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ObjectiveTo understand the health information needs of chronic disease inpatients and the current utilization of community health resources， and to analyze the influencing factors， so as to provide basis for personalized and high-quality health education for chronic disease inpatients and to guide them to make full use of community health resources. MethodsFrom November 2020 to February 2021， we conducted a face-to-face multi-center clinical epidemiological survey with paper questionnaire in three general hospitals of Shanghai. The study included 404 inpatients with diabetes， hypertension， coronary heart disease， chronic respiratory diseases， cancer and other chronic diseases. Results94.01% of the 404 respondents had different needs for disease or health related information， and there was no significant difference between patients of different ages， genders and educational backgrounds in their needs for health knowledge. Among these patients， only 39.11% of them participated in the establishment of a card for chronic disease management in the community or signed for a family doctor. The participation rate of male patients was lower than that of female patients （P<0.05）. ConclusionPatients with chronic diseases have a high demand for health related information， and we need to provide health information in multiple ways. We should increase investment in community health resources， improve service quality， and guide residents with chronic diseases to make full use of community health resources.
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Objective:To verify that hypoxia induces epithelial mesenchymal transition in HaCaT cells, and to observe the effect of LncRNA HOTAIR on epithelial mesenchymal transition in HaCaT cells.Methods:From Jan. 2018 to Dec. 2018 in Chinese Academy of Medical Science, HaCaT cells were divided into four groups: group A cultured under normoxia, group B cultured under hypoxia, group C transfected with sh-control cultured under hypoxia, and group D transfected with sh-LncRNA HOTAIR cultured under hypoxia. After 36 hours of culturing, the expression of E-cadherin and vimentin were detected using qPCR and Western blot. The migration of HaCaT cells was evaluated by Transwell assay.Results:The relative quantity of E-cadherin mRNA in the four groups were 3.076±0.271, 1.000±0.089, 1.024±0.222, and 2.595±0.085, while vimentin mRNAs were 1.002±0.183, 4.170±0.279, 4.111±0.477, and 2.412±0.134, respectively. In addition, the Transwll invasion assay showed that numbers of cell migration in the four groups were 32.70±3.93, 125.40±6.26, 120.10±6.79, and 58.24±7.06, respectively.Conclusions:The study suggests that hypoxia promotes epithelial mesenchymal transition in keratinocytes. Furthermore, downregulation of HOTAIR is noted to inhibit epithelial mesenchymal transition of keratinocytes under hypoxia condition.
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Objective:To explore the effect of supplementing stem cell therapy with aerobic exercise in left ventricle remodeling after myocardial infarction.Methods:Sixty 6-week-old male Wistar rats had acute myocardial infarction induced by ligation of the anterior descending coronary artery. They were then randomly divided into a model group, a stem cell group, an exercise group and an observation group. Another ten healthy Wistar rats formed a sham operation group. The rats in the stem cell and observation groups were infused with a suspension of bone marrow mesenchymal stem cells through the tail vein. Beginning four weeks later, the exercise and observation groups underwent 60 minutes of aerobic treadmill exercise 5 days per week for 8 weeks. At the beginning and end of the eight weeks the rats′ exercise performance was evaluated using a graded treadmill exercise test. And after the last training session cardiac structure and function were detected using ultrasound imaging. Tissue was then collected from the left ventricles and the collagen volume fractions were calculated. The expression of myocardial brain natriuretic peptide (BNP), heavy chain β-myosin (β-MHC) and α-MHC mRNA was detected using real-time fluorescence quantitative PCRs.Results:Compared with the sham operation group, the time and distance to exhaustion shortened significantly in the model group, with a significant decrease in the average maximum running speed, left ventricle ejection fraction (LVEF), left ventricle shortening fraction (LVFS), expression of α-MHC and the α-MHC/β-MHC ratio. There was a significant increase in the average resting heart rate, collagen volume fraction, expression of BNP and β-MHC in the model group. Compared with the model group, there was a significant increase in the average LVEF and LVFS of the stem cell group as well as in the time and distance to exhaustion, maximum running speed, expression of α-MHC and in the α-MHC/β-MHC ratio of the observation group, but a significant decrease in the average collagen volume fraction of the stem cell group compared with the observation group, together with the resting heart rate, collagen volume fraction, the expression of BNP and of β-MHC. Compared with the stem cell group, the observation group showed a significant increase in the average time and distance to exhaustion, maximum running speed, expression of α-MHC and the α-MHC/β-MHC ratio, with a significant decrease in the average resting heart rate, collagen volume fraction, expression of BNP and β-MHC.Conclusion:Aerobic exercise or stem cell therapy alone can inhibit left ventricular remodeling and improve cardiac function after myocardial infarction, at least in rats. The combination of the two treatments has a synergistic effect and can further enhance the effect of stem cell therapy.
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OBJECTIVE To make up the research gap of the concept of collaboration between clinical pharmacists and physicians in China， and to provide a theoretical basis for further improving the collaboration. METHODS Literature analysis was used to sort out the existing concepts of collaboration. Combined with the current practice and development trend of the collaboration between clinical pharmacists and physicians in China， the basic elements of the concept were deconstructed and the connotation of each component of the concept was explained in detail. RESULTS & CONCLUSIONS Based on the above theoretical research and practical analysis， the concept of collaboration between clinical pharmacists and physicians in the context of China was defined， that is， clinical pharmacists and physicians adhere to the patient-centered and rational drug use as the core in clinical drug therapy， and make joint decisions on drug management and drug therapy on the basis of communication， respect， trust and sharing， so as to ensure the effectiveness， safety and economy of clinical pharmaceutical care， and improve the coordination and cooperation process of comprehensive disease treatment system.
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Objective:To explore any effect of 8 weeks of high-intensity interval training (HIIT) on glycemia and pancreatic β-cell function among persons with type 2 diabetes to provide data for optimizing their exercise protocol.Methods:Sixty patients with type 2 diabetes and without a habit of regular exercise were randomly divided into an exercise group ( n=30) and a control group ( n=30). Both groups maintained their daily living habits, except that the exercise group practiced HIIT on a power vehicle ergometer 3 times a week for 8 weeks. Before and after the intervention, the 2-hour oral glucose tolerance test (OGTT) was conducted to evaluate glycemia and pancreatic β-cell function. Body composition was also detected using dual-energy X-ray absorptiometry. Results:After the intervention a significant decrease was observed in the fasting blood glucose, mean blood glucose, glycosylated hemoglobin, blood glucose levels at the end of a 2h OGTT, blood glucose area under the curve and homeostatic model assessment of insulin resistance, as well as waist circumference and abdominal fat content of the exercise group. And there was a significant increase in the homeostatic model assessment of pancreatic β-cell function and disposition index among the exercise group. In the control group no significant differences were observed.Conclusion:Eight weeks of HIIT can improve glycemia and pancreatic β-cell function and reduce abdominal fat among persons with type 2 diabetes. It can be used as an effective rehabilitation protocol.
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Bacterial multi-drug resistance (MDR) is a global challenge in the fields of medicine and health, agriculture and fishery, ecology and environment. The cross-region spread of antibiotic resistance genes (ARGs) among different species is one of the main cause of bacterial MDR. However, there is no effective strategies for addressing the intensifying bacterial MDR. The CRISPR-Cas system, consisting of clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR associated proteins, can targetedly degrade exogenous nucleic acids, thus exhibiting high application potential in preventing and controlling bacterial MDR caused by ARGs. This review briefly introduced the working mechanism of CRISPR-Cas systems, followed by discussing recent advances in reducing ARGs by CRISPR-Cas systems delivered through mediators (e.g. plasmids, bacteriophages and nanoparticle). Moreover, the trends of this research field were envisioned, providing a new perspective on preventing and controlling MDR.
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Anti-Bacterial Agents , Bacteriophages/genetics , CRISPR-Cas Systems , Drug Resistance, Bacterial/genetics , Plasmids/geneticsABSTRACT
Objective:To study the effect of resveratrol (RES) on interleukin-1β (IL-1β)-induced chondrocytes and its pathways of action.Methods:Wistar mammary rat chondrocytes were extracted and divided into 5 groups: control group, IL-1β group, RES+IL-1β group, RES+IL-1β+EX-527 [silent information regulator 1 (SIRT1) inhibitor] group and RES+IL-1β+AS [frame transcription factor O1 (FOXO1) inhibitor] group. Quantitative real time polymerase chain reaction (qRT-PCR) was used to detect SIRT1, forkhead FOXO1 and matrix metalloproteinase 3 (MMP-3) mRNA expression. Protein expression of chondrocyte type Ⅱ collagen (Col-Ⅱ) detected by immunofluorescence, and the expression of chondrocyte SIRT1 and p-FOXO1/FOXO1 was measured by Western blot. The expression of chondrocyte inflammatory factors IL-6 and TNF-α was measured by enzyme-linked immunosorbent assay. One-way analysis of variance (ANOVA) was performed and two-way comparisons between groups were made using the least significant difference (LSD) method. P< 0.001 was statistically significant. Results:Compared to normal chondrocytes, the mRNA and protein expressions of Col-Ⅱ, SIRT1, FOXO1 and p-FOXO1/FOXO1 in chondrocytes induced by IL-1β was significantly decreased ( P<0.001). The secretion of tumor necrosis factor (TNF)-α [(24.70±2.84), t=19.24, P<0.001] and IL-6 [(3.35±0.28), t=12.97, P<0.001] was significantly increased, and the mRNA expression of MMP-3 [(2.46± 0.23), t=12.61, P<0.001] was significantly increased. The mRNA and protein expressions of Col-Ⅱ, SIRT1, FOXO1 and p-FOXO1/FOXO1 were significantly increased. The secretion of TNF-α [(12.60±1.05), t=10.14, P<0.001] and IL-6 [(2.00±0.15), t=9.89, P<0.001] was significantly reduced by RES treated IL-1β-induced chondrocytes. mRNA expression of MMP-3 [(1.30±0.14), t=10.460, P<0.001] was decreased. After adding SIRT1 inhibitor EX-527 or FOXO1 inhibitor AS, RES significantly reduced the mRNA and protein expression of Col-Ⅱ, SIRT1, FOXO1 and p-FOXO1/FOXO1 in IL-1β-induced chondrocytes ( P<0.001). The secretion of TNFα and IL-6 was significantly decreased ( P<0.001), and the mRNA expression of MMP-3 was significantly decreased ( P<0.001). Conclusion:RES significantly ameliorates IL-1β-induced cartilage extracellular matrix egradation and inflammatory responses via the SIRT1/FOXO1 pathway.
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Objective:To explore the effect of potentially inappropriate medication (PIM) on frailty among community-dwelling elderly patients with mild cognitive impairment (MCI).Methods:From March to July 2021, a total of 252 elderly patients with MCI in Hefei community were selected.The data of basic information and PIM of subjects were collected.All subjects were assessed by the comprehensive frailty assessment instrument (CFAI), Montreal cognitive assessment scale-basic (MoCA-B), and the Barthel index (BI). The subjects were divided into PIM group ( n=136) and non-PIM group ( n=94) according to whether there was PIM.Taking the confounding factors as the matching condition, the subjects of the two groups were matched with 1∶1 propensity score.After matching, there were 52 in the PIM group and 52 in the non-PIM group.SPSS 23.0 was used for data analysis.Multivariate Logistic regression analysis was performed to analyze the effect of PIM on frailty of subjects. Results:(1)Before matching, the incidence of frailty in PIM group and non-PIM group were 80.9% and 19.1%, respectively, with statistically significant differences ( P<0.01). Logistic regression analysis revealed that PIM was a risk factor for the frailty ( β=1.704, OR=5.495, 95% CI=2.539-11.892). (2)After matching, the confounders of age, hearing status, chewing function, activities of daily living, Charlson comorbidity index, handgrip strength, and cognitive function were balanced and comparable between the two groups.The incidence of frailty in PIM group and non-PIM group were 67.9% and 32.1%, respectively.The differences remained statistically significant ( P<0.01). PIM remained a risk factor for frailty ( β=1.791, OR=5.998, 95% CI=2.393-15.032). Conclusion:PIM is a risk factor for the occurrence of frailty in elderly patients with MCI.Therefore, the accurate screening and standardized management of PIM will provide a new target for the frailty management of elderly patients with MCI.
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Temporomandibular joint osteoarthritis (TMJOA) is mainly manifested as perforation of temporomandibular joint disc (TMJD) and destruction of condylar osteochondral complex (COCC). In recent years, tissue engineering technology has become one of the effective strategies in repairing this damage. With the development of scaffold material technology, composite scaffolds have become an important means to optimize the performance of scaffolds with the combined advantages of natural materials and synthetic materials. The gelling method with the minimally invasive concept can greatly solve the problems of surgical trauma and material anastomosis, which is beneficial to the clinical transformation of temporomandibular joint tissue engineering. Extracellular matrix scaffolds technology can solve the problem of scaffold source and maximize the simulation of the extracellular environment, which provides an important means for the transformation of temporo joint tissue engineering to animal level. Due to the limitation of the source and amplification of costal chondrocytes, the use of mesenchymal stem cells from different sources has been widely used for temporomandibular joint tissue engineering. The fibrochondral stem cells isolated from surface layer of articular cartilage may provide one more suitable cell source. Transforming growth factor β superfamily, due to its osteochondrogenesis activity has been widely used in tissue engineering, and platelet-rich derivative as a convenient preparation of compound biological factor, gradually get used in temporomandibular joint tissue engineering. With the deepening of research on extracellular microenvironment and mechanical stimulation, mesenchymal stem cells, exosomes and stress stimulation are increasingly being used to regulate the extracellular microenvironment. In the future, the combination of complex bioactive factors and certain stress stimulation may become a trend in the temporomandibular joint tissue engineering research. In this article, the progress on tissue engineering in repairing COCC and TMJD, especially in scaffold materials, seed cells and bioactive factors, are reviewed, so as to provide information for future research design and clinical intervention.
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Animals , Mesenchymal Stem Cells , Temporomandibular Joint/surgery , Temporomandibular Joint Disc/surgery , Tissue Engineering , Tissue ScaffoldsABSTRACT
Objective:To explore the effect of inspiratory muscle training (IMT) on cardiac autonomic nerve function and the life quality of elderly women.Methods:Fifty-six healthy women aged 60 to 70 were randomly divided into an IMT group and a placebo control group (PLA), each of 28. The IMT group was given IMT training 5 times a week for 5 weeks with the inspiratory resistance set at 50% of their maximum inspiratory pressure (MIP). The PLA group was treated similarly, but the inspiratory resistance was set at the 5% of the MIP. Before and after the intervention, both groups were evaluated in terms of heart rate variability (HRV) at rest, and heart rate during the inspiratory phase (HR-in) and expiratory phase (HR-ex) of deep breathing. Their quality of like was quantified using the World Health Organization′s quality of life scale (WHOQOL-100).Results:After the intervention, the average MIP and high frequency power in the HRV spectrum had increased significantly, but the ratio of low frequency to high frequency power had decreased significantly in the IMT group. In deep breathing the average HR-in and HR-ex both had decreased significantly. The average scores on all dimensions of the WHOQOL-100 were significantly higher than before the intervention and higher than those of the control group. Indeed, there were no significant differences in the PLA group′s results before and after the intervention.Conclusions:Five weeks of IMT training can significantly improve the cardiac autonomic nerve function and life quality of elderly women. This provides a reference for prescribing rehabilitation exercise for such women.
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Objective:To explore the effect of regular aerobic exercise on oxidative stress, inflammatory reaction and apoptosis with a rat model of colitis.Methods:Forty-five C57BL/6 mice were randomly divided into a control group, a model group and a model exercise group, each of 15. Colitis was induced in the rats of the model and model exercise groups through administration of 3.5% sodium dextran sulfate. The control group and the model group were kept quiet in their cages, while the model exercise group performed voluntary wheel running for 8 weeks after the successful modelling. Any histopathological changes in the colon tissue were observed after hematoxylin and eosin staining. Oxidative stress, inflammatory reaction and apoptosis were measured from colon tissue homogenates.Results:Compared with the control group, the average expression of the tumor necrosis factor α (TNF-α), interleukin (IL)-1β, IL-6 and prostaglandin E2 (PGE2) as well as levels of reactive oxygen species (ROS), malondialdehyde (MDA) and nitric oxide (NO) and inducible nitric oxide synthase (iNOS) and Caspase-3 activity and the protein expression of cyclooxygenase 2 (COX2), nuclear factor kappa B (NF-κB) p65, apoptosis inducing factor (AIF), cytochrome c (Cyt C) and Bax had all increased significantly in the other two groups, while the levels of IL-10 and glutathione (GSH), the activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx) and the protein expression of Bcl-2 protein had decreased significantly in the model group. Compared with the model group, the average content of TNF-α, IL-1 β, IL-6, PGE2, ROS, MDA and NO, the activity of iNOS and Caspase-3 and the protein expression of COX2, NF-κB p65, AIF, CytC and Bax had decreased significantly, while that of IL-10 and GSH, the activity of SOD and GPx and the protein expression of Bcl-2 protein had increased significantly in the model exercise group.Conclusion:Regular aerobic exercise has a protective effect against colitis through improving oxidative stress, inflammation and apoptosis, at least in rats.
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Objective:To compare the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the abdominal visceral fat of obese women.Methods:Sixty-eight obese female college students were randomly divided into an HIIT group ( n=23), an MICT group ( n=22) and a control group ( n=23). The control group was not given any training intervention. The MICT group performed continuous exercise at an intensity of 60% of each person′s maximum oxygen uptake (VO 2max) until 300kJ of work had been performed. Those in the HIIT group performed repeated 4-minute bouts of cycling at 90% of their VO 2max with 3-minute intervals until 300kJ of work had been performed. The interventions lasted 12 weeks. The subjects′ visceral fat (AVFA) and abdominal subcutaneous fat (ASFA) were measured using computed tomography. Whole-body fat mass (FM) and FM in the android, gynoid and trunk regions were detected using dual energy X-ray absorptiometry before and 48 hours after the final session. Results:After the intervention, the average AVFA, ASFA, percentage of fat mass (FM%), whole-body FM, and FM in the abdominal, gluteo-femoral and trunk regions of the HIIT group and MICT group were significantly lower than before the intervention, but there was no significant difference between them. No significant differences were observed in any of the control group′s indexes.Conclusions:Both HIIT and MICT can reduce the abdominal visceral fat of obese female college students, and the effects of the two exercise modes are equivalent.
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Melanoma is a highly aggressive malignant skin tumor characterized by rapid growth and early metastasis. Surgical resection is currently still the main treatment. There are still some challenges in the early diagnosis and thorough surgical resection of melanoma, which affect the prognosis of patients. To date, great progress has been made in the application of fluorescent probes to the diagnosis and surgical resection of, as well as sentinel lymph node localization and resection in melanoma. Fluorescent probes have advantages of good chemical stability, less adverse effects, high specificity, high accuracy and visualization, and may provid new ideas for the diagnosis and treatment of melanoma.
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Objective:To analyze the clinical phenotypes and molecular genetic characteristics of hereditary spherocytosis (HS) in children.Methods:The clinical data of children with HS in the Affiliated Children′s Hospital of Zhengzhou University from June 2014 to June 2018 were collected and analyzed retrospectively.The peripheral blood samples of 20 children and their parents were collected and targeted capture or whole exon group sequencing was performed using the second generation sequencing technique, and the suspicious mutation sites were verified by Sanger sequencing.Results:A total of 43 pediatric patients (23 males, 20 female) were included in this study.The median age of onset of 1 year old and 11 months (1 month to 10 years old). Pallor (27/43 cases, 62.79%) was the main symptom.Typical clinical manifestations were anemia (36/43 cases, 83.72%), jaundice (35/43 cases, 81.40%), splenomegaly (33/43 cases, 76.74%), and hepatomegaly (27/43 cases, 62.79%). The proportion of spherical erythrocytes in peripheral blood of 23 cases (23/43 cases, 53.49%)≥ 0.1, and the proportion of spherical erythrocytes in bone marrow smears of 17 cases (39.53%) was ≥ 0.1, and 20 cases were positive in erythrocyte osmotic fragility test (20/43 cases, 46.51%). Comparison of 29 children before and after blood transfusion: post-transfusion hemoglobin (Hb) [(88.69±11.22) g/L vs. (78.24±14.47) g/L], mean corpuscular volume (MCV) [(89.37±7.15) fL vs.(84.08±7.49) fL], mean corpuscular hemoglobin (MCH) [(29.12±2.70) pg vs.(27.36±1.95) pg], mean corpuscular hemoglobin corpuscular (MCHC) [(361.79±32.27) g/L vs.(356.31±31.43 ) g/L] were increased, and the total bilirubin (TB) level was lower after blood transfusion than before blood transfusion [(33.27±16.42) μmol/L vs.(41.58±15.40) μmol/L], the differences were statistically significant ( t=-3.538, -5.187, -5.412, -7.404, 2.527, all P<0.05). Seven children underwent splenectomy: postoperative Hb[(116.00±5.54) g/L vs.(75.71±9.96) g/L], MCH[(29.87±1.62) pg vs.(24.61±1.65) pg], MCHC [(391.14±12.99) g/L vs.(315.14±51.99) g/L] all increased, the difference was statistically significant ( t=-9.234, -4.330, -4.031, all P<0.05). The Hb in the operation group was significantly higher than that in the blood transfusion group, including the treatment effect of operation was more significant ( t=-9.247, P<0.05). Thirteen pathogenic mutations (11 new mutations not reported) were detected in 3 genes ( ANK1, SPTB and SPTA1) in 13 children, 8 of who were mutations in ANK1, 4 cases of which were mutations in SPTB and 1 case of which was mutation in SPTA1.Among the 13 mutations, 12 cases were de novo except one inherited from the mother. Conclusions:Anemia and pallor are the initial symptoms of HS in children.Blood transfusion can temporarily improve the symptoms of anemia and jaundice.Splenectomy is an effective and fundamental treatment.The gene diagnosis of 13 pediatric patients got gene diagnosis, which provided basis for genetic consultation of the next fetus.Eleven new mutations were found in ANK1, SPTB, SPTA1 genes, which exten-ded the gene mutation spectrum of HS.
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Objective:To investigate the treatment, safety and prognosis of advanced non-small cell lung cancer patients with leptomeningeal metastasis and performance status score more than 3.Methods:The clinical data of 6 NSCLC patients with leptomeningeal metastasis admitted to the People's Hospital of Wuhan University from November 2016 to September 2018 were analyzed retrospectively. The curative effect and adverse reactions were observed, and the prognosis was analyzed.Results:There were 5 females and 1 male among 6 patients. The median age was 57 years old (46-74 years old). All 6 patients were diagnosed as stage Ⅳ lung adenocarcinoma. There were 3 patients with epidermal growth factor receptor (EGFR) exon 21 mutation, 2 patients with exon 19 mutation and one with anaplastic lymphoma kinase (ALK) fusion mutation. The time window of leptomeningeal metastasis occurred after the progression of adenocarcinoma of lung: 3 cases was more than 12 months, the other 3 cases was less than 12 months, and the average was 20.3 month. Performance status score was more than 3 when leptomeningeal metastasis occurred. The brain magnetic resonance imaging of 6 patients showed linear enhancement of leptomeningeal, cancer cells were found in cerebrospinal fluid in one case, 4 cases were treated with a combination of bevacizumab and EGFR-tyrosine kinase inhibitor (EGFR-TKI), 1 case was treated with oral administration of EGFR-TKI, 1 case was treated with oral administration of EGFR-TKI combined with temozolomide. The median overall survival (mOS) was 9 months (2-13 months), and the median progression free survival was 6 months (2-11 months).Conclusion:Lung adenocarcinoma may be prone to leptomeningeal metastasis; for NSCLC patients with leptomeningeal metastasis and performance status score more than 3, a combination of EGFR-TKI and bevacizumab has good tolerance, high safety and considerable curative effect.
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Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.
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Objective:To explore the effect of twelve weeks of resistance training on the functional sympatholysis of the skeletal muscles in persons with primary hypertension.Methods:Thirty untreated adult men with stage 1 essential hypertension (SBP/DBP: 140-159/90-99mmHg) formed a hypertension group, while thirty healthy counterparts (SBP/DBP: 90-120/60-80mmHg) served as a control group. Both groups underwent 12 weeks of progressive resistance training, 3 times a week. Before and after the intervention, any changes in forearm haemodynamics at rest were measured, along with handgrip after activation of the sympathetic nerve using a cold pressor test (CPT). The sympathetic vasoconstriction response was represented by the rate of change in brachial vascular conductance (%FVC) induced by the CPT, and the ability to suppress sympathetic vasoconstrictor responses using muscle contractions (functional sympatholysis) was quantified as the difference in sympathetic vasoconstrictor response between the handgrip test and at rest (△%FVC).Results:There were no significant differences between the two groups in their average △%FVCs before the intervention. After the intervention, significant increases were observed in both groups, but there was still no significant difference between the two groups′ average △%FVCs.Conclusion:Twelve weeks of resistance training can improve the functional sympatholysis of adult men with essential hypertension. Their elevated blood pressure does not impair functional sympatholysis.
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Objective To evaluate the prognostic value of a novel prediction model based on fibrinogen concentration in combination with neutrophil-to-lymphocyte ratio (F-NLR score) in patients with esophageal squamous cell carcinoma (ESCC) receiving neoadjuvant therapy and investigate their relationship with pathologic complete response (pCR).Methods Clinical data of 218 eligible ESCC patients treated with neoadjuvant therapy in the Affiliated Cancer Hospital of Zhengzhou University between 2012 and 2015 were retrospectively analyzed.The cut-off values for fibrinogen and neutrophil-to-lymphocyte ratio (NLR)were defined by the receiver operating characteristic (ROC) curve.The effects of different F-NLR scores on survival and pCR were evaluated.The survival rate was analyzed using the Kaplan-Meier method.The relationship among fibrinogen,NLR and pCR was analyzed by using Wilcoxon rank sum test.Results The 3-year overall survival (OS) rates with F-NLR scores of 0,1 and 2 were 72.1％,66.5％ and 50.2％(P=0.010),respectively.The corresponding 3-year disease-free survival (DFS) rates were 64.1％,60.2％ and 45.4％ (P=0.012),respectively.The clinical prognosis of patients with an F-NLR score of 2 was significantly worse compared with those of their counterparts with an F-NLR score of 0-1 (P=0.003).Multivariate analysis demonstrated that the F-NLR score (P=0.004) and TNM stage (P=0.000) were the independent prognostic factors.Conclusions The F-NLR score can be used as an independent prognostic factor for ESCC patients treated with neoadjuvant therapy,which is promising supplement to current TNM staging system,thereby facilitating more accurate risk stratification analysis and achieving individualized multidisciplinary treatment for ESCC patients.
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Objective To investigate the effect of metoprolol and metoprolol combined with moderate inten-sity aerobic exercise on the sympathetic vasoconstriction response of skeletal muscle, functional sympatholysis and the exercise capacity of hypertensive men. Methods Thirty men with mild ( stage 1) essential hypertension were divi-ded into a drug group and an observation group. The drug group received only metoprolol while the observation group took metoprolol and performed aerobic exercise (intensity 50-70％ of VO2max, 30-45 min/time, 3-5 times/week) for 12 weeks. Before and after the experiment, the subjects' maximum oxygen uptake (VO2max), peak power (PP) as well as a rating of perceived exertion ( RPE) curve during exercise were determined using the graded exercise test. Forearm vascular conductance ( FVC) induced by the cold pressor test was measured using Doppler ultrasound at rest and during a handgrip exercise. Sympathetic vasoconstriction response was manifested by the rate of change in the conductance (％FVC) before and after the cold pressor test. Functional sympatholysis ( the ability of muscle contrac-tions to inhibit sympathetic vasoconstrictor response) was quantified using the difference in the ％FVC values (△％FVC) between the handgrip exercise and at rest. Results After the treatment,％FVC during the handgrip exercise was lower than at rest in the observation group.△％FVC had increased significantly, as had VO2max and PP. The RPE curve during a graded exercise test shifted to the right in the observation group, but there was no significant change in the other observations. In the drug group, PP had decreased significantly and the RPE curve had shifted to the left. Conclusion Metoprolol can better improve functional sympatholysis and enhance exercise capacity when it is com-bined with moderate intensity aerobic exercise. That will alleviate any exercise intolerance in men with mild hyperten-sion caused by taking metoprolol alone.
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<p><b>OBJECTIVE</b>To investigate the feasibility and application value of improved anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion.</p><p><b>METHODS</b>A retrospective study was performed on 17 patients who were operated by improved extracorporeal anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion at Huaihe Hospital of Henan University during June 2015 and June 2017.</p><p><b>INCLUSION CRITERIA</b>(1) distance from tumor low margin to anal edge was 4 to 6 cm; (2) protrusive type tumor with a circumferential diameter of less than 3 cm; (3) ulcer type tumor with circumferential bowel infiltration of less than 1/2; (4) no distant metastasis(M0) and preoperative MRI of pelvic floor indicating T1-3N0. Patients with BMI>35 kg/m, or insufficient length of sigmoid and mesentery, or thickening sigmoid and mesentery were excluded. According to total mesorectal excision(TME) principle, rectum and its mesentery was resected completely; the sigmoid colon was cut off at the superior margin of tumor; the oval forceps was placed through anus to clamp and evert the rectum out of the anus; the rectum was transected at 1-2 cm from the lower edge of the tumor; the distal sigmoid colon was pulled out through anus; purse string suture was made after insertion of anvil and was restored to the abdominal cavity; end-to-end anastomosis of the rectum and sigmoid colon was performed after closing rectal stump.</p><p><b>RESULTS</b>Of 17 low rectal cancer patients, 10 were male and 7 were female with age of 42 to 71 (median 58) years old and BMI of 20.6 to 33.5(median 26) kg/m. Preoperative staging indicated 2 cases of stage I, 15 cases of stage II. Distance from tumor low margin to anal edge was 4 to 6(median 5.0) cm and diameter of tumor was 3.4 to 4.8 (median 4.2) cm. All the patients completed operations successfully without conversion to laparotomy. The operation time was 124 to 182 (median 136) minutes. Distal sigmoid colon was difficult to pull out in 1 patient due to the insufficient free of the mesosigmoid, which was then successful after the mesosigmoid was dissociated with laparoscopy thoroughly again. The intraoperative blood loss was 10 to 50 (median 20) ml. Postoperative pathology reveled 2 cases of stage I, 12 cases of stageII and 3 cases of stage III; 1 case of poorly differentiated adenocarcinoma, 15 cases of moderately differentiated adenocarcinoma and 1 case of highly differentiated adenocarcinoma. The postoperative exhaust time was 24 to 128 (median 36) hours and hospital stay was 5 to 15 (median 8) days. No anastomotic leakage and intra-abdominal infection was found. Fifteen patients were followed up for 5 to 24 months without local recurrence or distant metastasis.</p><p><b>CONCLUSION</b>The improved anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion without abdominal incision is safe and feasible.</p>