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Objective:To analyze the independent risk factors for the occurrence of post-traumatic cognitive dysfunction, construct a prediction model for the risk factors of post-traumatic cognitive dysfunction, and verify the effectiveness of the risk prediction model, so as to provide a clinical tool for early prediction of the risk of post-traumatic cognitive impairment.Methods:Part I: patients with brain trauma (training set with 556 subjects) who were hospitalized in 21 tertiary and secondary hospitals from Tangshan, Cangzhou and Chengde cities of Hebei province were retrospectively collected from February to May 2021 for Montreal cognitive assessment, and 33 influencing factors (general data, symptoms and signs, laboratory and imaging parameters) were obtained obtained through literature research.The patients were divided into case group and control group according to whether they had cognitive impairment or not, and univariate and multivariate analysis were used to screen independent risk factors.Part Ⅱ: a binary Logistic regression equation was used to construct a cognitive impairment prediction model, the visualization model of line graph is presented.Part Ⅲ: brain trauma patients (260 subjects of the validation set) hospitalized in the aforementioned 21 hospitals from August to October 2021 were collected as a prospective validation population for the prediction model of cognitive impairment, and the grouping basis of case group and control group was the same as before.And the risk factors between the two groups were compared.The receiver operating characteristic curve(ROC), calibration curve and clinical applicability of the model were drawn to evaluate the effectiveness of the model for internal and external verification of the model.Results:Binary Logistic regression analysis showed that the risk factors for post-traumatic cognitive dysfunction were basal ganglia injury, severe injury, amnesia experience after injury, frequent headache after injury, upper limb dysfunction after injury, age ≥ 60 years, and education level of elementary school or below.Visual nomograms showed that the experience of amnesia after injury, frequent headache after injury, upper limb dysfunction, and degree of injury among the symptom factors were the factors that contributed greatly to the risk of traumatic brain injury cognitive impairment in this model.Predictive model discrimination using area under curve(AUC) values of the area under the ROC curve showed that internal validation and external validation were 0.868 and 0.885 for R language analysis and 0.868 and 0.901 for SPSS analysis, respectively.The curve after model calibration almost coincided with the reference line, Hosmer-Lemeshow test P>0.05.The two decision curve analysis (DCA) curves drawn by the clinical applicability of the model were higher than the two extreme curves, predicting that traumatic brain injury patients with cognitive impairment could benefit from the predictive model, and there was a net benefit rate in the range of Pt about 0.1-0.8, when Pt reached about 0.1 until the approximate 1.0 composite evaluation model. Conclusion:Risk factors such as experience of amnesia after injury, frequent headache after injury, upper limb dysfunction, and degree of injury are predicting factors contributed to the risk of cognitive impairment in traumatic brain injury, and their prediction models have good predictive effect, high predictive accuracy and good clinical applicability, which can be applied in clinical diagnosis.
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This paper studies the necessity of the current legislation on the supervision of medical devices in China from the perspectives of strengthening administration according to law, protecting public health, perfecting the legal system of medicine and promoting the development of the medical device industry. This study analyzes and summarizes the legislative experiences and forms in the field of medical device regulation in the United States, the European Union, Japan and other countries and regions, at present, the conditions of carrying out the legislation of medical device supervision in China are quite mature, and some policy suggestions are put forward for the enactment of the law of medical device management in China.
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Equipment and Supplies , European Union , Feasibility Studies , Industry , Medical Device Legislation , United States , United States Food and Drug AdministrationABSTRACT
BACKGROUND:Polyester fabric as a common clinical consumable item is characterized by simple drawing, low cost, and high toughness and ductility, and can serve as a good repair material. OBJECTIVE:To investigate the clinical efficacy of polyester fabrics used for huge chest wal repair. METHODS: Totaly 46 patients with chest wal tumors, aged 39-73 years, including 29 males and 17 females. These patients were randomly and equaly divided into observation group and control group. After the removal of chest wal tumors, patients in the observation group underwent polyester fabric repair of huge chest wal defects, and those in the control group were treated with autologous pedicle flap for repair of huge chest wal defects. The clinical efficacy and patient satisfaction were recorded in the two groups. RESULTS AND CONCLUSION: After treatment, al the patients could feel up to their daily work, and there were no death and serious complications. Only two cases developed postoperative local effusion, and then recovered after wound drainage. Thoracic appearance was good in al patients, and the patients did not feel discomfort at the reconstruction site during breathing and movement. At the end of 6-24 months of folow-up, X-ray review showed good reconstruction of the thorax, and there were no loose transplants, foreign body rejection, chest wal deformity, recurrence and serious complications. Clinical efficacy and patient satisfaction were better in theobservation group than the control group (P < 0.05). These results show that polyester fabrics for the repair of huge chest wal defects are effectively, safe and reliable.
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Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.
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Objective To investigate the effect of individualized and comprehensive therapy in treatment of severe acute pancrea-titis in early stage for preventing MODS .Methods 85 patients with severe acute pancreatitis treated in this Chengde medical college affiliated hospital from January 2008 to January 2012 were divided into two groups .The control group included 42 patients ,all used conventional basic treatment ;the test group included 43 patients ,and all used individualized and comprehensive therapy in early stage .The APACHEⅡ ,MODS and Ranson scores ,and serum inflammatory cytokines indexes of patients in each group before and after admission were all recorded .Results The APACHEⅡ and MODS scores after admission of test group were significantly low-er than the control group(P< 0 .05) .The TNF α,CRP and IL 10 after admission of two groups had significant difference (P<0 .05) .The MODS incidence of control group was 64 .3% (27/42) ,pancreatic encephalopathy incidence was21 .4% (9/43) ,the inci-dence of pancreatic infection was 33 .3% (14/42) ,hospital mortality incidence was 19 .1% (8/42) and length of hospital stay was (30 .4 ± 5 .7) d .The MODS incidence of test group was 27 .9% (12/43) ,pancreatic encephalopathy incidence was11 .6% (5/43) , pancreatic infection rate was 14 .0% (6/43) ,hospital mortality incidence was 4 .7% (2/43) and length of hospital stay was (23 .5 ± 4 .3) d .The incidence of MODS ,hospital mortality and pancreatic infection rates of test group were significantly lower than that of the control group (P<0 .05) .The average length of stay of test group were significantly lower than the control group (P<0 .05) . Conclusion To use individualized and comprehensive therapy in treatment of severe acute pancreatitis in early stage can reduce MODS ,protect organ function ,and reduce mortality .
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Objective To evaluate the feasibility of intra-operative ultrasound guide in breast conservative-surgery and its effect on positive margin rate and breast tissue volume.Methods Fifty-five cases of invasive breast cancer staged T1-2N0-1 were randomly assigned to palpation-guided group(control group) 26 cases and ultrasound-guided group(experiment group) 29 cases.Before and during operation,high-frequency ultrasound was used to guide the resection of breast cancer with 1 cm margin in experiment group.The resection margin positive rate deteced by tissue section frozen biopsy and resected breast tissue volume were compared between experiment and control group.Results The clinicopathologic features were accordant between two groups.The margin positive rate and near-margin positive rate in experiment group were 0 and 3.45％ respectively,slightly lower than that of control group 3.85％ and 15.38％,but with no statistical significance (P ＞ 0.05).The same situation occurred at the re-exision rate.The resected breast tissue volume in experiment group (32.40 ± 10.93) cm3 was lower than that of control group (55.11 ± 12.88) cm3,and with statistical significance (P ＜ 0.01).Conclusions Intra-operative ultrasound guide could reduce the margin positive rate and unnecessary resected brcast tissue volume in breast conservative-surgery,and improve cosmetic effect.
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In order to investigate the chemical constituents from the fraction with cardiovascular activtiy of Chrysanthemum indicum, the isolation and purification of compounds from this active fraction were performed, and the chemical structures were elucidated by spectral analysis and comparison of the spectral data with those reported in the literature. As a result, twelve compounds were obtained and identified as (2S) -eriodictyol-7-O-beta-D-glucuronide (1), (2S) -eriodictyol-7-O-beta-D-glucoside (2), (2S) -hesperetin-7-O-beta-D-glucuronide (3), luteolin-7-O-beta-D-glucoside (4), luteolin-7-O-beta-D-glucuronide (5), diosmetin-7-O-beta-D-glucuronide (6), quercetin -7-O-beta-D-glucoside (7), (2S)-eriodict-dicaffeoylquinate (8), 3, 5-dicaffeoylquinic acid(9), 3, 5-cis-dicaffeoylquinic acid (10), 1, 5-dicaffeoylquinic acid (11), and 1, 3-dicaffeoylquinic acid (12). The above result indicated that flavonoids were the ma-dicaffeoylquinate (8), 3, 5-dicaffeoylquinic acid (9), 3, 5-cis-dicaffeoylquinic acid (10), 1, 5-dicaffeoylquinic acid (11), and 1, 3-dicaffeoylquinic acid (12). The above result indicated that flavonoids were the major components of the active fraction. Compounds 2, 3, 7, 8 and 10 were obtained from this genus for the first time, and compounds 5, 6, 9, 11, and 12 were first isolated from C. indicum.
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Cardiovascular Agents , Chemistry , Chromatography, High Pressure Liquid , Chrysanthemum , Chemistry , Drugs, Chinese Herbal , Chemistry , Magnetic Resonance Spectroscopy , Molecular StructureABSTRACT
Homeobox gene Six1,as a transcription factor has been proved to participate in most malignant tumors.Its overexpression is associated with the genesis and development of breast cancer intimately.Overexpression of Six1 in mammary cells is sufficient to induce activation of stem cells.Similarly,Six1-overexpressed tumors could activate the TGF-β pathway and Wnt/β-catenin pathway,lead to malignant transformation by inducing epithelial-mesenchymal transition and mammary tumorigenesis.Research on the role of sixl will improve understanding the mechanisms of breast cancer initiation and development.
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<p><b>OBJECTIVE</b>To provide a new approach for studying the compatibility principle of traditional Chinese medicine formula (TCMF) by constructing compatibility network of phamarcologic action of TCMF according to the network theory.</p><p><b>METHOD</b>With Chinese herb as node and compatibility relationship of herb-herb as edge according to network theory, compatibility network of phamarcologic action of TCMF was constructed after the compatibility relationship of herb-herb was analysed by two-way analysis of variance (ANOVA)through phamarcology experiment. Then compatibility principle of TCMF was analysed with network efficiency (NE) and NE related parameters.</p><p><b>RESULT</b>The network approach was applied for studying compatibility principle of Jiawei Shengmai San on it's antimyocardial ischemia reperfusion injury action. The results indicated that rhizoma corydalis was the main herb in Jiawei Shengmai San, and in turn was radix ophiopogonois, radix salvia miltiorrhiza, radix ginseng and fructus schizandrae, radix ginseng and radix salvia was clustered first, and in turn was radix, Formule composed of ophiopogonois and fructus schizandrae. Formule composed of radix ginseng and radix salvia, and radix ophiopogonois and fructus schizandrae; radix ginseng, radix salvia miltiorrhiza and rhizoma corydalis was the most effective one among all the formulaes. These results were consistent with validation experiments.</p><p><b>CONCLUSION</b>Studying compatibility principle of TCMF by network theory is a new and feasible method.</p>
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Animals , Male , Rats , Chemistry, Pharmaceutical , Methods , Drug Interactions , Drugs, Chinese Herbal , Chemistry , Pharmacology , Panax , Chemistry , Plants, Medicinal , Chemistry , Random Allocation , Rats, Sprague-Dawley , Salvia miltiorrhiza , ChemistryABSTRACT
OBJECTIVE: To investigate the effects of serum containing Scutellaria Barbata extract (ESB) on apoptosis rate and mitochondrial transmembrane potential (MTP) of liver cancer cell line H22 from mice in vitro. METHODS: H22 cells were cultured in vitro and divided into 5 groups: blank control group, low-dose ESB group, medium-dose ESB group, high-dose ESB group and fluorouracil (5-Fu) group. Methyl thiazolyl tetrazolium assay was utilized to determine the proliferation rates of H22 cells. Cellular morphology was observed under a transmission electron microscope (EM). The rhodamine 123 was used as a fluorescence probe to label the H22 cells, and the fluorescence intensities were observed with a laser scanning confocal microscope. The fluorescence intensity of H22 cells indicated the MTP of H22 cells. RESULTS: The inhibition of serum containing ESB on the proliferation of H22 cells in vitro was observed in a time-dependent manner. The typical morphological changes of apoptosis were observed after incubation with ESB-containing serum in high dose for 48h. The apoptosis rates of blank control group, 5-Fu group, low-dose ESB group, medium-dose ESB group and high-dose ESB group were (0.51+/-0.32)%, (11.26+/-2.97)%, (1.07+/-0.46)%, (3.15+/-1.12)%, (7.83+/-2.25)% respectively. ESB could reduce the MTP of H22 cells from mice as compared with the untreated group. The MTPs of the blank control group, 5-Fu group, and low-, medium- and high-dose ESB groups were (245.45+/-67.37), (127.42+/-41.35), (213.68+/-65.52), (186.34+/-56.37) and (142.65+/-39.44) respectively, which were negatively correlated with the apoptosis rates. CONCLUSION: ESB-containing serum effectively induces apoptosis, which may be related to the decrease of MTP in H22 cells.
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OBJECTIVE: To study the assistant effect of Scutellaria barbata extract (ESB) in 5-fluorouracil (5-FU) chemotherapy. METHODS: A mouse model of transplanted hepatoma H22 was used in this study to evaluate the synergic and attenuating effects of ESB in chemotherapy. Tumor inhibition rate, life span of mice and the toxicity of chemotherapy were observed. The body weight, tumor weight, thymus index and spleen index in H22-bearing mice were also measured. The phagocytotic function of macrophages was studied by observing phagocytization of peritoneal macrophages. RESULTS: The increase of body weight in 5-FU plus ESB groups was higher than that in 5-FU group, and the side effects such as anorexia, abdominal distention and athrepsy were relieved. Compared with untreated group, prolonged lifetime in 5-FU plus high-dose ESB group and 5-FU plus low-dose ESB group was improved. Life prolongation rates in 5-FU plus high-dose ESB group and 5-FU plus low-dose ESB group were 61.46% and 23.59% respectively. High-dose ESB, 5-FU, 5-FU plus low-dose ESB and 5-FU plus high-dose ESB could inhibit the tumor growth, and the tumor inhibition rates were 36.98%, 42.26%, 52.45% and 65.28%, respectively. Thymus index and spleen index were increased significantly in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. White blood cell (WBC) count was decreased obviously in 5-FU group, while the count of WBC was increased in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. The phagocytotic function of macrophages was also increased in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. CONCLUSION: ESB can enhance the effect of chemotherapy, relieve the side effects and improve immune function of mice in chemotherapy. These results suggest that ESB, as a biochemical modulator to enhance the therapeutic effects, is useful in cancer chemotherapy.
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Objective: To observe the cholagogic effect of Danning Tablet. Methods: We determined the gallbladder contractibility, the bile flow volume and the tensity of Oddis sphincte of rabbit. Results: Danning Tablet could increase the frequence and extent of the gallbladder contractibility and the bile flow volume, it also relaxed Oddis sphincte ( P