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Objective: To investigate the long-term outcomes of patients with unilateral vocal fold paralysis resulting in dysphonia treated with lateral vocal fold autologous fat injection. To analyze the factors that may affect the long-term efficacy of the procedure. Methods: From July 2003 to June 2020, 163 patients (86 males and 77 females), aged 9-73 years (mean (34.50±12.94) years) with unilateral vocal fold paralysis resulting in dysphonia underwent transoral laryngoscopic injection of autologous fat into the lateral vocal folds. Subjective auditory perception assessment (GRBAS scale), objective acoustic assessment, voice handicap index (VHI) evaluation and stroboscopic laryngoscopy were compared before and after the surgery. Patients were followed up for 1 to 18 years, with median follow-up time of 6 years. SPSS 22.0 software was used for statistical analysis. Results: Of 163 patients, 17 patients (10.4%) had mild hoarseness (G1) and 146 patients (89.6%) had moderate to severe hoarseness (G2-3). Stroboscopic laryngoscopy revealed an arch-shaped vocal fold on the affected side, fixed in the paramedian position or abduction position, with obvious glottic closure fissure. Postoperatively, voice recovered to normal (G0) in 139 patients (85.3%), mild hoarseness (G1) in 18 patients (11.0%) and moderate hoarseness (G2) in 6 patients (3.7%). Of these, 131 patients (80.4%) showed significant improvement in hoarseness, 29 patients (17.8%) showed mild improvement and 3 patients (1.8%) showed no significant improvement in hoarseness. Objective acoustic parameters of Jitter, Shimmer, NHR and MPT improved significantly, as did VHI scores. Stroboscopic laryngoscopy showed medialization of the affected vocal folds, improved vocal fold closure and normal or nearly normal vocal fold mucosal waves. With a fat injection volume of 3.0-4.5 ml, the patient's subjective auditory perception scores of G, R, B and A improved more significantly within 3 months after surgery, and both VHI and MPT were significantly better since 1 year after surgery. With bilateral vocal fold injection, the B and A scores improved significantly from 1 month postoperatively compared to unilateral injections(unilateral vs. bilateral injection 1 month post-operation, tB scores=1.42,tA scores=1.51,P<0.05). Conclusions: The long-term efficacy of autologous fat injection in the paraglottic space for the treatment of unilateral vocal fold paralysis was stable. The efficacy of the surgery was related to the amount of fat injected, unilateral or bilateral of the injection.
Subject(s)
Male , Female , Humans , Vocal Cords/surgery , Dysphonia/surgery , Hoarseness , Treatment Outcome , Vocal Cord Paralysis/surgeryABSTRACT
Objective: To summarize the clinical experience of expanded internal mammary artery perforator (IMAP) flap combined with vascular supercharge in reconstruction of faciocervical scar. Methods: The retrospective observational study was conducted. From September 2012 to May 2021, 23 patients with postburn or posttraumatic faciocervical scars who met the inclusion criteria were admitted to Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, including 18 males and 5 females, aged from 11 to 58 years, all of whom were reconstructed with expanded IMAP flaps. At the first stage, one or two skin and soft tissue expander (s) with appropriate rated capacity were implanted in the anterior chest area according to the location and size of the scars. The IMAP, thoracic branch of supraclavicular artery, and lateral thoracic artery were preserved during the operation. The skin and soft tissue expanders were inflated with normal saline after the operation. The flaps were transferred during the second stage. The dominant IMAP was determined preoperatively using color Doppler ultrasound (CDU) blood flow detector. The faciocervical scars were removed, forming wounds with areas of 9 cm×7 cm-28 cm×12 cm, and the perforators of superficial temporal artery and vein or facial artery and vein were preserved during the operation. The flaps were designed according to the area and size of the wounds after scar resection with the dominant IMAP as the pedicle. Single-pedicle IMAP flaps were used to repair small and medium-sized wounds. For larger defects, the blood perfusion areas of vessels in the anterior chest were evaluated by indocyanine green angiography (ICGA). In situations where the IMAP was insufficient to nourish the entire flap, double-pedicle flaps were designed by using the thoracic branch of supraclavicular artery or lateral thoracic artery for supercharging. Pedicled or free flap transfer was selected according to the distance between the donor areas and recipient areas. After transplantation of flaps, ICGA was conducted again to evaluate blood perfusion of the flaps. The donor sites of flaps were all closed by suturing directly. Statistics were recorded, including the number, rated capacity, normal saline injection volume, and expansion period of skin and soft tissue expanders, the location of the dominant IMAP, the total number of the flaps used, the number of flaps with different types of vascular pedicles, the flap area, the flap survival after the second stage surgery, the occurrence of common complications in the donor and recipient areas, and the condition of follow-up. Results: Totally 25 skin and soft tissue expanders were used in this group of patients, with rated capacity of 200-500 mL, normal saline injection volume of 855-2 055 mL, and expansion period of 4-16 months. The dominant IMAP was detected in the second intercostal space (20 sides) or the third intercostal space (5 sides) before surgery. A total of 25 expanded flaps were excised, including 2 pedicled IMAP flaps, 11 free IMAP flaps, 4 pedicled thoracic branch of supraclavicular artery+free IMAP flaps, and 8 free IMAP+lateral thoracic artery flaps, with flap areas of 10 cm×8 cm-30 cm×14 cm. After the second stage surgery, tip necrosis of flaps in three patients occurred, which healed after routine dressing changes; one patient developed arterial embolism and local torsion on the vascular pedicle at the anastomosis of IMAP and facial artery, and the blood supply recovered after thrombectomy and vascular re-anastomosis. Fourteen patients underwent flap thinning surgery in 1 month to 6 months after the second stage surgery. The follow-up for 4 months to 9 years showed that all patients had improved appearances of flaps and functions of face and neck and linear scar in the donor sites of flaps, and one female patient had obvious nipple displacement and bilateral breast asymmetry. Conclusions: The expanded IMAP flap is matched in color and texture with that of the face and neck, and its incision causes little damage to the chest donor sites. When combined with vascular supercharge, a double-pedicle flap can be designed flexibly to further enhance the blood supply and expand the flap incision area, which is a good choice for reconstruction of large faciocervical scar.
Subject(s)
Female , Humans , Male , China , Cicatrix/surgery , Mammary Arteries/surgery , Perforator Flap , Plastic Surgery Procedures , Saline Solution , Skin Transplantation , Soft Tissue Injuries/surgery , Surgical Wound , Treatment OutcomeABSTRACT
The complement system plays a major role in systemic lupus erythematosus (SLE). At present, complement component 3(C3) and component 4(C4) are the diagnostic markers in the internationally recognized standard of SLE classification. Complement C3 and C4 can play a role in the diagnosis of SLE patients, but they are not very specific diagnostic markers. Therefore, it is important to find more better biomarkers of SLE. In this review, the latest findings in complement-focused research in SLE were explored. Complement level, cell-bound complement activation products and membrane-bound complement regulatory proteins are associated with the pathogenesis of SLE. They may become SLE biomarkers and aid the diagnosis and monitoring of patients with this disease.
ABSTRACT
The complement system plays a major role in systemic lupus erythematosus (SLE). At present, complement component 3(C3) and component 4(C4) are the diagnostic markers in the internationally recognized standard of SLE classification. Complement C3 and C4 can play a role in the diagnosis of SLE patients, but they are not very specific diagnostic markers. Therefore, it is important to find more better biomarkers of SLE. In this review, the latest findings in complement-focused research in SLE were explored. Complement level, cell-bound complement activation products and membrane-bound complement regulatory proteins are associated with the pathogenesis of SLE. They may become SLE biomarkers and aid the diagnosis and monitoring of patients with this disease.
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ObjectiveIopromide can induce injury to HK-2 cells, but its exact mechanism remains poorly understood. This study aimed to explore the influence of iopromide on ROS-NLRP3 inflammasome signaling in HK-2 cells.MethodsHK-2 human renal tubular epithelial cells were divided into six groups: control and iopromide at 37, 74, 111, 148 and 185 mgI/mL. The HK-2 cells in the latter five groups were treated with different concentrations of iopromide for 24 hours. Then the ROS level in the cells was detected by 2′,7′-Dichlorodihydrofluorescein diacetate staining and flow cytometry and the protein expressions of NLRP3, ASC, caspase-1, IL-1β, NF-κB and TNF-α determined by Western blot.ResultsThe ROS level was significantly increased in the HK-2 cells treated with iopromide at 37 mgI/ml (4103.89±98.89), 74 mgI/mL (4450.12±108.90), 111 mgI/mL (5050.85±606.76), 148 mgI/mL (6210.57±145.74) and 185 mgI/ml (7105.13±426.63) as compared with that in the control group (2551.71±84.00) (P<0.05). Western blot showed markedly upregulated expressions of NLRP3, ASC, caspase-1, IL-1β and TNF-α in the HK-2 cells in all the latter five groups in comparison with the control (P<0.05) and an increased level of NF-κB after treated with iopromide at ≥111 mgI/ml (P<0.05).ConclusionIopromide may induce injury to HK-2 cells by activating the ROS-NLRP3 inflammasome signaling pathway.
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BACKGROUND: In recent years, genetic haploidentical peripheral blood stem cell transplantation has been gradually improved, and haploid allogeneic hematopoietic stem cell transplantation has become an important treatment choice for malignant hematopoietic disease. OBJECTIVE: To observe the clinical efficacy of genetic haploidentical peripheral blood stem cell transplantation for myelodysplastic syndrome. METHODS: The clinical data of 21 myelodysplastic syndrome cases undergoing genetic haploidentical peripheral blood stem cell transplantation were retrospectively analyzed. Modified BU/CY+ATG administration was performed as a pretreatment strategy for haploidentical peripheral blood stem cell transplantation, and the combined use of cyclosporine A+mycophenolate mofetil+short-range methotrexate±basiliximab was adopted to prevent graft-versus-host disease (GVHD). RESULTS AND CONCLUSION: (1) The 21 cases were followed for an median of 333 days (22-1 222 days), with 76% (16/21) infection of granulocyte lack period, 100% (21/21) neutrophil reconstruction, the median implantation time of 12 days (7-17 days), 81% (17/21) platelet engraftment, and the median implantation time of 14 days (7-68 days). (2) The accumulative incidence of GVHD was 52.4% (11/21), including 29% (6/21) of acute GVHD and 24% (5/21) of chronic GVHD. The incidence of hemorrhagic cystitis was 38.1% (8/21). The recurrence rate after transplantation was 4.8% (1/21). (3) The 2-year non-relapse mortality was 48% (10/21), and the 2-year disease-free survival rate was 46.8%. These results show that in the absence of HLA-identical related donors and unrelated donor, genetic haploidentical peripheral blood stem cell transplantation is a safe, effective, feasible and alternative treatment option for myelodysplastic syndrome.
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BACKGROUND: Proximal femoral nail antirotation (PFNA) is the most commonly used internal fixation for femoral intertrochanteric fracture. However, a large amount of hidden blood loss makes negative effect on the functional recovery postoperatively. OBJECTIVE: To compare the clinical efficacy of the modified incision and standard incision in PFNA for femoral intertrochanteric fracture. METHODS: Sixty-nine patients with femoral intertrochanteric fractures were analyzed retrospectively, and were then divided into two groups, followed by treated with modified incision of PFNA (group A) or standard incision of PFNA (group B). The postoperative biomechanical stability, fracture healing time, complications, Harris scores at the last follow-up, proximal incision length, operation time, and blood loss were compared between two groups. RESULTS AND CONCLUSION: (1) All the patients were followed up for more than 12 months. The fracture healing time, Harris scores at the last follow-up and incidence of postoperative complications did not differ significantly between two groups. (2) The intraoperative blood loss, total blood loss and total blood transfusion in the group A were significantly less than those in the group B (P < 0.05). (3) The proximal incision length and operation time in the group A were significantly shorter than those in the group B. (4) These results manifest that in the treatment of femoral intertrochanteric fracture, both methods exhibit good biomechanical properties and stability. Notably, compared with the standard incision method, the modified incision method has less trauma, shorter operation time, less blood loss and blood transfusion.
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The purpose of this study was to evaluate the roles of different housing environments in neurological function,cerebral metabolism,cerebral infarction and neuron apoptosis after focal cerebral ischemia.Twenty-eight Sprague-Dawley rats were divided into control group (CG) and cerebral ischemia group,and the latter was further divided into subgroups of different housing conditions:standard environment (SE) subgroup,individual living environment (IE) subgroup,and enriched environment (EE) subgroup.Focal cerebral ischemia was induced by the middle cerebral artery occlusion (MCAO).Beam walking test was used to quantify the changes of overall motor function.Cerebral infarction and cerebral metabolism were studied by in vivo magnetic resonance imaging and 1H-magnetic resonance spectra,respectively.Neuron necrosis and apoptosis were detected by hematoxylin-eosin and TUNEL staining methods,respectively.The results showed that performance on the beam-walk test was improved in EE subgroup when compared to SE subgroup and IE subgroup.Cerebral infarct volume in IE subgroup was significantly larger than that in SE subgroup (P＜0.05) and EE subgroup (P＜0.05) on day 14 after MCAO.NAA/Cr and Cho/Cr ratios were lower in MCAO groups under different housing conditions as compared to those in CG (P＜0.05).NAA/Cr ratio was lower in IE subgroup (P＜0.05) and higher in EE subgroup (P＜0.05) than that in SE subgroup.NAA/Cr ratio in EE was significantly higher than that in IE subgroup (P＜0.05).Cho/Cr ratio was decreased in MCAO groups as compared to that in CG (P＜0.05).A significant decrease in normal neurons in cerebral cortex was observed in MCAO groups as compared to CG (P＜0.05).The amount of normal neurons was less in IE subgroup (P＜0.05),and more in EE subgroup (P＜0.05) than that in SE subgroup after MCAO.The amount of normal neurons in EE subgroup was significantly more than that in IE subgroup after MCAO (P＜0.05).The ratio of TUNEL-positive neurons in EE was significantly lower than that in SE subgroup (P＜0.05) and IE subgroup (P＜0.05).Correlation analysis showed that the beam walking test was negatively correlated with NAA/Cr ratio (P＜0.05).Cerebral infarct volume was negatively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).The amount of normal cortical neurons was positively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.05).The TUNEL-positive neurons showed a negative correlation with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).This study goes further to show that EE may improve neurological functional deficit and cerebral metabolism,decrease cerebral infarct volume,neuron necrosis and apoptosis,while IE may aggravate brain damage after MCAO.
ABSTRACT
The purpose of this study was to evaluate the roles of different housing environments in neurological function,cerebral metabolism,cerebral infarction and neuron apoptosis after focal cerebral ischemia.Twenty-eight Sprague-Dawley rats were divided into control group (CG) and cerebral ischemia group,and the latter was further divided into subgroups of different housing conditions:standard environment (SE) subgroup,individual living environment (IE) subgroup,and enriched environment (EE) subgroup.Focal cerebral ischemia was induced by the middle cerebral artery occlusion (MCAO).Beam walking test was used to quantify the changes of overall motor function.Cerebral infarction and cerebral metabolism were studied by in vivo magnetic resonance imaging and 1H-magnetic resonance spectra,respectively.Neuron necrosis and apoptosis were detected by hematoxylin-eosin and TUNEL staining methods,respectively.The results showed that performance on the beam-walk test was improved in EE subgroup when compared to SE subgroup and IE subgroup.Cerebral infarct volume in IE subgroup was significantly larger than that in SE subgroup (P＜0.05) and EE subgroup (P＜0.05) on day 14 after MCAO.NAA/Cr and Cho/Cr ratios were lower in MCAO groups under different housing conditions as compared to those in CG (P＜0.05).NAA/Cr ratio was lower in IE subgroup (P＜0.05) and higher in EE subgroup (P＜0.05) than that in SE subgroup.NAA/Cr ratio in EE was significantly higher than that in IE subgroup (P＜0.05).Cho/Cr ratio was decreased in MCAO groups as compared to that in CG (P＜0.05).A significant decrease in normal neurons in cerebral cortex was observed in MCAO groups as compared to CG (P＜0.05).The amount of normal neurons was less in IE subgroup (P＜0.05),and more in EE subgroup (P＜0.05) than that in SE subgroup after MCAO.The amount of normal neurons in EE subgroup was significantly more than that in IE subgroup after MCAO (P＜0.05).The ratio of TUNEL-positive neurons in EE was significantly lower than that in SE subgroup (P＜0.05) and IE subgroup (P＜0.05).Correlation analysis showed that the beam walking test was negatively correlated with NAA/Cr ratio (P＜0.05).Cerebral infarct volume was negatively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).The amount of normal cortical neurons was positively correlated with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.05).The TUNEL-positive neurons showed a negative correlation with both NAA/Cr ratio (P＜0.01) and Cho/Cr ratio (P＜0.01).This study goes further to show that EE may improve neurological functional deficit and cerebral metabolism,decrease cerebral infarct volume,neuron necrosis and apoptosis,while IE may aggravate brain damage after MCAO.
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The open reading frame of 1-hydroxy-2-methyl-2-(E)-butenyl 4-diphosphate reductase (HDR) was cloned from Phlegmarirus carinatus by RT-PCR method and the sequence was analyzed by bioinformatics tools. After searching the transcriptome dataset of P. carinatus, one unique sequence encoding 1-hydroxy-2-methyl-2-(E)-butenyl 4-diphosphate reductase was discovered. The primers were designed according to the cDNA sequence of 1-hydroxy-2-methyl-2-(E)-butenyl 4-diphosphate reductase from the dataset. And then, the open reading frame (ORF) of 1-hydroxy-2-methyl-2-(E)-butenyl 4-diphosphate reductase, named as PcHDR1 (GenBank Accession number：JQ957845), was cloned by RT-PCR strategy with the template of mixed RNA extracted from roots, stem and leaf of P. carinatus. The bioinformatic analysis of this gene and its corresponding protein was performed. The ORF of PcHDR1 consisted of 1 437 base pairs (bp), encoding one polypeptide with 478 amino acids. The sequence comparison showed that PcHDR1 is closest with GbHDR (Ginkgo biloba),and the sequence homology was up to 78%. Bioinformatics prediction and analysis indicated that PcHDR1 protein contained a conserved domain of LytB, without transmembrane region and signal peptides. This study cloned and analyzed 1-hydroxy-2-methyl-2-(E)-butenyl 4-diphosphate reductase from P. carinatus. The result will provide a foundation for exploring the function of PcHDR1 involved in terpene biosynthesis in P. carinatus plants.
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<p><b>OBJECTIVE</b>To explore the expression of PD-L1 in acute leukemia patients, and to analyze the relationship of PD-L1 expression with the patients' clinical characteristics and prognosis.</p><p><b>METHODS</b>The expression of PD-L1 in leukemia cells of 75 patients including 59 de novo patients and 16 relapse/refractory patients with acute leukemia was detected by the flow cytometry, the clinical information was collected, and the therapeutic efficacy of de novo patients was analyzed.</p><p><b>RESULTS</b>The PD-L1 was expressed in human acute leukemia cells with total expression rate 32% (24/75), and its expression level in AML-M5 was higher than that in other leukemias [56.3% (9/16) vs 25.4% (15/59)], there was statistical significance (P = 0.019). The PD-L1 possitive rate in relapse/refractory group was higher than that in de novo patient group [(56.3% (9/16) vs 25.4% (15/59)], and there was statistical significance (P = 0.019). In 59 de novo patients, the CR rate of PD-L1 positive group after 1 course of chemotherapy was lower than that in PD-L1 negative group (66.7% vs 71.4%), the CR rate of PD-L1 positive group after 2 courses of chemotherapy was also lower than that in PD-L1 negative group (70% vs 88.6%). The relapse rate and the proportion of refractory patients in PD-L1 possitive group were higher than those in PD-L1 negative group. The expression of PD-L1 did not correlated with the clinical parameters, such as sex, age, extramedullary infiltration, percentage of blast cells in bone marrow, counts of WBC, RBC and platelet, as well as molecular biological features and cytogenetical characteristics.</p><p><b>CONCLUSION</b>PD-L1 is expressed in human acute leukemia cells, and may be involved in the immune escape and primary resistant mechanisms, PD-L1 may be used as an indicator for evaluation of the the patients' prognosis and reocurrence.</p>
Subject(s)
Humans , Acute Disease , B7-H1 Antigen , Flow Cytometry , Leukemia , Prognosis , RecurrenceABSTRACT
Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction (stroke group) in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers (control group) were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90 (SCL-90), the social support by the Social Support Rating Scale (SSRS), and medication adherence by Morisky's self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group (P150 group" were significantly higher than in the "SCL-90 total scores 150 group", 28 (75.67%) patients with medium medication adherence in the "SCL-90 total scores between 100 to 150 group", and 12 (61.16%) patients with low medication adherence in the "SCL-90 total scores <100 group", respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients (P<0.05 or P<0.01). It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.
ABSTRACT
Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction (stroke group) in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers (control group) were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90 (SCL-90), the social support by the Social Support Rating Scale (SSRS), and medication adherence by Morisky's self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group (P<0.01). Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions (including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety) of SCL-90 were significantly higher in the stroke group than those in the control group (P<0.05, or P<0.01). The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group (P<0.05, or P<0.01). Those in the "SCL-90 total scores >150 group" were significantly higher than in the "SCL-90 total scores <100 group" and the "SCL-90 total scores between 100 to 150 group" (P<0.05, or P<0.01). Those in the "SCL-90 total scores between 100 to 150 group" were significantly higher than in the "SCL-90 total scores <100 group" (P<0.05). In 90 patients with ischemic stroke, 26 (28.89%) patients obtained high medication adherence, 47 (52.22%) patients medium medication adherence, and 17 (18.89%) patients low medication adherence, respectively. Among these stroke patients, there were 17 (50.00%) patients with high medication adherence in the "SCL-90 total scores >150 group", 28 (75.67%) patients with medium medication adherence in the "SCL-90 total scores between 100 to 150 group", and 12 (61.16%) patients with low medication adherence in the "SCL-90 total scores <100 group", respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients (P<0.05 or P<0.01). It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Asian People , Psychology , China , Infarction, Middle Cerebral Artery , Drug Therapy , Psychology , Medication Adherence , Social Support , Stress, Psychological , Psychology , Surveys and QuestionnairesABSTRACT
AIM@#To study the chemical constituents of the roots of Asparagus cochinchinensis (Asparagaceae).@*METHODS@#The compounds were isolated with Diaion HP20, silica gel, and ODS chromatography, and their structures were determined on the basis of chemical methods, HR-ESI-MS, and 1D- and 2D-NMR techniques.@*RESULTS@#Seven compounds were isolated from the n-butanol fraction of the roots of A. cochinchinensis, and their structures were elucidated as (25S)-26-O-β-D-glucopyranosyl-5β-furostan-3β, 22α, 26-triol-12-one-3-O-β-D-glucopyranoside (1), (25S)-26-O-β-D-glucopyranosyl-22α-methoxy-5β-furostan-3β, 26-diol-12-one-3-O-β-D-glucopyranoside (2), (25S)-26-O-β-D-glucopyranosyl-5β-furostan-3β, 22α, 26-triol (3), (25S)-26-O-β-D-glucopyranosyl-5β-furstan-3β, 22α, 26-triol-3-O-β-D-glucopyranoside (4), (25S)-26-O-β-D-glucopyranosyl-5β-furostan-3β, 22α, 26-triol-3-O-α-L-rhamnopyranosyl-(1, 4)-β-D-glucopyranoside (5), (25S)-5β-spirostan-3β-ol-3-O-α-L-rhamnopyranoside (6), and (25S)-5β-spirostan-3β-ol-3-O-β-D-glucopyranoside (7).@*CONCLUSION@#Compounds 1 and 2 were two new furostanol saponins.
Subject(s)
Asparagus Plant , Chemistry , Molecular Structure , Plant Extracts , Chemistry , Plant Roots , Chemistry , Saponins , ChemistryABSTRACT
This study was aimed to explore the clinical efficacy and toxicity of idarubicin (IA regimen) and daunoru-bicin combined with cytarabine (DA regimen) for treating aged patients with AML as induction chemotherapy. The clinical data of 60 newly diagnosed AML aged patients treated with IA or DA regimen were analyzed retrospectively. IA regimen group included 22 patients (8 male and 14 females with median age of 66 yrs), while the DA regimen group included 38 patients (20 males and 18 females with median age of 64 yrs). The complete remission rate, total effective rate and adverse effects after one chemotherapy course were compared. The results showed that the CR rate in IA regimen group was 63.63%, which was significantly higer than that in DA regimen group (31.58%) (P < 0.05). The total effective rate was 63.63% and 36.84% respectively in IA and DA regimen groups, there was significant difference between the two groups (P < 0.05). Both the hematological and non-hematological adverse effects were observed and no difference was found in the two regimen groups, neither in myelosupression (P > 0.05), the major hematological adverse effects, nor in non-hematological adverse effects (P > 0.05). It is concluded that for aged AML patients, IA regimen can achieve a higher CR rate and higher total effective rate than that in DA regimen without increase of adverse effects after one induction chemotherapy course.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cytarabine , Idarubicin , Induction Chemotherapy , Leukemia, Myeloid, Acute , Drug Therapy , Retrospective StudiesABSTRACT
This study was purposed to compare the therapeutic efficacy and prognosis of acute myeloid leukemia M2a (AML-M2a) patients treated by idarubicin (IDA) combined with cytarabine (Ara-C) (IA) and daunorubicin (DNR) combined cytarabine (Ara-C) (DA) regimens. The clinical data of 65 patients with AML-M2a in our hospital were collected from May 2009 to May 2013 and analyzed. The results indicated the complete remission in IA group was slightly higher than that in DA group, there was no statistically significant difference(P > 0.05); leukocyte minimum value in IA group [(0.58 ± 0.40)×10(9)/L] was obviously lower than that in DA group [(0.99 ± 0.67)×10(9)/L] (P < 0.05); neutrophil minimum value in IA group [(0.19 ± 0.09)×10(9)/L] was significantly lower than that in DA group [(0.21 ± 0.16)×10(9)/L] (P < 0.05); the neutropenia duration in IA group (12.59 ± 5.31)d was much longer than that in DA group (9.17 ± 7.04)d (P < 0.05). The median survival time of patients in IA group was 36.67 months, which was obviously longer than that of patients in DA group (21.45 months) (P < 0.05). The lactate dehydrogenase (LDH) value and chemotherapy regimens were the independently risk factor affecting the prognosis of AML-M2a patients. It is concluded that as compared with DA regimen, the IA regimen can prolong the median survival time and has better long-term therapeutic efficacy, thus it can be used as the first chemotherapy regimen for treatment of AML-M2a.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Leukemia, Myeloid, Acute , Diagnosis , Drug Therapy , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study the characteristics and regular pattern of the medicine in common use and combined medication in patients of acute pancreatitis in real world.</p><p><b>METHOD</b>Collect the information of 5 433 acute pancreatitis patients in 19 grade IIIA general hospitals in China, analysis by descriptive statistics and association rule.</p><p><b>RESULT</b>In the 5 433 patients of acute pancreatitis, the glycyrrhizic acid injection and somatostatin are the frequency top used Chinese traditional and western medication. Glycyrrhizic acid injection, somatostatin and insulin are the frequency top used drug combination pattern.</p><p><b>CONCLUSION</b>The Chinese and western integrative medicine drug use pattern are accord with the clinical guideline of acute panceatitis. The hepatic and renal function, blood routine and coagulation function should be monitored when the medicines are used.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Anti-Inflammatory Agents , Therapeutic Uses , Drug Therapy, Combination , Drugs, Chinese Herbal , Therapeutic Uses , Glycyrrhizic Acid , Therapeutic Uses , Medicine, Chinese Traditional , Methods , Pancreatitis , Drug Therapy , Somatostatin , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To investigate the correlation between different Chinese medicine (CM) syndromes and variations in microcirculation in septic shock patients.</p><p><b>METHODS</b>seventy Septic shock patients were divided into four groups: heat damaging qi-yin group (HDQY, 23 cases); yin exhaustion and yang collapse group (YEYC, 26 cases); excessive heat in Fu organ group (EHFO, 10 cases); and heat damaging nutrient-blood group (HDNB, 11 cases). Sublingual microcirculation parameters were observed by sidestream dark-field (SDF) imaging and scored by Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Sequential Organ Failure Assessment (SOFA), and parameters of microcirculation perfusion variations and prognoses were analyzed.</p><p><b>RESULTS</b>Compared with those with qi-yin heat damage, perfused vessel density (PVD) in other groups decreased dramatically (P<0.05), and APACHE II scores increased significantly (P<0.05). In addition, the recovery time was prolonged substantially (P<0.05), and the mixed venous oxygen saturation (SVO2) decreased (P<0.05). Blood lactic acid increased significantly (P<0.05), and the mixed SVO decreased (P<0.05), in the YEYC group. Compared with the thermal injury camp blood group, sublingual microcirculation parameter variations showed no obvious difference in the YEYC and EHFO groups (P>0.05). There were significant positive correlations between CM syndromes and APACHE II scoring in different groups (r=0.512, P<0.05). There were negative correlations between PVD and APACHE II scoring (r=-0.378, P=0.043), the proportion of perfused vessels (PPV) and APACHE II scoring (r=-0.472, P=0.008), as well as between the microvascular flow index (MFI) and APACHE II scoring (r=-0.424, P=0.023) in different patients.</p><p><b>CONCLUSION</b>Sublingual microcirculation may serve as a clinical diagnostic parameter of the patient condition, as well as being a prognostic indicator.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Dopamine , Therapeutic Uses , Dose-Response Relationship, Drug , Hemodynamics , Medicine, Chinese Traditional , Microcirculation , Physiology , Mouth Floor , Perfusion , Shock, Septic , Blood , Drug Therapy , Mortality , SyndromeABSTRACT
<p><b>OBJECTIVE</b>To study the biological effects of nanoscale copper oxide (nCuO), zinc oxide (nZnO), cerium dioxide (nCeO2) and their mixtures on Carassius auratus.</p><p><b>METHODS</b>Juvenile fish (Carassius auratus) were exposed to aqueous suspensions of nCuO, nZnO, and nCeO2 (alone and in mixtures) at concentrations of 20, 40, 80, 160, and 320 mg/L. The biomarkers-acetylcholinesterase (AChE) in brain, sodium/potassium-activated ATPase (Na+/K+-ATPase) in gill, and superoxide dismutase (SOD) and catalase (CAT) in liver-were determined after 4 days of exposure. Integrated biomarker response (IBR) was calculated by combining multiple biomarkers into a single value.</p><p><b>RESULTS</b>AChE and SOD activities were significantly inhibited by all test metal oxide nanoparticles (NPs) at high concentrations (⋝160 mg/L) with the exception of nCeO2. Na+/K+-ATPase induction exhibited bell-shaped concentration-response curves. CAT activity was significantly inhibited at concentrations equal to or higher than 160 mg/L. The order of IBR values was nCeO2 ≈ nZnO/nCeO2 ≈ nCuO/nCeO2 < nCuO/nZnO/nCeO2 < nZnO < nCuO < nCuO/nZnO. The joint effect seemed to be synergistic for nCuO/nZnO mixtures, additive for the ternary mixture and less than additive or antagonistic for the binary mixtures containing nCeO2.</p><p><b>CONCLUSION</b>Concentration-dependent changes of enzymatic activities (AChE, Na+/K+-ATPase, SOD, and CAT) were observed in fish exposed to nanoscale metal oxides. IBR analysis allowed good discrimination between the different exposures and might be a useful tool for the quantification of integrated negative effects induced by NPs toward fish.</p>
Subject(s)
Animals , Acetylcholinesterase , Metabolism , Biomarkers , Metabolism , Brain , Cerium , Toxicity , Copper , Toxicity , Gills , Goldfish , Metabolism , Liver , Metal Nanoparticles , Toxicity , Random Allocation , Sodium-Potassium-Exchanging ATPase , Metabolism , Superoxide Dismutase , Metabolism , Toxicity Tests , Water Pollutants, Chemical , Toxicity , Zinc Oxide , ToxicityABSTRACT
To investigate the effects of oleanolic acid (OA) on the proliferation, migration and the formation of tube-like structure in human vascular endothelial cells (HUVECs). MTT assay, flat plate scarification, Transwell plates and matrigel-induced tube formation assay were performed to detect the effects of OA on proliferation, migration and tube formation. MTT assay showed that the inhibition rates of HUVECs treated with 60 and 100 microg x mL(-1) of OA for 24 h were 19% and 83% respectively. Treatment of HUVECs significantly inhibited the cell migration in a dose-dependent manner. The vascular indexes of HUVECs treated with 40 and 60 microg x mL(-1) OA were 33% and 20% respectively. Western blotting analysis showed that treatment of the cells with OA significantly attenuated the expression and secretion of VEGF. Additionally, VEGF could in part reverse the effects of OA on migration and tube formation of HUVECs. In conclusion, OA inhibits the proliferation, and VEGF plays an important role in OA induced decreased migration and tube formation of HUVECs.