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Objective: To analyze whether the upper airway of patients with catathrenia has obstructive manifestations using nasal resistance, craniofacial, and upper airway imaging methods, which could benefit the exploration of the etiology and treatment options. Methods: From August 2012 to September 2019, a total of 57 patients with catathrenia in the Department of Orthodontics at Peking University Hospital of Stomatology were included in the study, including 22 males and 35 females, aged (31.1±10.9) years, with a body mass index of (21.7±2.7) kg/m2. All the patients were diagnosed by full-night polysomnography at the Sleep Division, Peking University People's Hospital, of which 10 patients were combined with obstructive sleep apnea hypopnea syndrome (OSAHS). The median groaning index of patients was 4.8 (1.8, 13.0) events/h. Nasal resistance and cone-beam CT were conducted on the patients, and measurements were performed on the craniofacial structures, upper airway, and surrounding soft tissues, compared with non-snoring normal occlusion individuals' references published by the same research team (144 college students recruited at Peking University and 100 non-snoring young adults with normal occlusion recruited at six universities in Beijing). Results: The total nasal resistance of patients with catathrenia was (0.26±0.08) Pa·cm-3·s-1. The patients had overall well-developed mandibular hard tissues. However, the patients were found with increased FH/BaN (steep anterior cranial base plane), increased MP/FH (forward rotation of the mandible); increased U1/NA and L1/MP (proclined upper and lower incisors). The sagittal diameter of the velopharynx [(19.2±4.5) mm] was significantly larger than the normal reference (t=8.44, P<0.001), while the sagittal diameter at the hypopharynx [(17.4±6.4) mm] was statistically smaller than the normal reference (t=-2.79, P=0.006). Catarhrenia patients combined with OSAHS presented longer soft palate, tongue, and lower hyoid bone than those with primary catathrenia. Conclusions: In patients with catathrenia, the overall craniofacial characteristics are well-developed skeletal structures, lower nasal resistance, proclined upper and lower incisors, wide upper sagittal development of the upper airway and narrow hypopharynx. Groaning sounds might be related to the narrowing of the hypopharynx during sleep.
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Objective:To analyze the clinical and pathological characteristics of chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) and not receiving antiviral therapy.Methods:This study retrospectively included CHB patients diagnosed by liver biopsy at the Third Hospital of Hebei Medical University from January 2008 to December 2022. According to the HBV DNA and HBeAg status of "immune tolerance period and immune control period", these patients were divided into three groups: chronic HBV carrier group, inactive HBsAg carrier group and indeterminate group including the patients that did not meet the inclusion criteria of the above two groups. Kruskal-Wallis H test was used for comparison of continuous data between multiple groups. Mann-Whitney U test was used for comparison of continuous data and ordered categorical data between two groups. Chi-square test or Fisher′s exact test was used for comparison of categorical data between two groups. Results:A total of 284 CHB patients with normal ALT were enrolled. There were 64, 88 and 132 cases in the chronic HBV carrier group, inactive HBsAg carrier group and indeterminate group, respectively. Histopathological analysis revealed that there were 182 (64.08%) cases with pathological inflammation grade (G) and/or fibrosis stage (S)≥2, 155 (54.58%) with S≥2 and 120 (42.25%) with G≥2. The proportion of patients with G and/or S≥2 in the indeterminate group [70.45% (93/132)] was higher than that in the chronic HBV carrier group [48.44% (31/64)] and inactive HBsAg carrier group [65.91% (58/88)] (both P<0.05). Patient′s age and the ratio of patients with S≥2 in the chronic HBV carrier group [33 years old, 39.06% (25/64)] were smaller than those in the inactive HBsAg carrier group [39 years old, 56.82% (50/88)] and the indeterminate group [39 years old, 60.61% (80/132)] (all P<0.05). Patients in the inactive HBsAg carrier group (19 U/L) had lower ALT levels than those in the chronic HBV carrier group (26 U/L) and the indeterminate group (23 U/L) (both P<0.05). The proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg was higher in patients with G and/or S≥2 than in patients with G and S<2 [73.08% (57/78) vs 32.08% (17/53), P<0.05], and the proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg increased gradually with age. The proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg was higher in patients with G and/or S≥2 than in patients with G and S<2 in the chronic HBV carrier status and indeterminate groups [93.33% (28/30) vs 43.33%(13/30), P<0.05; 59.46% (22/37) vs 12.50% (2/16); both P<0.05]. There was a statistically significant difference in the incidence of significant liver injury between patients≤ 30 years old and >30 years old [52.7% (39/74) vs 68.1% (143/210), P<0.05]. Conclusions:Significant liver injury occurred in 64.08% (182/284) of CHB patients with normal ALT not receiving antiviral therapy, which required the attention of clinicians. Among CHB patients with normal ALT, the expression site of HBcAg in hepatocytes was related to the occurrence of significant liver injury and could be expected to serve as an important indicator for predicting the patient′s status and the necessity of antiviral treatment. CHB patients with positive HBV DNA who were older than 30 years required antiviral treatment, and CHB patients≤30 years with normal ALT and significant hepatic tissue damage also required antiviral treatment.
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Objective:To investigate feasibility, efficiency and safety of kissing pancreatojejunostomy after pancreatoduodenectomy.Methods:From Jan 2006 to Sep 2020, the clinical data of 267 patients undergoing pancreatoduodenectomy and kissing pancreatojejunostomy were retrospectively analyzed.Results:Grade B postoperative pancreatic fistula (POPF) occurred in 6.37%, Grade C POPF in 2.25% of patients. There was no mortality within 30 days postoperatively as to pancreatic fistula, by cut-off of pancreatic duct diameter at 3mm, there was no significant difference between two subgroups (15/140 vs. 8/127, P=0.20). also, when grouped by texture of the pancreas, no there was significant difference (20/194 vs. 3/73, P=0.11). Conclusions:Kissing pancreatojejunostomy is feasible and easy to perform. It also does not increase the POPF rate when applied to the pancreatojejunostomy with thin pancreatic duct and soft texture.
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Glaucoma is an irreversible cause of blindness, and elevated intraocular pressure (IOP) is an important risk factor for it.There is no clearly defined value of ocular hypertension in children, thus the accurate evaluation of IOP in children and understanding of its influencing factors are of great significance for the timely detection of ocular hypertension in children and the prevention of childhood glaucoma.Different measuring instruments and principles, as well as differences in ocular structures between children and adults, lead to the various sensitivity and reliability of the measurement.Many studies have shown that there are many factors affecting IOP in children, the main influencing factors of which are central corneal thickness, age, race, region, gender, corneal biomechanics, and so on.Obesity, blood pressure, and the use of anesthetics may also have influences on IOP in children.The possible relationship between IOP and refractive state in children is still controversial.For children with high myopia and the tendency to develop high myopia, their IOP should be monitored.Clinical diagnosis of children with ocular hypertension should be cautious, whether to carry out clinical intervention depends on the results of standardized testing and long-term follow-up.At present, accurate assessment and measurement of IOP in children to determine the timing of early warning of ocular hypertension is still the focus of research.Recent progress in IOP and its related influencing factors in children were reviewed in this article.
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Objective:To formulate surgical strategies and guide the implementation of laparoscopic anatomical hepatectomy with preoperative simulative resection.Methods:Twenty-two cases of hepatocellular carcinoma undergoing laparoscopic lobe, segment, subsegment and combined segment liver resection following preoperative simulative resection from Sep 2020 to Jan 2022 were enrolled in this study retrospectively.We observed and analyzed the operation time,intraoperative blood loss,postoperative hospital stay and postoperative complication.Results:All patients underwent laparoscopic hepatectomy successfully according to the preoperative simulative resection plan without conversion, some of them adjusted plan according to preoperative simulative resection. The median operation time was 170.0 min, the median intraoperative blood loss was 150.0 ml, the median times of pringle maneuver was done on 4 episodes, and the median postoperative hospital stay was 6.5 days. There were no severe postoperative complications in all cases.Conclusion:Preoperative simulative resection can plan the range of surgical resection accurately by visualizing important anatomical structures,greatly helping the actual surgical hepatectomy.
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Objective To investigate the clinical and pathological features of children with glycogen storage disease (GSD). Methods A retrospective analysis was performed for ten children with GSD who were admitted to the Third Hospital of Hebei Medical University and The Fifth Medical Center of Chinese PLA General Hospital from January 2002 to January 2022, based on medical history, liver biochemistry, and liver biopsy, and population characteristics, clinical manifestations, biochemical parameters, and liver histopathological characteristics were compared and analyzed. Results All ten children had developmental retardation and a short stature, with the manifestations of abnormal liver function, mild weakness, poor appetite, yellow urine, and yellow eyes, and four children had hepatosplenomegaly. Among the ten children, six had the clinical manifestations of hypoglycemia, and one had bilateral gastrocnemius hypertrophy and positive Gower sign. Two children had positive CMV IgG. Liver histopathological manifestations included diffuse enlargement of hepatocytes, light cytoplasm, and small nucleus in the middle like plant cells, with or without fibrous tissue proliferation. Conclusion Most patients with GSD have developmental retardation and abnormal aminotransferases, and liver pathological examination shows specific pathological features.
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Objective:To explore the change trend of average hospitalization expense and cost structure of inpatients after the implementation of diagnosis-intervention packet (DIP) payment reform in Zhuhai.Methods:The data of hospitalization expense and the proportion of each classification cost (i.e. the value of a classification cost per thousand yuan of medical cost) in Zhuhai before and after the reform were analyzed by interrupted time series method, and the changes of per capita hospitalization cost and cost structure were studied.Results:The average hospitalization expense showed a linear change trend before and after the reform, and the immediate level and the slope of regression line did not change significantly after the reform, which was basically consistent with the trend before the reform. After the implementation of DIP, the proportion of various categories of expenses changed. Among them, the proportion of comprehensive medical services, treatment, traditional Chinese medicine, western medicine, blood and blood products, and other categories changed significantly, P values were less than 0.05. There was no obvious change in the proportion of expenses of diagnosis, rehabilitation and traditional Chinese medicine, but there was a change in the immediate level. The change in the level of diagnosis was -13.649 ( P< 0.001), the change in the level of rehabilitation was -1.053 ( P< 0.001), and the change in the level of traditional Chinese medicine was 2.781 ( P< 0.001). The immediate level and trend change of the proportion of consumables after the reform was not obvious. Conclusions:After the implementation of DIP payment in Zhuhai, the average expense of inpatients has not changed significantly, but the expense structure has changed significantly.
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Objective To investigate the prevalence of Vibrio parahaemolyticus(VP)in oysters in Jinshan District, Shanghai and make assessment on the risks that may cause, providing the basis for prevention and control of foodborne disease. Methods Raw oyster samples with shells were randomly collected from markets, supermarkets and restaurants in Jinshan District from July to October in 2017. The content of VP in oysters was tested in accordance with the national standard methods. The semi-quantitative risk assessment for VP in oysters was made by Risk Ranger combining with the monitoring results of diet and health status of residents in Jinshan District of Shanghai in 2012-2013. Results The overall positive rate of VP in the 40 oyster samples was 80.0%(32/40). The positive rate of VP in oyster samples from farmer's markets was the highest, 85.7%(12/14), followed by those from restaurants and supermarkets. The relative risk for VP in raw oysters was 63. The probability of illness caused by VP in oysters per day per consumer of interest was 6.85×10-4, and the total predicted patients annual incidence rate in this population was 1 247.8/105. Conclusion The contamination of VP in seafood oysters in Jinshan District is serious. Eating raw oysters is at high risk; consumers are advised to reduce or avoid eating raw oysters, and processing food before eating is an effective method to decrease VP infection. Strengthening surveillance and management is imperative in this regard.
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OBJECTIVE@#With the rapid development of sleep medicine, there are various methods for detecting sleep diseases. This study compared the correlation between the lightweight watch-type sleep monitor (Actiwatch) and the "gold standard" polysomnography (PSG) in the Chinese population, in order to provide a basis for clinical application.@*METHODS@#From August 2018 to December 2019, 121 subjects who simultaneously performed sleep breathing monitoring (PSG) and wearing a watch-type sleep monitor (Actiwatch) in the Sleep Center of Peking University People's Hospital were enrolled. All subjects received PSG and Actiwatch at the same time, and filled out the sleep diary next morning. Monitoring indicators were collected for linear correlation analysis and paired t test to compare the differences.@*RESULTS@#Under low sensitivity conditions, the correlation coefficient of total sleep time (TST) between PSG and Actiwatch was 0.53 (P < 0.05). Paired t test analysis showed that there was no significant difference between the TSTs of Actiwatch and PSG (t=-0.890, P=0.36). According to age stratification, the smaller the age, the stronger the correlation between the TSTs of Actiwatch and PSG, and the coefficient could be up to 0.92 (P < 0.05). Paired t test showed that there was no significant difference between them (t=-1.057, P=0.35). According to the stratification by diagnosis, the correlation coefficient between the TSTs of Actiwatch and PSG in normal PSG group could be as high as 0.79 (P < 0.05), the results of paired t test showed that there was no significant difference between the TSTs of Actiwatch and PSG in normal PSG group (t=-0.784, P=0.44).@*CONCLUSION@#As a wearable home recorder, when the analysis parameters of Actiwatch were set as low sensitivity, PSG and Actiwatch had the highest TST correlation. The younger the age, the stronger correlation between the TSTs of Actiwatch and PSG. The PSG and Actiwatch subjects with normal PSG presentation had a higher TST correlation.
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Humans , Actigraphy , Polysomnography , Reproducibility of Results , Sensitivity and Specificity , Sleep , Sleep Wake Disorders , TimeABSTRACT
Objective To investigate the status of cadmium contamination in commercially sold aquatic products and to analyze the risk of dietary intake of cadmium among residents in one district of Shanghai. Methods Multistage sampling was used to collect 397 animal aquatic products from agricultural markets and supermarkets in 11 communities (townships), the District from 2018 to 2019.Cadmium content was tested according to national standard.The status of cadmium contamination was assessed by single factor pollution index(Pi)method.Risk of dietary intake of cadmium among residents was assessed by point evaluation method in combination with food consumption and dietary survey in 2013 and calculation of safe limits for cadmium in various aquatic diets(MOS). Results The detection rate of cadmium was 75.06% in the 397 animal aquatic products and the content of cadmium in 10 samples which crabs were totally exceeded the standard, accounting for 2.52%.The average contents of cadmium in crabs, bivalves which were higher than in shrimps(11.0 μg/kg), gastropods(7.6 μg/kg) and marine fish(3.8 μg/kg) were respectively 140.0 μg/kg and 90.0 μg/kg(χ2=186.41, P < 0.005), but no cadmium was detected in freshwater fish.The single factor pollution index(Pi) of crabs was 0.280 which meant light pollution and the Pi of other kinds of aquatic products was respectively under 0.100 that meant no cadmium contamination.The consumption of animal aquatic products was the highest in freshwater fish followed by shrimps, marine fish and crabs.The MOS of every kind of aquatic products is higher than 1 which meant cadmium intake from commercially sold animal products was an acceptable health risk for the population. Conclusion The risk level of cadmium intake by residents in the district through commercially sold animal aquatic products is relatively low, but the cadmium pollution status of commercially sold crustacean crabs should be vigilant, and the intake of crabs is advised to be reduced as far as possible.Relevant departments should also pay attention and strengthen monitoring and management in this regard.
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Objective To investigate the effects of parental support for the moderate-to-vigorous physical activity (MVPA) of their children and to promote physical activity for children and adolescents. Methods A total of 622 students were selected by stratified clustering sampling methods.Physical activity and parental support factors were assessed by self-report questionnaire survey.Logistic regression was used to analyze determinants of physical inactivity. Results Nearly 58.7% of the parents purchased sports equipment for their children and 57.6% of the parents accompanied their children to do exercise.The rate of parental explicit modeling was 22.8%.The students who received parental logistic support and explicit modeling did longer MVPA on weekends.The students with parental logistic support were prone to be in activity (OR=1.51, 95%CI:1.01-2.27). Conclusion Family-based interventions from parental logistic support and explicit modeling could promote middle-to-high-intensity activities for junior high school students.
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Objective@#To observe the dynamic impacts of shock waves on the severity of lung injury in rats with different injury distances.@*Methods@#Simulate open-field shock waves; detect the biomechanical effects of explosion sources at distances of 40, 44, and 48 cm from rats; and examine the changes in the gross anatomy of the lungs, lung wet/dry weight ratio, hemoglobin concentration, blood gas analysis, and pathology.@*Results@#Biomechanical parameters such as the overpressure peak and impulse were gradually attenuated with an increase in the injury distance. The lung tissue hemorrhage, edema, oxygenation index, and pathology changed more significantly for the 40 cm group than for the 44 and 48 cm groups. The overpressure peak and impulse were significantly higher for the 40 cm group than for the 44 and 48 cm groups ( < 0.05 or < 0.01). The animal mortality was significantly higher for the 40 cm group than for the other two groups (41.2% . 17.8% and 10.0%, < 0.05). The healing time of injured lung tissues for the 40 cm group was longer than those for the 44 and 48 cm groups.@*Conclusions@#The effects of simulated open-field shock waves on the severity of lung injuries in rats were correlated with the injury distances, the peak overpressure, and the overpressure impulse.
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Animals , Male , Rats , Biomechanical Phenomena , Blast Injuries , Pathology , Disease Models, Animal , Explosions , Lung Injury , Pathology , Random Allocation , Rats, Sprague-DawleyABSTRACT
As the disease progresses, there is a significant change in the body composition of patients with liver cirrhosis, and sarcopenia is one of the common complications in liver cirrhosis, especially in decompensated cirrhosis. About 30%-70% of patients with liver cirrhosis have sarcopenia, which greatly affects patients’ survival and is closely associated with the development of hepatic encephalopathy. Sarcopenia may also increase the risk of infection. Sarcopenia and muscle fatty degeneration can be used as poor prognostic indicators of hepatocellular carcinoma and may increase the risk of recurrence of liver cancer. This article reviews the research advances in the definition of sarcopenia, the association of sarcopenia with liver cirrhosis, and assessment and clinical management of sarcopenia.
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Background@#Recent genome-wide association studies have identified an important role of T-cell receptor α (TRA) gene in the development of narcolepsy type 1. However, the role of TRA haplotype polymorphisms in the symptomatic diversity of narcolepsy remains unclear. This study aimed to investigate whether TRA polymorphisms can influence the symptomatic diversity of narcolepsy.@*Methods@#Totally, 903 patients with narcolepsy type 1 were included in the study. Patients were divided into different groups according to their symptoms. First, 13 genotyped single nucleotide polymorphisms in the TRA were assessed for their association with symptoms of narcolepsy. We used the Chi-square test to determine differences in genotype frequencies in patients with narcolepsy. Further, we identified the haplotypes and variations of the TRA and tested their association with the symptoms of narcolepsy using a logistic regression model.@*Results@#According to the results of the logistic regression, TRA haplotypes TG and CT were significantly associated with auditory hallucination, with odds ratios of 1.235 (95% confidence interval [CI], 1.012–1.507) and 1.236 (95% CI, 1.012–1.511), respectively (P < 0.05).@*Conclusions@#The patterns of haplotype in TRA (haplotypes TG and CT) are associated with hypnagogic auditory hallucination in patients with narcolepsy type 1. However, further studies are needed to confirm our results and explore the underlying mechanisms.
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The present study was aimed to evaluate resting-state functional connectivity and topological properties of brain networks in narcolepsy patients compared with healthy controls. Resting-state fMRI was performed in 26 adult narcolepsy patients and 30 matched healthy controls. MRI data were first analyzed by group independent component analysis, then a graph theoretical method was applied to evaluate the topological properties in the whole brain. Small-world network parameters and nodal topological properties were measured. Altered topological properties in brain areas between groups were selected as region-of-interest seeds, then the functional connectivity among these seeds was compared between groups. Partial correlation analysis was performed to evaluate the relationship between the severity of sleepiness and functional connectivity or topological properties in the narcolepsy patients. Twenty-one independent components out of 48 were obtained. Compared with healthy controls, the narcolepsy patients exhibited significantly decreased functional connectivity within the executive and salience networks, along with increased functional connectivity in the bilateral frontal lobes within the executive network. There were no differences in small-world network properties between patients and controls. The altered brain areas in nodal topological properties between groups were mainly in the inferior frontal cortex, basal ganglia, anterior cingulate, sensory cortex, supplementary motor cortex, and visual cortex. In the partial correlation analysis, nodal topological properties in the putamen, anterior cingulate, and sensory cortex as well as functional connectivity between these regions were correlated with the severity of sleepiness (sleep latency, REM sleep latency, and Epworth sleepiness score) among narcolepsy patients. Altered connectivity within the executive and salience networks was found in narcolepsy patients. Functional connection changes between the left frontal cortex and left caudate nucleus may be one of the parameters describing the severity of narcolepsy. Changes in the nodal topological properties in the left putamen and left posterior cingulate, changes in functional connectivity between the left supplementary motor area and right occipital as well as in functional connectivity between the left anterior cingulate gyrus and bilateral postcentral gyrus can be considered as a specific indicator for evaluating the severity of narcolepsy.
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BACKGROUND@#Recent genome-wide association studies have identified an important role of T-cell receptor α (TRA) gene in the development of narcolepsy type 1. However, the role of TRA haplotype polymorphisms in the symptomatic diversity of narcolepsy remains unclear. This study aimed to investigate whether TRA polymorphisms can influence the symptomatic diversity of narcolepsy.@*METHODS@#Totally, 903 patients with narcolepsy type 1 were included in the study. Patients were divided into different groups according to their symptoms. First, 13 genotyped single nucleotide polymorphisms in the TRA were assessed for their association with symptoms of narcolepsy. We used the Chi-square test to determine differences in genotype frequencies in patients with narcolepsy. Further, we identified the haplotypes and variations of the TRA and tested their association with the symptoms of narcolepsy using a logistic regression model.@*RESULTS@#According to the results of the logistic regression, TRA haplotypes TG and CT were significantly associated with auditory hallucination, with odds ratios of 1.235 (95% confidence interval [CI], 1.012-1.507) and 1.236 (95% CI, 1.012-1.511), respectively (P < 0.05).@*CONCLUSIONS@#The patterns of haplotype in TRA (haplotypes TG and CT) are associated with hypnagogic auditory hallucination in patients with narcolepsy type 1. However, further studies are needed to confirm our results and explore the underlying mechanisms.
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Objective@#To observe the bone marrow signals of acetabulum and proximal femur of asymptomatic non-professional marathoners by 3.0 T magnetic resonance imaging (MRI) T1WI, and evaluate the bone marrow transformation, so as to obtain the effect of Marathon exercise on bone marrow composition and function.@*Methods@#The study group was randomly selected to participate in and complete the whole marathon at least once a year in the past two years. The training mileage of long-distance running was not less than 1 600 kilometers per year. There were no symptoms such as hip pain. There were no abnormalities in hip joint physical examination. The age of 22-53 years old. A total of 31 and 62 hips were evaluated. The control group was randomly selected 29 healthy persons (58 hip joints), aged 23-53 years, without hip pain and regular exercise. All subjects underwent hip joint MRI scan, and the hip joint MRI showed normal. At least 12 hours before MR scan, he did not engage in long-distance running or other sports. The bone marrow signal intensity of acetabulum and proximal femur in T1WI was compared with that of surrounding muscles and fat. The signal intensity was graded from low to high and evaluated by grade. The research group was divided into two groups according to the training years of marathon (running age). The running age of group A was more than 4 years and group B was less than 4 years. The distribution of bone marrow signal in proximal femur was also evaluated by a more intuitive 3-4 classification method. Mann-Whitney U test was used for statistical analysis.@*Results@#Bone marrow signal grading evaluation showed that there were significant differences in bone marrow signal grade distribution between the two groups (Z=-6.828, -4.779, -3.046, -5.266, -3.490, - 5.053, P<0.05). In the study group, there were 14, 28 hips and 168 parts in group A, 17, 34 hips and 204 parts in group B, bone marrow signals were graded. There were significant differences in acetabulum, femoral neck and upper femoral shaft bone (Z=-2.202, -2.214, -2.730, P<0.05), but no significant differences in femoral head, trochanter and trochanter bone (Z=-0.886, -1.642, -0.711, P>0.05). To evaluate the classification of bone marrow signals in proximal femur, 62 cases of bone marrow signals in the study group were classified as follows: 10 cases with type 1a, 24 cases with type 1b, 17 cases with type 2 and 11 cases with type 3. In the control group, 58 cases of bone marrow signals in proximal femur were classified as follows: 2 cases with type 1a, 13 cases with type 1b, 26 cases with type 2 and 17 cases with type 3. There were significant differences between the two groups (Z=-4.003, P<0.05).@*Conclusion@#The T1WI signal intensity of asymptomatic non-professional marathoners′ acetabulum and proximal femur bone marrow is lower than that of non-marathoners; the T1WI signal intensity of acetabulum, femoral neck and upper femoral shaft bone marrow of the elderly runners is lower; that is, marathon exercise has certain influence on the bone marrow signal of acetabulum and proximal femur, that is, the change of bone marrow signal in weight-bearing area has a certain phase with the amount of exercise.
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Objective To observe the bone marrow signals of acetabulum and proximal femur of asymptomatic non?professional marathoners by 3.0 T magnetic resonance imaging (MRI) T1WI, and evaluate the bone marrow transformation, so as to obtain the effect of Marathon exercise on bone marrow composition and function. Methods The study group was randomly selected to participate in and complete the whole marathon at least once a year in the past two years. The training mileage of long?distance running was not less than 1 600 kilometers per year. There were no symptoms such as hip pain. There were no abnormalities in hip joint physical examination. The age of 22?53 years old. A total of 31 and 62 hips were evaluated. The control group was randomly selected 29 healthy persons (58 hip joints), aged 23?53 years, without hip pain and regular exercise. All subjects underwent hip joint MRI scan, and the hip joint MRI showed normal. At least 12 hours before MR scan, he did not engage in long?distance running or other sports. The bone marrow signal intensity of acetabulum and proximal femur in T1WI was compared with that of surrounding muscles and fat. The signal intensity was graded from low to high and evaluated by grade. The research group was divided into two groups according to the training years of marathon (running age). The running age of group A was more than 4 years and group B was less than 4 years. The distribution of bone marrow signal in proximal femur was also evaluated by a more intuitive 3?4 classification method. Mann?Whitney U test was used for statistical analysis. Results Bone marrow signal grading evaluation showed that there were significant differences in bone marrow signal grade distribution between the two groups (Z=-6.828, -4.779, -3.046,-5.266,-3.490,-5.053, P<0.05). In the study group, there were 14, 28 hips and 168 parts in group A, 17, 34 hips and 204 parts in group B, bone marrow signals were graded. There were significant differences in acetabulum, femoral neck and upper femoral shaft bone (Z=-2.202, -2.214, -2.730, P<0.05), but no significant differences in femoral head, trochanter and trochanter bone (Z=-0.886,-1.642,-0.711, P>0.05). To evaluate the classification of bone marrow signals in proximal femur, 62 cases of bone marrow signals in the study group were classified as follows: 10 cases with type 1a, 24 cases with type 1b, 17 cases with type 2 and 11 cases with type 3. In the control group, 58 cases of bone marrow signals in proximal femur were classified as follows: 2 cases with type 1a, 13 cases with type 1b, 26 cases with type 2 and 17 cases with type 3. There were significant differences between the two groups (Z=-4.003, P<0.05). Conclusion The T1WI signal intensity of asymptomatic non?professional marathoners′acetabulum and proximal femur bone marrow is lower than that of non?marathoners; the T1WI signal intensity of acetabulum, femoral neck and upper femoral shaft bone marrow of the elderly runners is lower; that is, marathon exercise has certain influence on the bone marrow signal of acetabulum and proximal femur, that is, the change of bone marrow signal in weight?bearing area has a certain phase with the amount of exercise.
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Objective To investigate the expressions of Toll-like receptors and NOD-like receptor (TLR/NLRP) in septic rats with acute kidney injury (AKI) and influence of Radix notoginseng. Methods One hundred and fifty male Sprague-Dawley (SD) rats were selected, and they were divided into three groups: sham operation group, model group and Radix notoginseng pretreatment group with 50 rats in each group. Sepsis rats with AKI models were established by cecal ligation puncture (CLP); only was laparotomy performed in the sham operation group without ligation. The rats in Radix notoginseng pretreatment group were given Radix notoginseng (3 g/kg) for consecutive 3 days by gastric perfusion before treatment, and the sham operation group and sepsis model group rats were given equal amount of normal saline by gastric perfusion. After their blood was collected, at each following time points 6, 12 and 24 hours after modeling, 10 rats in each group were sacrificed, and the kidney specimens were collected. The endotoxin levels were detected by limulus assay; the levels of serum creatinine (SCr) and urea nitrogen (BUN) were detected by automatic biochemical analyzer; serum levels of interleukins (IL-1β, IL-18, IL-6) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA); the expression levels of NLRP1/3 and TLR2/4 mRNA and protein in renal tissue were detected by real-time fluorescence quantitative polymerase chain reaction (qPCR) and Western Blot, respectively; the pathological changes of renal tissues were observed by optical microscope. The 4-day and 7-day survival rates were observed in the remaining 20 rats in each group. Results The levels of endotoxin, SCr, BUN, IL-1β, IL-6, IL-18, and TNF-α and the expressions of NLRP1/3, TLR2/4 mRNA and proteins in sepsis model group and Radix notoginseng pretreatment group were significantly higher than those in sham operation group, and the levels of endotoxin, IL-18, and the expressions of NLRP1/3, TLR2/4 mRNA and proteins showed statistically significant differences at 6-hour after operation [endotoxin (kU/L): 61.3±25.7, 56.9±18.6 vs. 0.2±0.1, IL-18 (ng/L): 16.7±5.0, 13.8±2.9 vs. 10.6±2.8, NLRP3 mRNA (2-ΔΔCt): 6.3±1.9, 4.0±1.2 vs. 1.1±0.4, TLR mRNA (2-ΔΔCt): 5.7±1.3, 2.0±0.8 vs. 0.9±0.3, TLR4 mRNA (2-ΔΔCt): 4.4±1.2, 2.3±0.7 vs. 0.6±0.2, NLRP3/β-actin: 38.2±9.3, 26.1±7.2 vs. 18.3±5.1, TLR4/β-actin: 21.9±6.1, 16.2±4.4 vs. 10.9±2.8, TLR4/β-actin: 18.3±6.7, 12.0±3.9 vs. 7.5±2.0, all P < 0.05], the levels of SCr, BUN, IL-1β, TNF-α and IL-6 showed statistically significant differences at 12-hour after operation [SCr (μmol/L): 62.3±21.6, 38.1±13.9 vs. 36.0±11.9, BUN (mmol/L): 16.5±7.2, 6.9±2.6 vs. 6.8±2.5, IL-1β (ng/L): 37.6±10.9, 31.2±9.3 vs. 20.3±6.5, TNF-α (ng/L): 15.6±3.9, 10.2±2.8 vs. 7.3±2.1, IL-6 (ng/L):9.3±2.5, 6.8±1.7 vs. 5.0±1.3, all P < 0.05], the levels of expressions of NLRP3 mRNA and protein were obviously lower than those in sham operation group, and there were statistical significant differences immediately after 6-hour after operation [NLRP1 mRNA (2-ΔΔCt): 0.5±0.1, 0.8±0.2 vs. 1.6±0.5, NLRP3/β-actin: 8.0±2.1, 16.8±5.0 vs. 35.6±10.5, all P < 0.05], and the amplitude changes of the above indexes in Radix notoginseng pretreatment group were obviously smaller than those in sepsis model group (all P < 0.05); the survival rates of 4-day and 7-day in sepsis model group were significantly lower than those in sham operation group [4-day: 25% (5/20) vs. 95% (19/20), 7-day: 15% (3/20) vs. 95% (19/20), both P < 0.05], while the survival rate in Radix notoginseng pretreatment group was significantly higher than that in sepsis model group [respectively 65% (13/20) vs. 25% (5/20), 60% (12/20) vs. 15% (3/20), both P < 0.05]. Conclusions TLR2/4 and NLRP1/3 may be involved in the pathogenesis of AKI of septic rats. Traditional Chinese medicine Radix notoginseng possibly via regulating the expressions of TLR2/4 and NLRP1/3 can reduce the inflammatory response, in turn ameliorate kidney injury in septic rats and improve their renal functions.
ABSTRACT
To study the protective effect of Wuzi Yanzong recipe on testicular DNA damage and apoptosis in natural ageing rats, SPF grade 16-month-old SD male rats were randomly divided into three groups: ageing model group, low and high dose Wuzi Yanzong recipe groups (WZ, 1， 4 g·kg⁻¹). In addition, 2-month-old SD rats were used as adult control group (10 rats in each group). The ageing model group and the adult control group were fed with normal diet for 4 months. Wuzi Yanzong groups received medicated feed for 4 months. After fasting for 12 hours, the rats were sacrificed. Then testis tissues were taken and weighed to calculate the testis index. The change of testicular tissue morphology was observed by HE staining. Expression and localization of DNA damage-associated protein ATR were observed by immunofluorescence. The expressions of DNA damage-related proteins γ-H2AX, Chk1, p-p53 and apoptosis-related proteins Bcl-2 and Bax in testes were detected by Western blot. The apoptosis of testis tissue in rats was detected by using TUNEL. The results showed that as compared with the youth control group, the protein expression levels of γ-H2AX, Chk1, p-p53 and Bax were significantly increased while Bcl-2 protein expression level was significantly decreased intestis tissues of ageing model group. Wuzi Yanzong recipe significantly decreased protein expression levels of γ-H2AX, Chk1, p-p53 and Bax and increased Bcl-2 protein expression level as well as Bcl-2/Bax ratio. Immunofluorescence results showed that Wuzi Yanzong recipe could significantly decrease the ageing-induced ATR, increase in testis tissues. TUNEL results showed that Wuzi Yanzong recipe could significantly attenuate the germ cell apoptosis in testicular tissues. All the above results suggest that Wuzi Yanzong recipe could protect the germ cell in testicular tissues of natural ageing rates from DNA damage and apoptosis, and the mechanism may be associated with regulating p53 signaling pathway.