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OBJECTIVE@#To analyze and compare the characteristics and causes of F wave changes in patients with Charcot-Marie-Tooth1A (CMT1A) and chronic inflammatory demyelinating polyneuropathy (CIDP).@*METHODS@#Thirty patients with CMT1A and 30 patients with CIDP were enrolled in Peking University Third Hospital from January 2012 to December 2018. Their clinical data, electrophysiological data(nerve conduction velocity, F wave and H reflex) and neurological function scores were recorded. Some patients underwent magnetic resonance imaging of brachial plexus and lumbar plexus, and the results were analyzed and compared.@*RESULTS@#The average motor conduction velocity (MCV) of median nerve was (21.10±10.60) m/s in CMT1A and (31.52±12.46) m/s in CIDP. There was a significant difference between the two groups (t=-6.75, P < 0.001). About 43.3% (13/30) of the patients with CMT1A did not elicit F wave in ulnar nerve, which was significantly higher than that of the patients with CIDP (4/30, 13.3%), χ2=6.65, P=0.010. Among the patients who could elicit F wave, the latency of F wave in CMT1A group was (52.40±17.56) ms and that in CIDP group was (42.20±12.73) ms. There was a significant difference between the two groups (t=2.96, P=0.006). The occurrence rate of F wave in CMT1A group was 34.6%±39%, and that in CIDP group was 70.7%±15.2%. There was a significant difference between the two groups (t=-5.13, P < 0.001). The MCV of median nerve in a patient with anti neurofascin 155 (NF155) was 23.22 m/s, the latency of F wave was 62.9-70.7 ms, and the occurrence rate was 85%-95%. The proportion of brachial plexus and lumbar plexus thickening in CMT1A was 83.3% (5/6) and 85.7% (6/7), respectively. The proportion of brachial plexus and lumbar plexus thickening in the CIDP patients was only 25.0% (1/4, 2/8). The nerve roots of brachial plexus and lumbar plexus were significantly thickened in a patient with anti NF155 antibody.@*CONCLUSION@#The prolonged latency of F wave in patients with CMT1A reflects the homogenous changes in both proximal and distal peripheral nerves, which can be used as a method to differentiate the CIDP patients characterized by focal demyelinating pathology. Moreover, attention should be paid to differentiate it from the peripheral neuropathy caused by anti NF155 CIDP. Although F wave is often used as an indicator of proximal nerve injury, motor neuron excitability, anterior horn cells, and motor nerve myelin sheath lesions can affect its latency and occurrence rate. F wave abnormalities need to be comprehensively analyzed in combination with the etiology, other electrophysiological results, and MRI imaging.
Subject(s)
Humans , Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/pathology , Median Nerve/pathology , Ulnar Nerve/pathology , Brachial Plexus/pathology , Magnetic Resonance Imaging/methodsABSTRACT
Objective:To evaluate the clinical efficacy of Qingkailing injection in the treatment of children with sepsis and heat syndrome， and investigate its anti-inflammatory， anticoagulant and protective effects. Method:Eighty patients were randomly divided into control group and observation group with forty cases in each group according to the number table. Both groups received comprehensive treatment measures such as fluid resuscitation， anti-infection， anti-inflammatory， anticoagulation， vasoactive drugs， and protection of vital organ functions. While patients in observation group additionally took Qingkailing injection， 5-10 mL each time， intravenous drip after dilution， 1 time/day. Treatment course was five days in both groups. Before and after treatment， the scores of quick sequential organ failure assessment （qSOFA）， pediatric critical illness score （PCIS） and acute physiology and chronic health evalution Ⅱ （APACHEⅡ） were graded； procalcitonin （PCT）， serum amyloid A protein （SAA） before and after treatment， heparin-binding protein （HBP）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， high-sensitivity C-reactive protein （hs-CRP）， interleukin-6 （IL-6）， IL-10， N-terminal brain sodium Peptide precursor （NT-proBNP）， high-sensitivity cardiac troponin T （hs-cTnT） level， cardiac troponin I （cTnI）， creatine kinase isoenzyme （CK-MB）， <italic>D</italic>-dimer （<italic>D-</italic>D ）， fibrinogen （FIB） and antithrombin Ⅲ （AT-Ⅲ） levels were detected. Result:The APACHEⅡ and qSOFA scores in the observation group were lower than those in the control group （<italic>P</italic><0.05）， while the PCIS score was higher than that in the control group （<italic>P</italic><0.05）. The levels of PCT， SAA，HBP，TNF-<italic>α</italic>， hs-CRP and IL-6 in the observation group were lower than those in the control group （<italic>P</italic><0.01）， while the IL-10 level was higher than that in the control group （<italic>P</italic><0.01）. The levels of NT-proBNP， hs-cTnT， cTnI， CK-MB， <italic>D</italic>-D and FIB in the observation group were lower than those in the control group （<italic>P</italic><0.01）， while the AT-Ⅲ activity was higher than that in the control group （<italic>P</italic><0.01）. Conclusion:Qingkailing injection as the adjuvant therapy in children with sepsis and fever syndrome， can play the role of anti-inflammatory， anticoagulant， reducing infection and myocardial damage， thereby reducing the severity of the disease and improving the prognosis.
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The whole chloroplast genome ofthe medicinal plant Paeonia mairei H. Lév. was sequenced using the Illumina HiSeq X Ten platform and then assembled, annotated, and characterized by bioinformatic methods in this study. The complete chloroplast genome of P. mairei is 152 731 bp in length with the typical quadripartite structure, which consists of a large single copy-region (LSC, 84 402 bp), a small single copy-region (SSC, 16 969 bp), and a pair of inverted repeat regions (IRa and IRb, 25 680 bp), with an overall GC content of 38.4%. A total of 136 predicted genes, including 90 protein-coding genes, 38 tRNA genes and eight rRNA genes were identified. Among these, seven protein-coding genes, seven tRNA genes and four rRNA genes were found duplicated in the IR regions. In addition, 28 dispersed repeats, 10 tandem repeats, and 64 simple sequence repeats were detected within the whole chloroplast genome of P. mairei. Comparative analyses between 12 Peaonia species showed that the chloroplast genomes are highly conserved in length, gene content, gene order, and GC content. Meanwhile, the noncoding sequences (intergenic regions and introns) show a higher variation than the protein coding sequences, and sequences from the LSC region and SSC region are more variable than those from the IR regions. P. mairei was inferred forming in a distinct clade with P. lactiflora, P. obovate, and P. anomala subsp. veitchii with a 100% bootstrap value and is phylogenetically closest to P. lactiflora. These results may provide a basis for further genetic studies and the development and utilization of medicinal P. mairei.
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@#AIM: To investigate the clinical effect of combined laser peripheral iridectomy for primary angle-closure glaucoma.<p>METHODS: A total of 82 eyes were included in 82 patients with primary angle-closure glaucoma who visited our hospital from August 2015 to October 2017. They were randomly divided into two groups. Patients in the simple laser group were performed Nd:YAG laser only. In the combined laser group, 532 semiconductor laser combined with Nd: YAG laser were used for laser peripheral iridectomy. Intraocular pressure(IOP)was measured preoperative and postoperative. Laser energy was recorded. Iridemia were observed.<p>RESULTS: Postoperative IOP increased significantly in the simple laser group compared with the combined laser group, and the differences between the two groups 1h, 1d and 1wk after operation were statistical significances(<i>P</i><0.01). The IOP of the two groups was basically restored to the preoperative level at 1mo postoperatively. The success rate of single laser surgery was significantly lower than that of combined laser surgery(73% <i>vs </i>100%, <i>P</i><0.05). The total energy of Nd:YAG laser was significantly higher than that of the combined laser group(40.16±13.43mJ <i>vs</i> 23.23±6.70mJ, <i>P</i><0.05). There was no significant difference in intraoperative iris bleeding rate between the two groups(33% <i>vs</i> 26%, <i>P</i>>0.05).<p>CONCLUSION: Totally 532 semiconductor laser combined with Nd: YAG laser for peripheral iridectomy has a high rate of penetration, especially for patients without iris recess. It can significantly decreases laser energy, reduces the difficulty of laser operation and relieves intraocular inflammation.
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@#AIM: To explore the risk factors of high intraocular pressure after vitrectomy.<p>METHODS: Patients who underwent vitrectomy in our hospital from June 2016 to December 2018 were retrospectively analyzed, general information of patients, intraocular pressure before and after operation and relevant information of operation were recorded, Univariate and Logistic multivariate regression analysis were performed to analyze the risk factors of high intraocular pressure after vitrectomy.<p>RESULTS: Early high intraocular pressure occurred in 49 of 159 eyes(30.8%). Gender and age had no significant effect on the occurrence of high intraocular pressure after vitrectomy(<i>P</i>=0.699; <i>P</i>=0.416). Early high intraocular pressure after vitrectomy was closely correlated with silicone oil filling, combined cataract surgery, total retinal laser photocoagulation and vitreous hemorrhage after vitrectomy, with statistically significant differences(<i>P</i><0.05). Logistic regression analysis showed that silicone oil filling, combined cataract surgery, total retinal photocoagulation and postoperative vitreous hemorrhage were independent risk factors affecting the occurrence of early postoperative high intraocular pressure(<i>P</i><0.05).<p>CONCLUSION: Early high intraocular pressure after vitrectomy is the result of multiple factors, which is closely related to silicone oil filling, combined cataract surgery, total retinal photocoagulation and vitreous hemorrhage after vitrectomy.
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OBJECTIVE@#To investigate the diagnostic value of tremor analysis in early stages of Parkinson's syndrome, when the clinical symptoms of tremor onset are not unilaterally often able for a definite diagnosis to be made.@*METHODS@#We included 70 patients with unilateral tremor, under 45 years old and disease duration within 3 years enrolled in Peking University Third Hospital from January, 2014 to December 2015. We recorded clinical features, unified Parkinson's disease rating scale (UPDRS)-III, non-motor symptom (NMS) scores. Tremor analysis and transcranial sonography were performed for all the patients. Based on the results of tremor analysis, we arbitrarily divided the patients into 3 groups: (1) The patients with classical Parkinson's syndrome manifestations on one side (25 cases); (2) The patients with classical Parkinson's syndrome manifestations on both sides (15 cases); (3) The patients with no classical Parkinson's syndrome manifestations (30 cases). The patients were monitored every 6 months to 3 years, until the final diagnosis was made.@*RESULTS@#There was no significant difference in age, gender distribution, Hamilton depression scale (HAMD) scores and H-Y scores among the three groups (P>0.05). The average UPDRS-III motor scores of the three groups were significantly different (P=0.001), with 18.23, 18.79 and 14.67, respectively. The average scores of NMS were significantly different, with 15.81, 17.07 and 9.90, respectively (P<0.001). The positive rates of transcranial sonography (TCS) in the three groups were 48.0%, 60.0% and 26.67%, with no significant difference (P=0.702). After three years of follow-up, 35 patients (50%) met the diagnostic criteria of Parkinson's disease of International Parkinson and Movement Disorder Society (MDS) in 2015, 19 patients (27.1%) met the criteria of idiopathic tremor, and 7 patients (10%) met the criteria of Parkinson's plus syndrome. The sensitivity and specificity of tremor analysis for early diagnosis of Parkinson's disease were 82.8% and 68.6%, respectively. Compared with TCS, the sensitivity and specificity of TCS were 65.7% and 62.9%. There were consistency (Kappa=0.568) and significant difference (P=0.031) between the two methods.@*CONCLUSION@#Tremor analysis is sensitive and a superior way in identifying early Parkinson's syndrome patients with tremor dominant manifestation. The combination of non-motor symptoms and transcranial sonography are also needed at diagnosis.
Subject(s)
Humans , Middle Aged , Parkinson Disease , Psychiatric Status Rating Scales , TremorABSTRACT
In this study, RACE technology was employed to isolate the full length cDNA of DoHT1 in Dendrobium officinale, followed by bioinformatics analysis of the sequence characteristics. And the expression pattern of the gene was also analyzed by quantitative PCR. The full length cDNA of DoHT1 was 1 586 bp in length, containing a 1 536 bp ORF, which encoded a 511-aa protein with molecular weight of 56.18 kD and isoelectric point of 9.08. The deduced DoHT1 protein had the major facilitator superfamily conserved domain (22-483), SUGAR₋TRANSPORT₋1 (139-164), and SUGAR₋TRANSPORT₋2 (338-355), typical for sugar transporter; DoHT1, without a single peptide had 11 transmembrane regions, and was predicted to locate in the plasma membrane; DoHT1 had high identities (54.7%-80.7%) with HTs proteins from various plants. DoHT1 belonged to the MST (monosaccharide transporter) group of the evolutionary tree, and was closely related to the Phalaenopsis equestris. DoHT1 was differentially expressed in the three included organs. The transcripts were significantly the most abundant in the leaves with 19.36 fold than roots, then 1.82 fold in the stems than the roots. The identification and molecular characterization of the full length DoHT1 will be essential for further function study of the gene during the regulation of sugar metabolism of D. officinale.
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This study is aimed to establish a high-performance liquid chromatography (HPLC) method for simultaneous determination of skimmin, scopolin and umbelliferone in Saussurea hieracioides. Samples were analyzed on a Wondasil C18-WR column (4.6 mm x 250 mm, 5 microm) with methanol (A) and water containing 0.1% phosphate (B) as mobile phases for gradient elution at a flow rate of 1.0 mL x min(-1). The detection wavelength and column temperature were set at 325 nm and 35 degrees C, respectively, and the sample size was 10 microL. The results showed that skimmin, scopolin and umbelliferone were simultaneously achieved within 40 min under the above conditions. A good linearity was observed in the range of 0.18-5.6 microg (r = 1.000 0), 0.060-1.8 microg (r = 0.999 9), 0.032-0.97 microg (r = 0.999 8) for skimmin, scopolin and umbelliferone, respectively, with the average recoveries of 99.16% (RSD = 0.41%), 100.3% (RSD = 0.79%), 102.2% (RSD = 0.87%). The method is simple, accurate and reproducible and can be used for the quality control of S. hieracioides.
Subject(s)
Chromatography, High Pressure Liquid , Coumarins , Glucosides , Medicine, Tibetan Traditional , Reproducibility of Results , Saussurea , Chemistry , UmbelliferonesABSTRACT
<p><b>OBJECTIVE</b>To provide a reference for the standardization of Tibetan medicine.</p><p><b>METHOD</b>Investigating the hospital preparations , Tibetan formulated products, and the literature recorded preparations in the Tibetan, Qinghai, Gansu, Sichuan and Yunnan Provinces. Moreover, the varieties, original bases and standard conditions of these preparations were analyzed. According to Chinese Pharmacopoeia, Tibetan medicine part of ministerial standard, Tibetan medicine standards and related monographs and literatures of Tibetan medicine.</p><p><b>RESULT</b>About 502 various of herbs were used in 711 hospital preparations from 40 medical institutions, Tibetan formulated products from Tibetan pharmaceutical factories, and 439 literature recorded preparations. About 154 herbs were used in more than 10 preparations, while most of them were Tibetan endemic species. About 416 medicinal varieties have the original documented basis, including 287 botanicals, 78 animal medicines, 51 mineral medicines, involving a total of 94 families, 261 genus and 643 species of botanical origin (including species of the next grade), 35 families, 52 genera and 61 species of the animal origin (including species of the next grade). About 122 varieties of herbs were cross-used in the traditional Chinese medicine and Tibetan medicine, about 80% of Tibetan medicinal varieties are produced in the Tibetan Areas of Tibet Plateau. About 293 medicinal varieties were contained in the above standards. Most of the herb's standards only contains character, indentification, and examination, except for 8 varieties which were recorded in the Chinese Pharmacopoeia (2010) as Tibetan medicine.</p><p><b>CONCLUSION</b>This study of quality standard of Tibetan medicine should have an emphasis on the general varieties, especially the study on the arrangement research and the efficacious material basis of the varieties and the original, as well as term standardization of the National Medicine.</p>
Subject(s)
Animals , Humans , Drugs, Chinese Herbal , Reference Standards , Medicine, Tibetan Traditional , Reference Standards , Plants, Medicinal , ChemistryABSTRACT
An unusual natural product named 2,4,6-trihydroxacetophenone-3, 5-di-C-beta-D-glucoside (18) were isolated from aerial parts of Rhododendron lepidotum grows in Tibet, along with other 17 known compounds: hopenol-B (1), lupeol (2), ursolic acid (3), avicularin (4), quercetin (5), myricetin (6), hyperoside (7), myricetin-3'-O-beta-D-xyloside (8), (+)-taxifolin-3-O-alpha-L-arabinopyranoside (9), (+)-taxifolin-3-O-beta-D-glucopyranoside (10), lyoniside (11), confluentin (12), 2-(4-hydroxyphenyl)-ethyltriacontanoate (13), 2, 6-dimethoxy-4-hydroxyphenyl-1-O-beta-D-glucopyranoside (14), (-)-2-hydroxy-5-(2-hydroxyethyl) phenyl-O-beta-D-glucopyranoside (15), (-)-isola-riciresinol (16) and isofraxoside (17). All the compounds were firstly isolated from this plant as well as compounds 1, 13-18 were reported occurrence in R. spp. for the first time. The structures were identified based on analyses of spectroscopic data and physico-chemical evidences.
Subject(s)
Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Chemistry , Organic Chemicals , Rhododendron , ChemistryABSTRACT
A phytochemical investigation of the leaves of Rhododendron anthopogon revealed the presence of five known monoterpenes: ranhuadujuanine A (1), cannabiorcicyclolic acid (2), ranhuadujuanine B (3), ranhuadujuanine C (4) and ranhuadujuanine D (5). All compounds are firstly reported as natural products. The assignments of some 13C-signals of ranhuadujuanine A reported in the literature were revised on the basis of 2D-NMR spectra.
Subject(s)
Biological Products , Magnetic Resonance Spectroscopy , Monoterpenes , Chemistry , Plant Leaves , Chemistry , Rhododendron , ChemistryABSTRACT
AIM: To study the causes of pyogenic granuloma after hydroxyapatite(HA) orbital implants.METHODS: HA orbital implants (250 cases) in our hospital (68 pegged implants) were reviewed.All patients were followed up from 18 months to 10 years. Implants were removed after medical therapy which was proved to be ineffective.RESULTS: Ten of 250 cases of HA orbital implants developed pyogenic granuloma. Pyogenic granuloma occurred in 1 unpegged implants patient and 9 patients after pegging and drilling of HA implantation over 4～7 years. The pyogenic granulomas were not controlled by medical therapy effectively. Implants were removed in 9 cases except 1 case denied removing and continued medical therapy.CONCLUSION: Pyogenic granuloma was serious complication that occurred after HA orbital implants. Partial vascularization, implant exposure, xenogenic sclera implant, pegging and drilling of HA implantation are risk factors that affect the development of pyogenic granuloma.Pyogenic granuloma hasn't relation with implanted peg material. Pyogenic granuloma denotes the potential implant infection, and all implants should be removed finally.