ABSTRACT
Literatures on pain intervention with transcutaneous electrical acupoint stimulation (TEAS) were collected by searching the databases both in Chinese and English, and summarized to understand the research progress of TEAS effects on pain mediators in recent years. This will provide a more objective and scientific theoretical basis for clinical practice of TEAS to treat pain syndrome, thus promoting the clinical application of TEAS. Our literature analysis indicated that TEAS effectively regulated the release levels of various pain factors such as prostaglandin, 5-hydroxytryptamine, interleukins, substance P and tumor necrosis factor-α to achieve the analgesic effects by affecting the conduction pathways. TEAS is a safe, non-invasive and effective treatment for pain syndrome. However, further research is necessary due to the lack of rigor of the current clinical trial design.
ABSTRACT
Objective:To explore the methods to improve the professional core competencies of medical students in the standardized residency training.Methods:A total of 82 medical students who participated in the standardized residency training ("resident students" for short) in the same period were selected in this study, and the self-edited professional core competencies textbooks were used for regular theoretical study, and at the same time, clinical practice cases were collected for regular scenario reduction teaching. When the resident students entered the department and after 12 months of the standardized training, the professional core competencies training evaluation scale was used to evaluate and compare the scores of the resident students, and the value of the above-mentioned training model to improve the professional core competencies of the resident students was evaluated. SPSS 18.5 was performed for t test between groups. Results:After being trained by the above model, the selected students had significantly improved such competencies as communication, cooperation and problems solving ( P<0.05). Compared with the scores of resident students before and after the training, there was no significant difference in communication and cooperation with other students ( P>0.05), with low satisfactory communication with the leader ( P>0.05), but the problem-solving ability had been significantly improved ( P<0.05), while the score of which was low and it should be pay more attention to in the future training. Conclusion:In the process of standardized residency training, the application of the above-mentioned training model can significantly improve the professional core competencies of resident students, and at the same time, it's necessary to strengthen the cultivation of satisfactory communication with leaders and problem solving ability.
ABSTRACT
OBJECTIVE@#To observe the therapeutic effect between acupuncture combined with medication and simple medication on migraine and cerebral hemodynamics.@*METHODS@#A total of 120 patients with migraine were randomized into an acupuncture plus medication group (60 cases, 3 cases dropped off) and a medication group (60 cases, 6 cases dropped off). In the medication group, flunarizine hydrochloride capsule was given orally before sleep, 10 mg a day. On the basis of the treatment in the medication group, acupuncture was applied at Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), Fengchi (GB 20) and etc. in the acupuncture plus medication group, 30 min each time, once a day. Treatment for 4 weeks was required in both groups. Before and after treatment, the visual analogue scale (VAS) score, indexes of cerebral hemodynamic [blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery (BA)] and total TCM syndrome score were observed, and the clinical therapeutic effect and the incidence of the adverse events were evaluated in both groups.@*RESULTS@#Compared before treatment, the VAS scores, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome scores were decreased in both groups (@*CONCLUSION@#Acupuncture combined with flunarizine hydrochloride capsule can effectively relieve the pain in patients with migraine, reduce the cerebral blood flow velocity, the efficacy is superior to simple flunarizine hydrochloride capsule.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Hemodynamics , Migraine Disorders/therapy , Pain , Treatment OutcomeABSTRACT
@#AIM: To evaluate and compare the quality of life of patients submitted to phacoemulsification combined with goniosynechialysis(PPI+GSL)and trabeculectomy, and analyze the potentially involved variables.<p>METHODS: A perspective, randomized case-control study was conducted. Patients with acute primary angle-closure glaucoma(ACG)and early cataracts underwent PPI+GSL implantation(group A, <i>n</i>=29)and trabeculectomy(group B, <i>n</i>=30). The quality of life was assessed using the National Eye Institute 25-Item Visual Function Questionnaire(NEI-VFQ-25)before and 6mo after surgery. Intraocular pressure(IOP), best corrected visual acuity(BCVA), review frequency and the basic characteristics were recorded simultaneously.<p>RESULTS: Compared with preoperative status, the IOP in both groups was significantly decreased(all <i>P</i><005), and the BCVA was significantly increased in group A(<i>P</i><0.05), while did not differ significantly in group B(<i>P</i>>0.05). Besides, group B presented higher review frequency than group A(<i>P</i><0.05). Moreover, significant increases in postoperative scores were founded in the two groups respectively(all <i>P</i><0.05). Compared with group B, group A had better postoperative performance in items of general vision, ocular pain, long-distance activities, social functioning and role limitations(all <i>P</i><0.05). Besides, group A presented significantly higher net increases in postoperative total scores than group B(<i>P</i><0.05), which was positively associated with the degree of the BCVA recovery and negatively associated with review frequency(<i>R</i><sup>2</sup>=0.48, <i>F</i>=5.00, <i>P</i><0.05).<p>CONCLUSION: APACG patients with early cataracts, PPI+GSL determines better improvement in quality of life compared to trabeculectomy.
ABSTRACT
OBJECTIVE: To investigate the status and association of anxiety, depression, tinnitus and sleep quality in patients with occupational noise-induced deafness(ONID). METHODS: A total of 302 ONID patients were selected as research subjects using judgment sampling method. Their status of anxiety, depression, tinnitus and sleep quality were investigated using questionnaires of Self-Rating Anxiety Scale, Self-Rating Depression Scale, Tinnitus Handicap Inventory and Pittsburgh Sleep Quality Index. RESULTS: Among the study subjects, there were 123 cases with no anxiety or depression, 46 cases with simple anxiety or depression, and 133 cases with combined anxiety and depression, accounting for 40.7%, 15.3% and 44.0%, respectively. The incidence of tinnitus and sleep disorder were 77.8%(235/302) and 48.0%(145/302), respectively. The total scores of tinnitus and sleep quality in simple anxiety or depression group were higher than those with no anxiety or depression(all P<0.01). The total scores of tinnitus and sleep quality in combined anxiety and depression group were higher than that with no anxiety and depression, and simple anxiety or depression group(all P<0.01). Among the research subjects, the incidence of tinnitus and sleep disorder from high to low were combined anxiety and depression group, simple anxiety or depression group, and no anxiety and depression group(tinnitus: 85.7% vs 76.1% vs 69.9%, sleep disturbance: 82.0% vs 37.0% vs 15.5%, all P<0.01). The standard scores of anxiety and depression in ONID patients were positively correlated with the total scores of tinnitus and sleep quality(correlation coefficients were 0.63, 0.72, 0.63, 0.69, all P<0.01). CONCLUSION: ONID patients can be accompanied by varying degrees of anxiety and depression. The existence of anxiety and depression may lead to increased tinnitus and decreased sleep quality in ONID patients.
ABSTRACT
Gout is the second largest metabolic disease in China， which can cause joint tissue damage and a variety of chronic diseases， and seriously affect human life and health. The increase in uric acid caused by disorder of purine metabolism or abnormal uric acid excretion is the biochemical basis of its pathogenesis. Western medical treatment mainly uses anti-inflammatory drugs such as colchicine， non-steroidal anti-inflammatory drugs， and uric acid lowering drugs such as febuxostat and benzbromarone， which have obvious effects， but there are problems such as easy to recurrence after drug withdrawal and more adverse reactions. Traditional Chinese medicine （TCM） has a long history in the treatment of gout， and has the advantages of multi-channel， multi-target， and multi-level symptomatic treatment. It exerts therapeutic effects through lowering uric acid， anti-inflammatory， anti-oxidation， and protecting the kidneys. Its curative effect is obvious and the adverse reaction rate is low. In recent years， there have been many studies on the mechanism of TCM for gout animal models. Based on the review of relevant literature in recent years， this article has systematically sorted out the pathogenesis of gout， the mechanism of TCM for gout and related experimental design. The paper summarized and analyzed the mechanism of TCM in the treatment of gout from the aspects of regulating the level of inflammatory factors， inhibiting oxidation reaction， reducing uric acid and regulating signaling pathway， so as to provide reference for the research and development of drugs for gout.
ABSTRACT
Objective:To explore the possible mechanism of electroacupuncture to improve detrusor hyperreflex after suprasacral spinal cord injury. Methods:A total of 60 female Sprague-Dawley rats were included. According to the random number table, twelve were selected as the blank group, twelve as the sham operation group, and the remaining 36 were made neurogenic bladder models using modified T10 spinal cord transection. After that, twelve of them were randomly selected as the model group and twelve were as the electroacupuncture group from the model rats that met the requirements. On the 19th day after modelling, Ciliao (BL32), Zhongji (RN3) and Sanyinjiao (SP6) were taken for electroacupuncture. After seven days of continuous treatment, urodynamic testing was performed, content of cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA) in detrusor was determined by ELISA, and the level of phosphorylation of myosin light chain kinase (p-MLCK) of detrusor was determined by Western blotting. Results:Compared with the blank group and the sham operation group, the maximum bladder capacity and bladder compliance significantly reduced (P < 0.01), and the base pressure and leakage point pressure of bladder significantly increased (P < 0.01); the content of cAMP and PKA in detrusor reduced (P < 0.01), p-MLCK in detrusor reduced (P < 0.05) in the model group. Compared with the model group, the maximum bladder capacity and bladder compliance increased (P < 0.01), the base pressure of the bladder and the pressure at the leak point decreased (P < 0.05); the contents of cAMP and PKA protein in detrusor increased (P < 0.05), the p-MLCK in detrusor increased (P < 0.05) in the electroacupuncture group. Conclusion:Electroacupuncture at Ciliao, Zhongji and Sanyinjiao points could improve the bladder function of rats with detrusor hyperreflex after complete spinal cord injury, and its mechanism may be related to up-regulating the expression of cAMP and PKA, phosphorylating and inactivating p-MLCK, which promote relaxation of detrusor.
ABSTRACT
Objective:To investigate the efficacy difference of totally laparoscopic total gastrectomy (TLTG) and laparoscopically assisted total gastrectomy (LATG) on radical gastrectomy for gastric cancer, and further to explore the safety and feasibility of totally laparoscopic esophagojejunostomy.Methods:PubMed, Web of Science, Wanfang and CNKI database were searched for all relevant articles regarding to TLTG versus LATG for gastric cancer published up to September 2019. The search keywords included: gastric/stomach cancer, total gastrectomy, totally/completely laparoscopic, laparoscopic-assisted/laparoscopy-assisted/laparoscopically assisted, esophagojejunostomy/esophagojejunal anastomosis. Meta-analysis was performed with RevMan 5.3 software.Results:A total of 258 articles were retrieved, and 11 studies were finally included after layer by layer screening, with a total sample size of 2421 cases, including 1115 cases in the TLTG group and 1306 cases in the LATG group. There were no statistical difference in age and gender between the two groups, while the mean BMI in the TLTG group was significantly higher than that in the LATG group ( P=0.01). Compared to the LATG group, shorter surgical incision ( P<0.001), less intraoperative blood loss ( P=0.003), larger number of retrieved lymph nodes ( P=0.04), less time to first oral intake ( P=0.03), and shorter postoperative hospital stay ( P=0.02) were found in the TLTG group. There were no significant differences in operation time, anastomotic time, tumor size, proximal resection margin length, postoperative pain score, time to first flatus, rate of postoperative anastomosis-related complication (including anastomotic fistula, stenosis and bleeding) and the overall incidence of postoperative complications ( P>0.05). Conclusions:Totally laparoscopic esophagojejunostomy is safe and feasible, and also suitable for obese patients. TLTG has advantages of minimally invasive, less intraoperative blood loss and easier access to lymph nodes compared to LATG. Totally laparoscopic gastrectomy will probably be the surgical trend for gastric cancer in the future.
ABSTRACT
This paper showed bioprinted HepG2 tumor tissues used for studying the sonodynamic anticancer activity of chlorine e6 (Ce6). HepG2 cells were printed by using alginate/gelatin/hydroxyethyl cellulose composite biomaterial as bio ink and cell viability was detected with Live-Dead assay and MTT proliferation. The ultrasonic intensities of self-built micro ultrasonic device under different powers were estimated by using the temperature change caused by the conversion of acoustic energy to heat energy. Ce6 of 14.3 and 28.6 μg·mL-1 were acted on two-dimensional cultured and three-dimensional printed HepG2 cells, and the antitumor activity of Ce6 was detected by MTT method with ultrasound intensity of 0.15 W·cm2 for 60 s. The results showed that the activities of bioprinted HepG2 cells were as high as 95%, and tumor microspheres were formed after 7 days of culture. The ultrasound intensity was lower than 3 W·cm2, which belonged to low ultrasound intensity and had no damage to normal hepatocyte LO2 cells. By comparing the antitumor activity of Ce6 on 2D cultured and printed HepG2 cells, it was found that the anticancer activity of Ce6 on bioprinted HepG2 cells was 63.4% lower than that on 2D culture cells, indicating the acoustic drug resistance of three-dimensional tumor model. Bioprinted tumor tissues show the potential in the application of in vitro activity evaluation models for sonodynamic therapy.
ABSTRACT
BACKGROUND: A large number of clinical research data show that acupoint injection has the advantages of good therapeutic effect and few adverse reactions in the treatment of knee osteoarthritis, but there is a lack of related multicenter and large-sample clinical trial. OBJECTIVE: To evaluate the effect of acupoint injection on the pain improvement and joint function in patients with knee osteoarthritis by meta-analysis. METHODS: CNKI, Wanfang, VIP, CBM, PubMed, Embase and Cochrane Library databases were searched for the randomized controlled trials concerning the acupoint injection for treating knee osteoarthritis published before May 2019. The observation group was acupoint injection or acupoint injection combined with other treatments. The control group was the treatments different from acupoint injection. The language was either in Chinese or English. After screening, the data included in the study were extracted by Review Manager 5.3 software for meta-analysis. RESULTS AND CONCLUSION: (1) Sixteen randomized controlled trials were included, involving 1 287 patients (648 cases in the observation group, and 639 cases in the control group). (2) Meta-analysis results showed that the overall effective rate, cure rate, Lysholm score and Japanese Orthopaedic Association scores in the observation group were significantly higher than those in the control group [OR=3.23, 95%CI (2.19, 4.76), Z=5.91, P < 0.000 01; OR=1.86, 95%CI (1.35, 2.58), Z=3.74, P=0.000 2; MD=7.87, 95%CI (2.66, 13.08), Z=2.96, P=0.003; MD=9.16, 95%CI (4.18, 14.13), Z=3.61, P=0.000 3]. The Visual Analogue Scale score, WOMAC score, Lequesne index score, and the incidence of adverse reactions between two groups showed no significant difference [MD=-1.11, 95%CI (-2.29, 0.07), Z=1.84, P=0.07; MD=-7.56, 95%CI (-17.26, 2.14), Z=1.53, P=0.13; MD=-0.46, 95%C I(-1.62, 0.71), Z=0.77, P=0.44; OR=1.31, 95%CI (0.31, 5.57), Z=0.37, P=0.71]. (3) These results indicate that the efficacy of acupoint injection for treating knee osteoarthritis is accurate. Because the literature quality included in the study is not high and bias may exist, more high-quality randomized controlled trials are still needed to verify the conclusions.
ABSTRACT
OBJECTIVE: To investigate the clinical effect of thunder-fire moxibustion combined with electroacupuncture in the treatment of cold-dampness knee osteoarthritis. METHODS: A total of 72 patients with cold-dampness knee osteoarthritis were randomly divided into observation group and control group according to the random numbers generated by computer software, with 36 patients in each group. For the observation group, electroacupuncture was performed at the main acupoints of Dubi (ST35), Neixiyan (EX-LE4), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Xuehai (SP10), Liangqiu (ST34), and Heding (EX-LE2) once a day, with a needle retaining time of 30 min, and thunder-fire moxibustion was performed at Shenque (CV8) and Guanyuan (CV4) in the form of suspended moxibustion once a day, with 30 min each time. The patients in the control group were given oral administration of diclofenac sodium double-release enteric-coated capsules, 75 mg each time, once a day, and Fugui Gutong capsules, 6 capsules a time and 3 times a day. Each course of treatment was 14 days, and both groups were treated for 2 courses, with an interval of 2 days between the two courses. Visual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were observed before the treatment, immediately after the treatment, and at 4 months after the treatment, and the outcome of traditional Chinese medicine (TCM) syndrome was compared between the two groups after treatment. RESULTS: Both groups had significant reductions in VAS score, WOMAC score, and Lequesne index immediately and at 4 months after the treatment (P<0.05). Compared with the control group, the observation group had significant reductions in VAS score, Lequesne index, and WOMAC score (scores of pain, function and total score) immediately and at 4 months after the treatment (P<0.05). The effective rate was 97.1% (34/35) in the observation group, and was 78.8% (26/33) in the control group. The effective rate of the observation group was obviously higher than that of the control group (P<0.05). CONCLUSION: Thunder-fire moxibustion combined with electroacupuncture has a better, more durable clinical effect and fewer adverse reactions than the drugs in the treatment of cold-dampness knee osteoarthritis.
ABSTRACT
OBJECTIVE：To establish UPLC method for the content determination of related substances in Terlipressin for injection. METHODS ：UPLC method was used to determine the contents of related substances in 5 batches of Terlipressin for injection. The separation was performed on Xtimate UPLC C 18 column with mobile phase A consisted of ammonium sulfate buffer （pH 2.3）-methanol（90 ∶ 10，V/V）and mobile phase B consisted of ammonium sulfate buffer （pH 2.3）-methanol（60 ∶ 40，V/V） （gradient elution ）at the flow rate of 0.2 mL/min. The detection wavelength was set at 210 nm，and sample size was 5 μL. RESULTS：The linear range of impurity A ，B，C，D，F，H，I，K，L and N were 0.43-3.86，0.44-3.95，0.44-3.97，0.45-4.08， 0.45-4.05，0.50-4.50，0.47-4.26，0.47-4.23，0.46-4.13，0.44-3.96 μg/mL（r≥0.999 7），respectively. The detection limits were 0.04， 0.04，0.05，0.04，0.05，0.05，0.05，0.05，0.04 μg/mL. The quantitation limits were 0.13，0.13，0.14，0.13，0.15，0.14，0.14， 0.14，0.13 μg/mL，respectively. RSDs of precision ，reproducibility and stability tests were all lower than 8％. The average recoveries were 94.95％，97.81％，101.88％，95.26％，93.40％，102.48％，104.26％，102.31％，96.42％，90.42％，with RSD s of 1.89％，1.86％，0.68％，1.30％，1.98％，3.36％，1.26％，1.30％，1.19％，1.40％（n＝9），respectively. Total contents of impurities in 5 batches of Terlipressin for injection were all lower than 4％. CONCLUSIONS ：Established method is rapid ，simple， accurate and specific ，which can be used for the quantitative analysis for related substances in Terlipressin for injection.
ABSTRACT
Neurogenic bowel dysfunction is one of the common complications after spinal cord injury. This paper reviewed the acupuncture and moxibustion used for neurogenic bowel dysfunction after spinal cord injury, from the aspects of prescription, acupoint selection, evaluation and possible mechanism. The ideas for further researches were discussed.
ABSTRACT
Objective@#The aim of this study was to evaluate the value for CBL and LBL teaching method in the training of refresher doctors in reproductive medicine.@*Methods@#A questionnaire survey was conducted among 186 refresher doctors who had studied in the reproductive medicine center at Peking University Third Hospital from January 2016 and December 2017 one year after their graduation. We tested 33 refresher doctors in observe group and 33 refresher doctors in the CBL+LBL group who graduated at the same period.@*Results@#Ninety-two refresher doctors responded to the investigation. The questionnaire survey showed that 84.78% of the refresher doctors thought that CBL and LBL teaching method could improve their learning abilities, clinical problem analysis and solving skills, and surgical techniques, which was conducive to promoting their assisted reproductive technology. Besides, 63.04% of refresher doctors believed this method improved their research abilities. In CBL+LBL group, examination scores of theoretical knowledge were significantly higher than the observe group (P<0.05).@*Conclusion@#The combination of CBL and LBL is effective and feasible in the training of refresher doctors in reproductive medicine.
ABSTRACT
Objective The aim of this study was to evaluate the value for CBL and LBL teaching method in the training of refresher doctors in reproductive medicine.Methods A questionnaire survey was conducted among 186 refresher doctors who had studied in the reproductive medicine center at Peking University Third Hospital from January 2016 and December 2017 one year after their graduation.We tested 33 refresher doctors in observe group and 33 refresher doctors in the CBL+LBL group who graduated at the same period.Results Ninety-two refresher doctors responded to the investigation.The questionnaire survey showed that 84.78％ of the refresher doctors thought that CBL and LBL teaching method could improve their learning abilities,clinical problem analysis and solving skills,and surgical techniques,which was conducive to promoting their assisted reproductive technology.Besides,63.04％ of refresher doctors believed this method improved their research abilities.In CBL+LBL group,examination scores of theoretical knowledge were significantly higher than the observe group (P＜0.05).Conclusion The combination of CBL and LBL is effective and feasible in the training of refresher doctors in reproductive medicine.
ABSTRACT
Objective:To analyze the main inputs and outputs of China's health reform,to propose suggestion on improving health policy.Methods:Using health economics input and output analysis methods.Results:From 2009 to 2016,more than 50％ of Chinese health personnel were distributed in the hospital and increased by year,more than 70％ of the government's main health expenditure were paid for disease treatment,the total number of new patients was 2.44 billion,and the number of inpatients was 100 million.The actual medical burden of individual residents in China was 49.36％ in 2016.The prevalence of chronic diseases among residents increased by 9％ from 2008 to 2013.Conclusion:China should put more new health investment and resources into disease prevention and control,so as to improve the health level and health input and output performance of residents.
ABSTRACT
BACKGROUND: Inadequate sources of islet cells mean that islet cell transplantation for diabetes cannot meet the clinical demand.Therefore,in vitro induction of pancreatic stem cells to differentiate into islets has become a focus of research. OBJECTIVE:To study the effect of Tripterygium wilfordii polysaccharides on the differentiation of pancreatic stem cells from islets in mice, so as to explore the effect of traditional Chinese medicine on the differentiation of pancreatic stem cells into pancreatic beta cells. METHODS:Tripterygium wilfordii polysaccharide was used to induce the differentiation of purified mouse pancreatic stem cells into islets in vitro.The islet-like cell clusters then underwent morphologic observation, dithizone (DTZ) staining, and western blot analysis. RESULTS AND CONCLUSION: Cell morphology, cell growth characteristics and immunocytochemical staining showed that mouse pancreatic stem cells were obtained.They were induced by Tripterygium wilfordii polysaccharide into spherical islet-like structures, which had a spindly pedicle connected with the bottom of the culture flask, and were DTZ-stained to iron red. Western blot assay detected β-cytokine proteins in the islet-like cell clusters. These findings confirm that mouse pancreatic stem cells can be induced to differentiate into islet-like cell clusters containing β cells in vitro by Tripterygium wilfordii polysaccharide.
ABSTRACT
·AIM: To observe the clinical efficacy of fumigation treatment of traditional Chinese medicine(Four Yellow Qing Ling Water) for dry eye, and to provide the reference for clinical treatment of dry eye. · METHODS: Totally 82 patients (164 eyes) were randomly divided into two groups from June 2016 to December 2016 in Ophthalmology Department of our hospital. The patients in control group were given artificial tears;the patients in the observation group were given artificial tears and fumigation treatment of traditional Chinese(Four Yellow Qing Ling Water) once a day. After treatment for 14d, the SchirmerⅠtest (SⅠt), break-up time (BUT), cornea fluorescein staining (FL) and clinical efficacy of two groups were compared. ·RESULTS:The efficiency rate of observation group was significantly better than the control group (87. 8% vs 70.7%,P<0.5). The SⅠt and BUT in the observation group were significantly higher than those in the control group (8.43 ± 2.51mm/5min vs 6.38 ± 2.52mm/5min, P<0.05;8.60±2.47s vs 6.35±2.29s, P<0.05); the FL in the observation group (0.84 ± 0.75 vs 1.26 ± 0.84, P<0.05) significantly lower than those in the control group. ·CONCLUSION: The fumigation treatment of traditional Chinese medicine (Four Yellow Qing Ling Water) combined with artificial tears for dry eyes can improve the clinical symptoms of dry eye syndrome.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the factors associated with the occurrence of transplant renal artery stenosis (TRAS).</p><p><b>METHODS</b>A retrospective analysis was conducted in 26 recipients who developed TRAS and 40 concurrent renal recipients without TRAS. We also conducted a nested case-control study in 14 patients with TRAS (TRAS-SD group) and another 14 non-TRAS recipients who received the allograft from the same donor (non-TRAS-SD group).</p><p><b>RESULTS</b>Compared with those in the concurrent recipients without TRAS, acute rejection (AR) occurred at a significantly higher incidence (P=0.004) and the warm ischemia time (WIT) was significantly longer (P=0.015) and the level of high?density lipoprotein cholesterol (HDL--C) significantly lower (P=0.009) in the recipients with TRAS. Logistic regression analysis suggested that AR (P=0.007) and prolonged WIT (P=0.046) were risk factors of TRAS while HDL-C (P=0.022) was the protective factor against TRAS. In recent years early diagnosis of TRAS had been made in increasing cases, the interval from transplantation to TRAS diagnosis became shortened steadily, and the recipients tended to have higher estimated glomerular filtration rate at the time of TRAS diagnosis.</p><p><b>CONCLUSION</b>Apart from the surgical technique, AR and prolonged WIT are also risk factors of TRAS while a high HDL-C level is the protective factor against TRAS. The improvement of the diagnostic accuracy by ultrasound is the primary factor contributing to the increased rate of early TRAS diagnosis in recent years.</p>
ABSTRACT
OBJECTIVE@#To investigate cognitive dysfunction in patients with carotid artery stenosis (CAS) and potential risk factors related to cognitive-especially memory-dysfunction.@*METHODS@#Forty-seven patients with carotid artery stenosis were recruited into our study cohort. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were adopted to assess cognitive function, the Wechsler Memory Scale (WMS) to assess memory function, high-resolution MRI and enhanced ultrasound to evaluate carotid plaques, and computed tomography perfusion (CTP) imaging to evaluate intracranial blood perfusion. Single-factor analysis and multiple-factor regression analysis were used to analyze potential risk factors of cognitive impairment.@*RESULTS@#Mini-Mental State Examination test results showed that 22 patients had cognitive impairment, and MoCA test results showed that 10 patients had cognitive impairment. Analysis of various risk factors indicated that the average memory quotient of female patients was higher than that of males (P = 0.024). The cognitive and memory performance of those with an educational background above high school were significantly better than those of participants with high school or lower (P = 0.045). Patients with abnormal intracranial perfusion performed worse on the MMSE test (P = 0.024), and their WMS scores were significantly lower (P = 0.007). The MMSE scores and the memory quotients were significantly lower in patients with a history of cerebral infarction (MMSE, P = 0.047, memory quotient score, P = 0.018).@*CONCLUSION@#A history of cerebral infarction and abnormal cerebral perfusion are associated with decline in overall cognitive function and memory in patients with carotid stenosis. Being female and having an educational background above high school may be protective factors in the development of cognitive dysfunction.