thickness (IMT) were determined in these patients. The relationship of UAER and hyperuricemia with carotid arterial IMT was analyzed statistically.</p><p><b>RESULTS</b>The levels of TG, TC, LDL and HDL showed no significant differences between the 4 groups (P>0.05). The disease course, BUA, UAER, and FBG levels and IMT in groups A and C were significantly higher than those in groups C and D (P<0.05), but no such differences were found between groups A and C or between groups B and D (P>0.05). Arotid arterial IMT was independently correlated to the disease course, BUA and UAER (r=0.201, 0.1999, 0.211, respectively, P<0.05), and a significant positive correlation was noted between BUA and UAER (r=0.221, P<0.05).</p><p><b>CONCLUSION</b>Macrovascular atherosclerosis in type 2 diabetic patients is significantly correlated to the disease course, BUA and UAER levels, which can be used to evaluate and predict macrovascular atherosclerosis in type 2 diabetic patients.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Albuminuria , Atherosclerosis , Pathology , Carotid Arteries , Pathology , Diabetes Mellitus, Type 2 , Pathology , Hyperuricemia , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of acupuncture for treatment of simple obesity, and to analyze the current situation of clinical studies.</p><p><b>METHODS</b>Randomized controlled trials (RCTs) involving acupuncture treatment for simple obesity were searched from PubMed (1979-2008), OVID (1979-2008), EBSCO (1973-2008), Cochrane Library (Issue 2, 2008), CBM (1978-2008), CNKI (1979-2008), VIP (1989-2008) and WanFang Database (1998-2008). Literatures were enrolled focusing on RCTs related to acupuncture treatment for simple obesity; the quality of literatures were evaluated by two evaluators unaidedly. Meta-analyses were conducted with the Cochrane Collaboration's RevMan 4.2.8 software.</p><p><b>RESULTS</b>Eight papers including 1,017 cases, conformed with the enrolled criteria. Meta-analyses showed that there were significant difference between acupuncture groups and western medicine groups in the effective rate [combined RR (fixed effects model) = 1.11, 95% CI (1.05, 1.18), P=0.0006]. There was a significant difference between acupuncture and Sibutramine in the body mass [combined WMD (fixed effects model) = 1.94, 95%CI (1.73, 2.16), P<0.00001] and body mass index (BMI) [combined WMD (fixed effects model) = 0.52, 95% CI (0.33, 0.70), P<0.00001]. However, acupuncture was not superior to Sibutramine in hip circumference (HC) [combined WMD (fixed effects model) = -0.35, 95% CI (-0.56, -0.15), P<0.0007].</p><p><b>CONCLUSION</b>For treating simple obesity, besides reasonable diet and exercise, acupuncture is safe and effective, which may be more effective than routine western medicine. The quantity of literature was limited and the quality of some literatures was low. Thus, more high-quality and large-scale of RCTs are needed.</p>
Subject(s)
Humans , Acupuncture Therapy , Obesity , Therapeutics , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the effect of continuous renal replacement therapy (CRRT) on patients with emergency and serious diseases.@*METHODS@#The patients were divided into 2 groups: Group A [71 patients with multiple organ dysfunction syndrome (MODS)] were treated by CRRT for 175 times. Group B (30 patients) were treated with common hematodialysis (HD). Blood urea nitrogen (BUN), serum creatinine (Scr), natrem (Na(+)), kalium (K(+)), chlorine (Clj), power of hydrogen (pH), bicarbonate (HCO3-), carbon dioxide partial pressure (PCO(2)), and oxygen pressure (PO(2)) were measured before and after the treatment.@*RESULTS@#After the treatment, all patients' general state of health, water-electrolyte and acid base disorder were improved. The levels of BUN, Scr, K(+) (All P(s)<0.01), and Na(+) (P<0.05 in Group A, P<0.01 in Group B) were all lower and the levels of CO(2)CP (P<0.01 in Group A, P<0.05 in Group B) were higher than that before the pretherapy in both Group A and Group B. There was significant difference on the levels of BUN, Scr, K(+)(All P(s)<0.01), Cl(-) and CO(2)CP (All P(s)<0.05) between Group A and Group B, which indicated the therapeutic effect in Group A was better than that in Group B. Furthermore, the levels of pH, PO(2) and HCO(3)(-) were higher (P<0.01) and PCO(2) was lower (P<0.05) obviously than that before the CRRT in 30 patients with acute respiratory distress syndrome (ARDS) in Group A. Among the 9 patients with poisoning, 7 were alleviated completely and 2 died after the CRRT plus hemoperfusion (HP). The survival time of patients was lengthened in Group A. No blood or bleed aggravation occurred in patients with bleeding inclination or 48 h before the operation after using the method of heparin soaking the blood filter.@*CONCLUSION@#CRRT has better curative effect on removing the toxin effectively, rapidly correcting the turbulence of water electrolyte and sour-alkali balance for patients compare with HD. At the same time, it can increase the level of PO(2) and reduce CO(2) retention, improve the lung function and brain edema, and increase the patient's survival rate. Using CRRT as early as possible is very important and it can improve the prognosis of the patients who had MODS or other dangers because the death rate of MODS patients is very high.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Blood Urea Nitrogen , Creatinine , Blood , Multiple Organ Failure , Therapeutics , Renal Replacement Therapy , MethodsABSTRACT
Objective The 4-and 16-hydroxylated metabolites of estrogens have been implicated in carcinogenesis,whereas its 2-hydroxylated metabolites have been shown to have antiangiogenic effects.We aimed to examine whether the polymorphisms of catechol-O-methyltransferase(COMT)involved in the estrogen metabolism are associated with endometrial cancer risk.Methods Polymerase chain reaction- restrictive fragment length polymorphism(PCR-RFLP)analysis was used to study the variant allele frequency distributions of COMT Val158Met genetic polymorphism in a population based case-control study with 132 endometrial cancer cases and 110 controls.Odds ratios(OR)and 95% confidence intervals(CI) were estimated by unconditional logistic regression after adjustment for known or suspected risk factors for endometrial cancer.Results The most frequent genotype was COMT~(Val/Val)(47.2%,52/110)in control group and COMT~(Mal/Met)(58.3%,77/132)in endometrial cancer group.The difference between the two groups was of statistical significance(P