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Objective:To observe any effect of high-intensity interval training on the blood pressure and renal function of Wistar-Kyoto rats modeling spontaneous hypertension (SHR) and to explore the mechanism of the renal renin-angiotensin system′s (RAS′s) role in this process.Methods:Twenty male SHR were randomly divided into a sedentary group and an exercise group, each of 10. Another 10 Wistar-Kyoto rats formed a normotensive control group. The rats in the normotensive and hypertensive sedentary groups were fed quietly in their cage, while the hypertensive exercise group performed high-intensity interval training for 8 weeks. After the last exercise, blood pressure, renal function, the kidney levels of nitric oxide and interleukin-6 (IL-6) and the protein expressions of angiotensin converting enzyme (ACE), ACE2, angiotensin type 1 receptor (AT1R), AT2R and Mas receptor (MasR) were measured.Results:Compared with the normotensive group, the hypertensive sedentary group showed a significant increase in average blood pressure, IL-6, ACE and AT1R protein and the ratio of AT1R to AT2R. There was a significant decrease in the renal function, the average NO level and the expression of ACE2, AT2R and MasR protein. That group also showed a significant decrease in blood pressure, IL-6, ACE and AT1R protein expression and the AT1R: AT2R ratio compared with the hypertensive sedentary group, but a significant increase in renal function, average NO content and the expression of ACE2, AT2R and MasR protein.Conclusion:Eight weeks of high-intensity interval training has a protective effect on the kidneys by regulating the renin-angiotensin system, at least in rats.
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ObjectiveTo investigate the effectiveness and safety of nanoknife ablation guided by real-time virtual sonography (RVS) in the treatment of locally advanced pancreatic cancer (LAPC). MethodsA retrospective analysis was performed for the clinical data of 27 patients with LAPC who attended The Fifth Affiliated Hospital of Zhengzhou University from April 2018 to October 2019, and according to the treatment method, the patients were divided into combination group (12 patients treated with IRE combined with chemotherapy) and control group (15 patients treated with chemotherapy alone). The chemotherapy regimen was gemcitabine combined with tegafur, gimeracil and oteracil potassium for both groups. Adverse reactions and complications were observed for the combination group during the perioperative period, and the two groups were compared in terms of the changes in myocardial enzymes, blood amylase, and carbohydrate antigen 19-9 (CA19-9) before treatment and at different time points after treatment, as well as remission rate (RR) and disease control rate (DCR) at 3 months after treatment and survival status during follow-up. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the Wilcoxon test was used for comparison within each group; the Fisher’s exact test was used for comparison of categorical data between groups; the Kaplan-Meier method was used to analyze the survival status during follow-up. ResultsIn the combination group, there were 12 cases of adverse reactions and mild complications during the perioperative period, i.e., 9 Clavien-Dindo grade I cases and 3 grade II cases. All patients in the combination group experienced a transient increase in myocardial enzymes, which returned to normal within 7 days, and there were no significant changes in creatine kinase and lactate dehydrogenase on day 7 after treatment (P＞0.05); 9 patients had a significant increase in blood amylase on day 1 after surgery, which significantly decreased on day 7 after surgery and basically returned to normal on day 14 after surgery, and there was no significant change in blood amylase on days 7、14， and 1 month after surgery (P＞0.05). Before treatment, the level of CA19-9 was higher than the normal value in both groups, and the combination group had a significant reduction in CA19-9 at 1, 2, and 3 months after treatment (all P＜005); in the control group, the level of CA19-9 firstly decreased for a short time and then increased, while there was no significant change in CA19-9 at 1, 2, and 3 months after treatment (all P＞0.05). At 3 months after treatment, the combination group had significantly higher RR and DCR than the control group (RR: 75.0% vs 26.7%, P=0.021; DCR: 91.6% vs 53.3%, P=0043). During the median follow-up time of 13 months, compared with the control group, the combination group had significantly higher median progression-free survival time (10 months vs 5 months, P=0.014) and median overall survival time (18 months vs 10 months, P=0.034). ConclusionRVS-guided percutaneous nanoknife ablation has marked clinical effect and high safety in the treatment of LAPC and can be used as a new treatment option for patients who refuse or cannot tolerate laparotomy for ablation therapy.
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A retrospective analysis was made on the effectiveness of with laparoscopy model in hepatoma surgery teaching for general practice residency training. One hundred and forty general practice residents undertook rotation in Department of Hepatobiliary Surgery of Fifth Affiliated Hospital of Zhengzhou University from January to December 2020. Seventy residents received multi-disciplinary team (MDT) with laparoscopy mode in hematoma surgery teaching (study group) and another 70 residents received conventional teaching mode (control group). After completing the study, the teaching effectiveness was compared between two groups. The questionnaire survey showed that the satisfaction score in study group was higher than that in control group (21.10±0.31 vs.17.48±0.35, P<0.05). The scores of clinical skill, graduation examination and case analysis in study group were all higher than those in control group(91.80±4.82 vs. 85.20±4.34, 87.5±4.1 vs. 85.1±3.6, 77.25±3.38 vs. 73.65±3.06, all P<0.05). The study indicates that laparoscopic combined with MDT teaching model can significantly improve the effectiveness of hepatoma surgery study for general practice residents, and is worthy of popularization and application in general surgery teaching.
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Objective:To explore the effect of regular aerobic exercise on renal fibrosis and its mechanism.Methods:Thirty male Sprague-Dawley rats were randomly divided into a young control group (YC group), an old control group (OC) and an old exercise group (OE), each of 10. The YC and OC groups were kept quietly in cages, while the OE group performed moderate-intensity treadmill aerobic exercise for 8 weeks. After the experiment, renal function was evaluated by measuring 24h urine protein, blood urea nitrogen (BUN) and serum creatinine (SCr). The degree of renal fibrosis was detected by Masson staining, and the expressions of transforming growth factor β 1 (TGF- β 1), p38 mitogen-activated protein kinase (p38MAPK), phosphorylated p38MAPK (p-p38MAPK), E-cadherin, and α-smooth muscle actin (α-SMA) were measured using western blotting. Results:Compared with the YC group, a significant increase was observed in the OC group in average 24h urine protein, BUN and SCr, but also in the degree of renal fibrosis, the protein expression of TGF-β 1, p-p38MAPK and α-SMA. There was a significant decrease in the average expression of E-cadherin. Compared with the OC group, the average 24h urine protein, BUN and SCr, the degree of renal fibrosis, the expression of TGF-β 1, p-p38MAPK and α-SMA protein had all decreased significantly in OE group, while the average expression of E-cadherin had increased significantly. Conclusions:Aerobic exercise relieves renal fibrosis in elderly rats, perhaps through inhibiting the TGF-β 1/p38MAPK signaling pathway and epithelial-mesenchymal transition.
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Objective:To study the complications of irreversible electroporation (nano-knife) ablation on locally advanced pancreatic cancer, and to analyse the causes of complications and related treatment.Methods:The clinical data of 36 patients with locally advanced pancreatic cancer treated with nano-knife ablation at the Fifth Affiliated Hospital of Zhengzhou University from January 2016 to March 2019 were studied retrospectively. The types and incidence of postoperative complications were analyzed. The complications were classified according to the Clavien-Dindo classification, and the severity of the complications was evaluated.Results:There were 15 patients (41.7%) who developed various degrees of complications, including splenic infarction, atrial fibrillation, portal vein thrombosis, pancreatic fistula, pseudoaneurysm, gastrointestinal bleeding, liver abscess and severe pancreatitis. Among them, 6 patients (16.7%) had grade III complication or above. Three (8.3%) patients with grade Ⅲ complications died of upper gastrointestinal bleeding 3 months after operation.Conclusions:Various complications might occur after nano-knife ablation, with postoperative gastrointestinal and abdominal bleeding being the main complications which resulted in death. Measures which can effectively reduce occurrence of complications need to be studied.
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Objective:To investigate the multi-sites high frequency ultrasound features of rectus diastasis (RD) in early postpartum women and their relationships with different delivery modes.Methods:Total of 571 primiparas who gave birth in the Obstetrics and Gynecology Hospital Affiliated to Zhejiang University Medical College from March to May 2020 and underwent 6-week postpartum examination were chosen, they were divided into vaginal delivery group (336 cases) and the cesarean section group (235 cases). The inter-rectus distance(IRD) of five loci (umbilical on 4.5 cm, umbilical on 3 cm, umbilical edge, edge of umbilical, umbilical down 3 cm) at resting state and two loci (umbilical edge, edge of umbilical) at curling state as well as the rectus thickness on the right side of umbilical level were observed by high frequency ultrasound. The impacts of the two delivery modes on IRD at each site and the changes of IRD under the two conditions were analyzed. Spearman correlation analysis was used to evaluate the correlation between the thickness of rectus abdominis and IRD at each site.Results:The incidence of early postpartum RD was 79.7% (455/571), most of which occurring at 3 cm above the umbilicus and the umbilicus levels. At resting state, the IRDs at the 5 loci of vaginal delivery group were (1.62±0.79)cm, (2.03±0.84)cm, (2.65±0.94)cm, (2.09±0.93)cm, and 0.54(0.00, 1.13)cm respectively, while the IRDs at 5 loci of the cesarean section group were (1.75±0.85)cm, (2.26±0.99)cm, (2.99±1.14)cm, (2.57±1.21)cm, and 1.00(0.41, 1.59)cm, with statistical differences at all the levels between groups ( P<0.05). Under the curling state, the IRDs at the 2 loci of vaginal delivery group were (2.10±0.84)cm and (1.66±0.86)cm respectively, while the IRDs at the 2 loci of cesarean section group were (2.28±0.87)cm and (1.91±0.87)cm, with statistical differences between groups( P<0.05). The incidences of increased IRD when compared between resting and curling states at the upper and lower umbilicus in the vaginal delivery group were 16.1% and 26.5%, with 17.4% and 20.4% in the cesarean section group. At the resting state, there was a significant difference in the thickness of rectus abdominis between the vaginal delivery and cesarean section groups [(0.74±0.12)cm vs (0.67±0.12)cm, P<0.05]. At the curling state, the difference between two groups was statistically significant [(1.11±0.23)cm vs (0.99±0.22)cm, P<0.05]. The thickness of rectus abdominis was negatively correlated with IRD(all the 5 loci at resting state, rs=-0.116, -0.140, -0.185, -0.143, -0.144, all P<0.01; and the upper umbilical loci at curling state, rs=-0.091, P<0.05). There was no significant correlation between the thickness of rectus abdominis and IRD at the lower umbilical edge at the curling state ( P>0.05). Conclusions:High frequency ultrasound can evaluate the morphological characteristics of the abdominal rectus muscle in early postpartum stage. Compared with vaginal delivery, rectus abdominis thickness, the IRD is larger in cesarean section primiparas, but less affected by the curling state.
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Objective@#To observe the effect of high-intensity interval training (HIIT) on G protein-coupled receptor kinase-2 (GRK2) levels in the hearts and adrenal glands of spontaneously hypertensive rats (SHRs) and explore how exercise might improve sympathetic over-excitation.@*Methods@#Twenty male SHRs were divided randomly into a sedentary control group and an HIIT group. Ten age-matched, male Wistar-Kyoto rats without hypertension served as the control group. The rats of the control and sedentary control groups were housed in cages at rest while those of the HIIT group underwent eight weeks of HIIT. Caudal artery pressure, cardiac structure and function, and heart rate variability (HRV) were determined using a non-invasive blood pressure tester, echocardiograms, and electrocardiograms. The plasma concentrations of epinephrine and norepinephrine, and the expression of GRK2 and β1-adrenoceptor (β1-AR) protein were measured in the rats′ hearts, and GRK2 and α2-adrenoceptor (α2-AR) protein were measured in their adrenal glands using high-pressure liquid chromatography and western blotting.@*Results@#Compared with the normotensive control group, animals in the sedentary control group showed elevated blood pressure, cardiac hypertrophy, reduced heart function, sympathetic over-excitation manifested by HRV, increased plasma epinephrine and norepinephrine concentrations, up-regulated GRK2 protein expression in the heart and adrenal gland, but down-regulated β1-AR in the heart and down-regulated α2-AR in the adrenal gland. Compared with the sedentary control group, the HIIT group did not show improved cardiac hypertrophy, but it did show reduced blood pressure, enhanced heart function, suppressed sympathetic over-excitation, as well as lowered plasma epinephrine and norepinephrine concentrations, on average. The expression of GRK2 in the heart and adrenal gland was significantly down-regulated, while that of β1-AR in the heart and of α2-AR in the adrenal gland were significantly up-regulated, on average.@*Conclusions@#HIIT can alleviate sympathetic over-excitation and enhance heart function despite spontaneous hypertension, at least in rats. The therapeutic mechanism may be related with the down-regulation of GRK2 expression in the heart and adrenal gland.
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Objective To evaluate the clinical value of combining irreversible electroporation (IRE) with a biliary composite stent implantation in the treatment of unresectable hilar cholangiocarcinoma.Methods A total of sixteen patients with unresectable hilar cholangiocarcinoma were treated in the Fifth Affiliated Hospital of Zhengzhou University,from April 2016 to July 2018 with combined IRE ablation with a 125I particle biliary composite stent implantation.A comparative analysis was conducted on the clinical data including total bilirubin,ALT,AST,myocardial enzymes before and after surgery.Results All patients underwent successful operation and the hemodynamics were stable during the operations.In 16 patients,the myocardial enzymes increased on the first day after surgery and fell to normal within 5 days.A total of thirteen patients had a progressive reduction of CA19-9,1 patient had no significant change in CA19-9,and 2 patients had CA19-9 in the normal range before and after treatment.Total bilirubin,AST,and ALT decreased gradually after surgery in all the patients.Postoperative complications included biliary bleeding (1 patient),and ascites (1 patient).All patients were able to have the PTCD tube removed after treatment.The median time to PTCD removal was 46 days (range 11 ～ 123 days),and the median catheter-free time before requiring another PTCD tube replacement was 184 days (range 43 ～365 days).Conclusions IRE ablation combined with a biliary composite stent in the treatment of unresectable hilar cholangiocarcinoma was safe.The treatment had good short-term outcomes and it significantly improved the quality of life of the patients.
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Based on the questionnaire survey among 10 Traditional Chinese Medicine medical institutions in Beijing , this paper found that 65 . 2％ of the medical staffs and 82 . 0％ of the patients agreed to include the medical expertise into Traditional Chinese Medicine service system;37 . 3％ of the medical staffs believed that there was a certain risk of relaxing access of Traditional Chinese Medicine clinics, and 38. 4％ of the patients showed that they would choose private clinics to see a doctor. Most medical staffs considered that the current risks of Traditional Chinese Medicine diagnosis and treatment focused on standardized use of toxic decoction pieces and overdose of drugs. Medical staffs were most concerned about the risk of"diagnosis and treatment" on the Internet, were least worried about the risk of "distribution". The clinic registration system of the Law of the People ' s Republic of China on TCM, the registration system of the processed concocted decoction pieces, and the unclear scope of diagnosis and treatment technology posed challenges to future risk management, and it need to adopt the following countermeasures to respond:establishing a new multiple and multi-level risk management mechanism, exploring differentiated supervision, perfecting the technical norms and application scope of Traditional Chinese Medicine diagnosis and treatment, establishing a special system for regulating Traditional Chinese Medicine health care services, and establishing and improving a flexible supervision and law enforcement model to protect the legitimate rights and interests of relatives.
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Different from Western medicine theory, Traditional Chinese Medicine knowledge is tacit knowledge, and the Traditional Chinese Medicine knowledge system also is a complete system independent from the Western medicine system. But the protection for Traditional Chinese Medicine knowledge nowadays still mainly stems from the Western intellectual property system. The current intellectual property system is in a dilemma in the protection of Traditional Chinese Medicine due to its limitations, and it urgently needs to build a special knowledge protection system that is specially applicable to traditional knowledge;while using genetic resources protection system and benefit sharing system of traditional knowledge from Convention on Biological Diversity to protect Traditional Chinese Medicine has its advanced nature and rationality. In the premise of clarifying the definition of "intellectual property right of Traditional Chinese Medicine", this paper proposed 5 countermeasures and suggestions, including establishing the legal content of Traditional Chinese Medicine intellectual property, promoting the legislative coordination of existing intellectual property law and the Law of the People' s Republic of China on TCM, strengthening the institutional coordination of the Law of the People' s Republic of China on TCM, the Law of Intangible Cultural Heritage and the Law of the People' s Republic of China on Drug Administration, promoting the institutional innovation at the local legislation level, and building a benefit sharing mechanism for the holders of Traditional Chinese Medicine knowledge.
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<p><b>OBJECTIVE</b>To investigate the prevalence and risk factors of diabetic nephropathy in Ningbo Yinzhou district.</p><p><b>METHODS</b>Nephropathy screening was conducted among patients with type 2 diabetes mellitus (T2DM) registered in Ningbo Yinzhou district. Demographic information, clinical examination information, diabetes complications and behavioral risk factors of enrolled patients were collected. Logistic regression model was used to identify possible risk factors for the occurrence of diabetic nephropathy.</p><p><b>RESULTS</b>Among 10 604 T2DM patients included in this study, there were 3744 cases of diabetic nephropathy(35.31%). Univariate analysis showed that gender, age, education level, diabetes duration, glycemic control, hypertension, stroke, smoking and waist circumference were associated with diabetic nephropathy (<0.05 or <0.01). Multivariate logistic regression analysis showed that male, elders, long diabetes duration, hypertension and smoking were independent risk factors of diabetic nephropathy (<0.05 or <0.01).</p><p><b>CONCLUSIONS</b>sDiabetic nephropathy is of high prevalence in T2DM patients. Male patients, elders, and those with long diabetes duration, hypertension and smoking habits are more likely to have diabetic nephropathy.</p>
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Humans , Male , China , Diabetes Mellitus, Type 2 , Diabetic Nephropathies , Hypertension , Logistic Models , Prevalence , Risk Factors , Surveys and QuestionnairesABSTRACT
Objective To discuss the association between ADRB2 gene polymorphism of rs1042713, rs1042714 locus and susceptibility of childhood bronchial asthma and response to the treatment,and to understant the preliminary pathogenesis of asthma preliminary. Methods The oral epithelial cells of children in asthma case group from the outpatient or inpatients at the Zhengzhou Children′s Hospital (173 cases)and healthy control group (166 ca-ses)were collec-ted. The genotypes of ADRB2 gene encoding area rs1042713 locus and rs1042714 were tested by the mean of Taqman probe real-time fluorescent quantitative PCR,and the difference was analyzed. The therapeutic effects between 2 groups were compared,and then the differences in the amino acid sequence and protein structure correspon-ding genotypes of ADRB2 genes were investigated by using bioinformatics analysis. Results There were statistical differences in genotype frequency and allele frequency of rs1042713 locus between asthma case group and healthy con-trol group(P = 0. 001,0. 000),but no difference at rs1042714 locus(P = 0. 159,0. 061). GG genotype of rs1042713 locus had significant differences in adjusting the drug dosage with AA,AG genotype patients(H = 12. 583,P = 0. 002), but the different genotype of rs1042714 locus had no significant differences in adjusting the drug dosage(H = 2. 696, P = 0. 260). The polymorphism of rs1042713 locus caused protein local structure changes,but the homologous protein structure of rs1042714 locus caused no changes. Conclusions ADRB2 gene polymorphism of rs1042713 locus is not only associated with the susceptibility of childhood bronchial asthma,but also has an effect on β2-receptor agonist treatment to a certain extent. But polymorphism of rs1042714 locus may not be associated with the susceptibility of asth-ma and the response to treatment. The reason may be different genotypes leading to different protein structures and bio-logical functions. The mechanism may be related to the structural and functional differences of protein structures corre-sponding to different genotypes.
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Objective To evaluate the long-term outcome of fully covered self-expandable metal stents(FCSEMS)for the treatment of benign biliary strictures(BBS). Methods Between June 2008 and September 2013, 68 patients with BBS receiving endoscopic retrograde cholangiopancreatography and FCSEMS placement were retrospectively enrolled. Data of endoscopic treatment, stricture resolution and recurrence were collected, and related risk factors were analyzed. Results FCSEMSs were successfully placed in all patients and removed in 93.4%(57/61). The median stent duration was 9.0(range 0.2-37.1)months. Stricture resolution occurred in 74.2%(46/62)patients. During median follow-up of 54.0 (range 2.5-96.0)months,stricture recurrences were seen in 16.7%(6/36)patients. Multivariate analysis revealed that distance between stricture and hepatic bifurcation of less than 1.5 cm(P=0.034,OR=6.395, 95%CI:1.153-35.464), and stent migration(P= 0.024, OR= 0.153, 95%CI:0.030-0.782)were significant risk factors for stricture resolution. Meanwhile, the stricture length longer than 1.0 cm(P=0.028, HR = 6.766, 95% CI:1.233-37.122)was a significant risk factor for stricture recurrence. Conclusion Endoscopic treatment combined with FCSEMS can achieve excellent efficacy in resolving BBS with low recurrence rate. However, location and length of BBS, as well as stent migration may impair its effectiveness.
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Objective To explore the role of the pyrin domain-containing 3 ( NLRP3) inflammasome in advanced glycation end products ( AGEs )-induced mice pancreatic β-cell damage. Methods AGEs were administered intraperitoneally for 6 weeks in NLRP3 knockout mice or C57BL/6J mice. Intraperitoneal glucose tolerance test and insulin releasing test were performed. Pancreatic sections were stained with haematoxylin and eosin, or with F4/80 and NLRP3 antibodies. Insulin and pancreatic tissue monocyte chemotactic protein 1 ( MCP-1) as well as interleukin-1β( IL-1β) levels were measured with ELISA kits. Expression of MCP-1 protein was determined by western blot. MIN6 cells and mouse peritoneal macrophages cells were treated with AGEs and different interventions (antioxidant NAC, adenovirus NLRP3 shRNA or NLRP3 knockout). Reactive oxygen species production, NLRP3 mRNA expression, IL-1β secretion, caspase 1 activity, apoptosis and glucose stimulated insulin release were determined. Results Injection of AGEs induced an abnormal response to glucose, enhanced the insulitis score, and increased the levels of pancreatic tissue MCP-1 and IL-1β, as well as raised the expression of NLRP3 and F4/80 in pancreatic islet. Remarkably, co-localization of NLRP3 and macrophage marker F4/80 was observed in islet. The damages were improved in NLRP3 knockout mice. After incubation with AGEs, reactive oxygen species production and cell apoptosis was enhanced, NLRP3 inflammasome activated, with glucose-stimulated insulin release impaired in MIN6 cells. NAC treatment alliviated the above damages, but NLRP3 gene silencing had no effect on ROS level, apoptosis, and insulin secretion. Finally NAC treatment and NLRP3 gene knockout inhibited activation of NLRP3 inflammasome induced by AGEs in mouse peritoneal macrophages cells. Conclusion NLRP3 knockout ameliorates the islet β-cell damage induced by AGEs. These effects were associated with AGEs-induced islets macrophage infiltrating by up-regulation of MCP-1 expression, and AGEs-induced activation of NLRP3 inflammasome in macrophage through ROS pathway, which results in the release of active IL-1βand leads to the lesions of β-cell.
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Objective To evaluate the safety and curative effect of nanoknife ablation in the treatment of unresectable hilar cholangiocarcinoma.Methods 15 patients with unresectable hilar cholangiocarcinoma received nanoknife ablation treatment from March 2016 to May 2017.The clinical variables of the patients before and after operation were analyzed.Results The operations in all the patients carred out successfully.Cardiac arrhythmia occurred in some patients during the operation accidentally.The level of CA19-9 increased significantly on postoperative day 1,3 and then gradually decreased in 13 patients;one patient had no significant change of CA19-9,and the data for another patient was always in the normal range.The liver function of all patients gradually improved after operation,and the level of total bilirubin,AST and ALT showed a downward trend.The myocardial enzyme in all the patients increased on postoperative day 1,then returned to normal within the following 5 days.Postoperative complications included atrial fibrillation (1 case),upper gastrointestinal bleeding (1 case).The recanalization rates of the bile duct at 2 weeks,1 month,and 2 months after surgery were 66.6％,86.6％,and 93.3％,respectively.Conclusion Nanoknife ablation has superior safety,noteworthy efficacy and less complications in the treatment of the unresectable hilar cholangiocarcinoma in the short term.
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Objective:To establish the alcoholic fatty liver(AFL) animal models,and to explore the protective effect of Zhi Zi Da Huang Tang (ZZDHT) on the rats with AFL and its dosage.Methods:A total of 54 SD rats were divided into normal control group (n=10) and model control group (n=44).The rats in model control group were given alcohol by lavage (50% ethanol solution 6.0 mL·kg-1) combined with high-fat feed to establish the rat models of AFL.After 4 weeks,the rats in model control group were randomly divided into model group(treated with water),simvastatin group (10 mg·kg-1),low and high doses (5.0 and 10.0 g·kg-1) of ZZDHT groups,and there were 10 rats in each group.Every 2 weeks during the process,the body weights and levels of serum total cholesterol (TC),triglyceride (TG),aspertate aminotransferase (AST),and alanine aminotransferase (ALT) were detected.After 4 weeks,the body weights and liver weights of the rats were detected;the levels of TC,TG,AST,ALT,alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) in serum and liver tissue of the rats of were detected;the levels of tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6) and interleukin-1β(IL-1β) in serum of the rats were detected;the morphology of liver tissue was observed by HE staining and the pathological examination was performed.Results:Compared with normal control group,the levels of serum TC,AST,ALT,TG,TNF-α,IL-6,and IL-1β of the rats in model group 4 weeks after administration were significantly increased (P<0.05 or P<0.01).Compared with model group,the levels of serum TC,TG,AST,and ALT of the rats in low and high doses of ZZDHT groups 4 weeks after administration were decreased (P<0.05 or P<0.01);the levels of serum TNF-α and IL-6,IL-1β of the rats in high dose of ZZDHT group were decreased (P<0.01);the levels of serum TNF-α and IL-1β of the rats in low dose of ZZDHT group were decreased (P<0.01);the levels of serum ADH and ALDH in liver tissue of the rats in low and high doses of ZZDHT groups and simvastatin group were decreased(P<0.05 or P<0.01).The HE staining result showed that compared with model group,the pathological conditions of the liver tissue of the AFL rats in ZZDHT groups were significantly improved.Conclusion:ZZDHT can significantly improve the liver injury caused by high fat diet combined with alcohol and fat liver lesions.
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Objective To investigate the role of metastatic lymph node ratio (MLR) in the evaluation of prognosis of patients with gastric cancer (GC) at different lymph node numbers examined.Methods Clinical data were reviewed retrospectively in a total 535 patients who underwent surgery for GC.Spearman correlation analysis between MLR or number of metastatic lymph nodes (N) and examined lymph node numbers,Kaplan-Meier method was used for comparison survival rates of N stage and MLR stage.A receiver operating characteristic (ROC) curve was used to evaluate the role of N stage and MLR stage in the prognosis of GC patients.Results Metastatic lymph node ratio and number of metastatic lymph nodes correlated with the examined lymph node numbers (r =0.146,r =0.378,P ＜ 0.01,P ＜ 0.001).The 5 year survival rate of MLR0,MLR1,MLR2 and MLR3 patients were 57.5％,69.9％,40.0％ and 21.7％ respectively when examined lymph node numbers ＜ 6 (P ＜ 0.01).The 5-YSR of MLR0,MLR1,MLR2 and MLR3 patients were 86.8％,59.2％,35.8％ and 39.2％ respectively when between 6-10 (P ＜0.001) and the 5-YSR of MLR0,MLR1,MLR2 and MLR3 patients were 88.7％,62.5％,0 and 17.7％ respectively when they ＞ 10(P ＜0.001).AUC of MLR staging was 0.68 ±0.05 when the numbers ＜ 6 (P ＜ 0.001).AUC of MLR staging was 0.72 ± 0.04 at numbers 6-10 (P ＜ 0.001).AUC of MLR staging was 0.79 ± 0.03 when numbers ＞ 10 (P ＜ 0.001).Conclusions MLR was less influenced by lymph node number examined than N.MLR stage has potential superiority to that the N stage in assessing prognosis of GC patients,especially for patients with more than 6 lymph nodes examined.
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Objective To investigate the safety and efficacy of hysterosopic management of typeⅡcesarean scar pregnancy (CSP) and the value of prophylactic uterine artery embolization (UAE). Methods Totally 104 patients with typeⅡCSP treated with hysteroscopic surgery at the Women′s Hospital,School of Medicine, Zhejiang University, during Jan. 2009 to Jun. 2016 were analyzed retrospectively, 67 patients combined with UAE (UAE group) and 37 patients without combined with UAE (non-UAE group). Laparoscopy or sonography guidance was conducted simultaneously.The following clinical parameters were compared, including: primary cure rate, uterine packing rate, uterine perforation rate, hemoglobin level change,the time for the mass absorption and the return of β-hCG to normal,complications,hospital days and hospital stay cost.Results Median gestational age,size of mass,thickness of the anterior myometrium and β-hCG level in UAE group versus non-UAE group were 47 versus 47 days,30 versus 30 mm,2 versus 2 mm, 36 524 versus 32 226 U/L(all P>0.05).Out of 104,100 patients were managed successfully with hysteroscopic surgery, and 4 patients transformed to laparoscopic or laparotomy surgery. Hysteroscopic surgery was effective in 63 out of 67 patients(94%)in UAE group and 34 out of 37 patients(92%)in non-UAE group(P>0.05). There was no significant differences regarding uterine perforation rate, uterine packing rate, hemoglobin change and recovery time between UAE group and non-UAE group (all P>0.05). The median hospital day was 7 days in UAE group versus 5 days in non-UAE group(P<0.01).The median hospital stay cost was 13 654 yuan in UAE group versus 9 108 yuan in non-UAE group (P<0.01). Serious complication occurred in 4 patients (6%, 4/67) in UAE group and 2 patients (5%, 2/67) in non-UAE group (P=0.906). Conclusions Hysteroscopic surgery is effective and safe for patients with typeⅡCSP in the first trimester with size≤30 mm in diameter and gestation age<7 weeks.The value of prophylactic UAE is uncertain.
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Objective To evaluate clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of intracranial infection with drug-resistant Acinetobacter baumannii (DRAB).Methods 12 patients with DRAB intracranial infection admitted in a department of neurosurgery between January 2014 and April 2015 were analyzed retrospectively,clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of DRAB intracranial infection were evaluated.Results After patients received tigecycline combined with cefoperazone/sulbactam for 12-62 days (39.5 days on average), clinical symptoms and signs (including body temperature,signs of meningeal irritation)of most patients were significantly improved compared with before treat-ment,3 cases were cured,5 were markedly effective,4 abandoned or ineffective(death).The overall effective rate was 66.67%(8/12),mortality was 33.33% (4/12);bacterial clearance rate of cerebrospinal fluid (CSF)was 83.33%(10/12).Causes of death:2 were with failure of brain stem following craniocerebral trauma,1was extensive parenchymal infection,1was recurrence of intracranial infection and formation of brain abscess after withdrawing an-timicrobial agents.No significant adverse reaction occurred during the treatment period.Conclusion On the basis of keeping CSF drainage unobstructed,long course treatment of tigecycline combined with cefoperazone/sulbactam can effectively eliminate DRAB from CSF,and has a good safety.
ABSTRACT
Hypokalemia is a common clinical symptom. It is quite important to clarify the cause of hypokalemia. Autoimmune thyroid disease and primary Sjogren syndrome ( pSS ) have a common genetic predisposition. The coexistence of both diseases is frequent. Renal tubular acidosis ( RTA) is one of the causes of hypokalemia, which can be primary and secondary to other diseases in etiology. Primary RTA is more common in children. As for adults, RTA is often secondary to pSS. In this paper, we reported a case of hypokalemia caused by Hashimoto’s thyroiditis associated with primary Sjogren’s syndrome and renal tubular acidosis in order to call attention to the special cause and treatment of hypokalemia.