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OBJECTIVES@#Diabetic kidney disease is one of the most serious complications of diabetes mellitus (DM), and it is a main cause for chronic kidney disease and end-stage kidney disease (ESRD). It is important to find out the factors that cause the progression of renal function. The study aims to explore the relationship between serum uric acid (SUA) trajectory and the progression of renal function in patients with Type 2 diabetes mellitus (T2DM).@*METHODS@#A total of 846 patients with T2DM, who were admitted to the Department of Nephrology and Endocrinology, the Third Xiangya Hospital of Central South University, from January 2009 to December 2021 and met the criteria of baseline estimated glomerular filtration rate (eGFR)≥60 mL/(min·1.73 m2), were selected as the research subjects. The SUA data of multiple measurements were collected and identified as different SUA trajectories by group-based trajectory modeling (GBTM). According to the SUA trajectories, the patients were divided into a low trajectory group (105 cases), a middle trajectory group (396 cases), a middle high trajectory group (278 cases), and a high trajectory group (67 cases). Cox regression analysis was used to examine the effect of SUA trajectory on the progression of renal function in patients with T2DM. Subgroup analysis was performed by sex, age, course of disease, body mass index (BMI) and hemoglobin A1c (HbA1c).@*RESULTS@#The median follow-up was 4.8 years. At the end of follow-up, 158 patients had different degrees of decline in renal function. After adjusting for multiple confounding factors by Cox regression analysis, the risks of eGFR<60 mL/(min·1.73 m2), eGFR reduction rate≥50%, serum creatinine (Scr) doubling and composite endpoint (eGFR reduction rate≥50%, Scr doubling or ESRD) in the high trajectory group were significantly higher than those in the low trajectory group, with HR of 3.84 (95% CI 1.83 to 8.05), 6.90 (95% CI 2.27 to 20.96), 6.29 (95% CI 2.03 to 19.52), and 8.04 (95% CI 2.68 to 24.18), respectively. There was no significant difference in the risk of ESRD among the above 4 groups (all P>0.05). Subgroup analysis showed that: compared with the low trajectory group, the risks of eGFR<60 mL/(min·1.73 m2) in patients with high trajectory in the subgroup of male, female, age<65 years, course of disease<10 years, BMI≥24 kg/m2 and HbA1c≥7% were increased (all P<0.05). The SUA trajectory had no interaction with sex, age, course of disease, BMI and HbA1c (all interactive P>0.05).@*CONCLUSIONS@#The high SUA trajectory increases the risk for progression of renal function in patients with T2DM. Long-term longitudinal changes of SUA should be paid attention to.
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Humans , Male , Female , Aged , Diabetes Mellitus, Type 2/complications , Cohort Studies , Uric Acid , Glycated Hemoglobin , Renal Insufficiency, Chronic , Kidney Failure, Chronic/complications , Glomerular Filtration Rate , Kidney/physiology , Risk FactorsABSTRACT
Objective:To explore the effects of non-suicidal self-injury on suicidal ideation in adolescents with depressive disorder, and the mediating role of rumination and depression between them.Methods:A sample of 397 depressive disorder adolescents were recruited to complete the adolescent non-suicidal self-injury behaviour questionnaire, ruminative responses scale (RRS), self-rating depression scale (SDS), and Beck scale for suicide ideation-Chinese version(BSI-CV). All data processing and analysis were performed using SPSS 23.0.The mediating effect was tested by correlation analysis and Bootstrap analysis.Results:The non-suicidal self-injury score was (29.192±11.281), the rumination score was (65.036±12.284), the depression score was (75.770±11.278), and the suicidal ideation score was (40.681±11.626). Non-suicidal self-injury was significantly and positively correlated with suicidal ideation( r=0.403, P<0.01), rumination and depression( r=0.332, 0.470, both P<0.01). Rumination was significantly and positively correlated with depression and suicidal ideation( r=0.549, 0.181, both P<0.05). Depression was significantly and positively correlated with suicidal ideation( r=0.313, P<0.01). The direct effect value of non-suicidal self-injury on suicidal ideation was 0.341(95% CI=0.238-0.444), the indirect effect of non-suicidal self-injury on suicidal ideation through two pathways, the separate mediating effect value of depression was 0.057(95% CI=0.077-0.114), and the chain mediating effect value of rumination and depression was 0.026(95% CI=0.004-0.057). Conclusion:Non-suicidal self-injury can directly affect suicidal ideation of depressive disorder adolescents and indirectly through rumination and depression.
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Based on the online course of Medical Imaging, the online and offline mixed teaching mode is an important reform against the traditional teaching mode. Combining the teaching reform experience of Chongqing Medical University, this paper introduces the resource construction of the online teaching platform of Medical Imaging, the construction of the online and offline mixed teaching mode (including the overall reconstruction design of the online and offline teaching content, and the organic integration of the online and offline teaching content before, during and after class), the details of teaching implementation (taking ischemic cerebral infarction as an example), the teaching efficiency, the existing problems and related improvement measures. The preliminary practice shows that it has great significance in enhancing the teaching quality since it can break through time and space constraints, expand teaching space, effectively stimulate students' learning autonomy, enhance their practical skills, increase the communication and interaction between teachers and students, and improve the teaching effect.
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Objective:To investigate the predictive value of preoperative abdominal adipose tissue measurement for early recurrence after resection of hepatocellular carcinoma (HCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 238 patients with HCC who underwent surgical resection from January 2018 to January 2020 in 2 medical centers in China were collected, including 46 cases in the First Affiliated Hospital of Chongqing Medical University and 192 cases in the First Affiliated Hospital of Army Medical University. There were 207 males and 31 females, aged 51(48,65)years. All patients underwent abdominal computed tomography (CT) and/or magnetic resonance imaging (MRI) before surgery. Observation indicators: (1) measure-ment of abdominal adipose tissue; (2) follow-up; (3) analysis of influencing factors for early recurrence after resection of HCC; (4) prediction of early recurrence after resection of HCC. Follow-up was conducted by outpatient examinations and telephone interview to detect the postoperative survival of patients up to February 2022. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was performed by the t test. Measurement data with skewed distribution was represented by M(range) or M( Q1, Q3), and comparison between groups was performed by the Mann-Whitney U test. Count data were expressed as absolute numbers or percen-tages, and the chi-square test was used for comparison between groups. Univariate analysis was conducted using the corresponding statistical methods based on data type. Multivariate analysis was performed using the Logistic regression model advance method. The receiver operating characteristic curve was drawn, and the area under curve was used to evaluate the efficacy. Results:(1) Measure-ment of abdominal adipose tissue. Of the 238 patients, the total abdominal adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, total adipose tissue index, visceral adipose tissue index, subcutaneous adipose tissue index were 292(198,355)cm 2, 153(99,194)cm 2, 128(95,154)cm 2, 106(76,130)cm 2/m 2, (57±27)cm 2/m 2, 46(34,58)cm 2/m 2 for 139 patients with early postoperative recur-rence, versus 174(114,251)cm 2, 78(50,110)cm 2, 88(55,127)cm 2, 64(42,91)cm 2/m 2, (30±16)cm 2/m 2, 31(19,46) cm 2/m 2 for 99 patients without early recurrence, respectively, showing significant diffe-rences between them ( Z=?7.39, ?7.87, ?5.03, ?7.25, t=?9.46, Z=?5.00, P<0.05). (2) Follow-up. All the 238 patients were followed up according to the plan. The survival time of 238 patients was 26(8,44)months. The survival time was 11(5,18)months for patients with postoperative early recur-rence, versus 36(32,43)months for patients without early recurrence, respectively. (3) Analysis of influencing factors for early recurrence after resection of HCC. Results of univariate analysis showed that body mass index, total adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, total adipose tissue index, visceral adipose tissue index and subcutaneous adipose tissue index were related factors for early recurrence after resection of HCC ( t=?5.88, Z=?7.39, ?7.87, ?5.03, ?7.25, t=?9.46, Z=?5.00, P<0.05). Results of multivariate analysis showed that visceral adipose tissue index was an independent influencing factor for early recurrence after resection of HCC ( odds ratio=1.06, 95% confidence interval as 1.04?1.08, P<0.05). (4) Prediction of early recurrence after resection of HCC. According to the results of multivariate analysis, the receiver operating characteris-tic curve showed that the area under curve of visceral adipose tissue index was 0.80 (95% confidence interval as 0.75?0.86, P<0.05), with the sensitivity and specificity as 75.5% and 71.7%. Conclusions:Visceral adipose tissue index is an independent influencing factor for early recurrence after resection of HCC. The risk of early recurrence increases with the increase of visceral adipose tissue index.
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Objective: To investigate the role of Portulaca oleracea (POL) in promoting revascularization and re-epithelization as well as inhibiting iron aggregation and inflammation of deep tissue pressure injury (DTPI). Methods: The hydroalcoholic extract of POL (P) and aqueous phase fraction of POL (PD) were prepared based on maceration and liquid–liquid extraction. The number of new blood vessels and VEGF-A expression level were assessed using H&E stain and Western blot on injured muscle to examine the role of POL different extracts in vascularization. The iron distribution and total elemental iron of injured muscle were detected using laser ablation inductively coupled plasma mass spectrometry (ICP-MS) and Perls’ staining to determine whether POL extracts can inhibit the iron accumulation. Besides, the ability of POL extracts to promote wound healing by combining re-epithelization time, inflammation degree and collagen deposition area were comprehensively evaluated. Results: In vitro, we observed a significant increase in HUVEC cell viability, migration rate and the number of the tube after P and PD treatment (P < 0.05). In vivo, administration of P and PD impacted vascularization and iron accumulation on injured tissue, evident from more new blood vessels, higher expression of VEGF-A and decreased muscle iron concentration of treatment groups compared with no-treatment groups (P < 0.05). Besides, shorter re-epithelization time, reduced inflammatory infiltration and distinct collagen deposition were associated with administration of P and PD (P < 0.05). Conclusion: POL extract administration groups have high-quality wound healing, which is associated with increased new blood vessels, collagen deposition and re-epithelization, along with decreased iron accumulation and inflammatory infiltration. Our results suggest that that POL extract is beneficial to repair injured muscle after ischemia–reperfusion, highlighting the potential of POL in the DTPI treatment.
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Objective:To observe the effect of water-based pulmonary rehabilitation on stable chronic obstructive pulmonary disease (COPD). Methods:From February, 2020 to February, 2021, 50 patients with stable COPD in our hospital were divided into control group (n = 25) and experimental group (n = 25), who accepted pulmonary rehabilitation training on land and in water, for eight weeks. They were measured forced expiratory volume in first second (FEV1), percents of forced expiratory volume in first second for prediction (FEVl%) and ratio of forced expiratory volume in first second in forced vital capacity (FEV1/FVC) with pulmonary function instrument; measured root mean square (RMS) of electromyogram of diaphragm and right transversus abdominis with surface electromyography; and assessed with modified breathlessness measurement of British Medical Research Council (mMRC), 6-minute walk test (6MWT) and quality of life scale for COPD adults (COPD-QOL) before and after treatment. Results:FEV1, FEVl%, FEV1/FVC, RMS of diaphragm and transversus abdominis, and 6MWT distance and COPD-QOL score increased in both group (t > 2.08, P < 0.05), and increased more in the experimental group than in the control group (t > 2.27, P < 0.05); while mMRC score decreased (t > 2.09, P < 0.05), and decreased more in the experimental group than in the control group (t = 2.13, P < 0.05). Conclusion:Water-based pulmonary rehabilitation training can further improve lung function, strength of respiratory muscles, dyspnea, tolerance and quality of life for patients with COPD.
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We established a simple and sensitive GC-MS method for the determination of β-elemene in rat plasma and measured the pharmacokinetics of citronella grass extract in rats. Plasma samples were pretreated using liquid-liquid microextraction: 100 μL of plasma sample (containing naphthalene as the internal standard) was extracted with 50 μL of n-hexane. The determination was performed on DB-5ms column (30 m×0.25 mm, 0.25 μm). The initial column temperature was 60 ℃ and raised to 160 ℃ at a rate of 50 ℃·min-1, maintained for 3 min, and finally increased to 260 ℃ for 3 min. Helium was the carrier gas and the flow rate was 0.15 mL·min-1. The injection volume was 2 μL. EI and selected monitored ions pattern were used for ion scanning with m/z 128 (naphthalene) and m/z 93 (β-elemene). Citronella grass extract was administered to rats by intragastric administration and intravenous administration (containing β-elemene 55 mg·kg-1), and plasma was collected and prepared using an automated blood collection system. The linear range of β-elemene in plasma was 1.0-250 ng·mL-1 (r = 0.997), the limit of quantification was 1.0 ng·mL-1, the accuracy was -4.47% - -0.85%, the extraction recovery was between 56.02%-66.89%, and no obvious matrix effect (94.28%-108.63%) was found. The main pharmacokinetic parameters of β-elemene were AUC0-t (23.56 ± 4.40) ng·mL-1, tmax (1.67 ± 0.58) h, Cmax (7.36 ± 0.69) ng·mL-1, MRT0-t (2.76 ± 0.27) h, t1/2z (2.73 ± 1.36) h, Vz (7.39 ± 3.18) L·kg-1, CLz (1.95 ± 0.51) L·h-1·kg-1, and the absolute bioavailability was about 8.78%. The method is simple, accurate, and sensitive, and is suitable for the pharmacokinetic analysis of β-elemene in citronella grass extract in rats. All animal studies were implemented according to protocols, which were reviewed and approved by the Institutional Animal Care and Use Committee at Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences.
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OBJECTIVE@#To study the effect of calorie-enriched formula on postoperative catch-up growth in infants with cyanotic congenital heart disease (CHD).@*METHODS@#A total of 100 infants with cyanotic CHD who underwent surgical operation from January to December, 2017, were randomly divided into a high-calorie group (receiving calorie-enriched formula after surgery) and a conventional group (receiving standard formula after surgery), with 50 infants in each group. All infants were followed up for 6 months. The observation indices included body height, body weight, prealbumin, and N-terminal pro-brain natriuretic peptide before surgery, at the time of ventilator weaning and extubation after surgery, and at 1, 3, and 6 months after surgery. Height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height Z-score (WHZ) were also assessed. Adverse reactions were recorded for both groups.@*RESULTS@#There were 25 cases (50%) and 21 cases (42%) of malnutrition in the high-calorie group and the conventional group respectively before surgery (@*CONCLUSIONS@#Compared with the standard formula, calorie-enriched formula can better help with postoperative catch-up growth in infants with cyanotic CHD.
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Humans , Infant , Body Weight , Energy Intake , Heart Defects, Congenital/surgery , Malnutrition , Nutritional Status , Prospective StudiesABSTRACT
The incidence rate of nonalcoholic fatty liver disease (NAFLD) has increased sharply, and there is still a lack of effective pharmacotherapy at present. Although great achievements have been made in the research on the pathogenesis of NAFLD, we still do not know enough about the gender differences of NAFLD. As an important sex hormone, estrogen affects the development and progression of NAFLD by regulating mood and energy homeostasis, adipose tissue function and distribution, inflammatory response, insulin resistance, liver fat accumulation, and liver immunity. An adequate understanding of the mechanism of action of estrogen and its receptor in NAFLD may provide new ideas for the treatment of NAFLD.
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Objective:To investigate the predictive value of quantitative parameters of ultrasound on early neoadjuvant chemotherapy (NAC) in breast cancer.Methods:Between March 2018 and October 2020, breast cancer patients who underwent surgery after NAC treatment in Renmin Hospital of Wuhan University were collected. Multimodal ultrasound examinations were performed before chemotherapy and after NAC in the second cycle. The quantitative parameters of ultrasound included diameter (D), peak enhancement (PE), time to peak (TTP), maximum shear wave velocity (Vmax) and mean shear wave velocity (Vmean). The change rates of corresponding parameters (ΔD, ΔPE, ΔTTP, ΔVmax, ΔVmean) were calculated. According to Miller & Payne (MP) pathological reaction classification, 93 patients were divided into effective group (37 cases) and ineffective group (56 cases). The differences of quantitative parameters between the two groups were compared. Multivariate logistic regression was used to analyze the effective quantitative parameters of NAC response, and ROC curve was plotted to analyze the predictive effect of quantitative parameters on NAC efficacy.Results:Before NAC, there were no significant differences in clinical data and pathological features between the two groups except age (all P>0.05). After the second cycle of chemotherapy, ΔPE and ΔVmax were significantly correlated with the efficacy of NAC ( t=-3.417, P=0.001; Z=-5.173, P<0.001). Multivariate regression analysis showed ΔPE and ΔVmax were effective predictors of NAC ( OR=1.105, 95% CI=1.032-1.184, P=0.004; OR=1.232, 95% CI=1.125-1.349, P<0.001). The cutoff values of ΔPE and ΔVmax in evaluating the efficacy of NAC were 16.37% and 28.52%. ΔPE>16.37%, and ΔVmax>28.52% suggested the pathologically effective response of NAC. The sensitivity and specificity of ΔPE, ΔVmax and ΔPE+ ΔVmax were 83.78%, 57.14%; 78.38%, 85.71%; 75.68%, 91.07%, respectively. Conclusions:The quantitative ultrasound parameters have certain clinical value in early prediction of NAC efficacy of breast cancer, and the combined application of parameters can help to improve the prediction efficiency.
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This study reported a case about a 30-year-old pregnant woman with placental teratoma. The presumptive diagnosis of placental teratoma was made based on the abnormal echo detected on the placental surface by ultrasound at 33 + gestational weeks. MRI examination also suggested the possibility. She had an otherwise uneventful pregnancy and puerperium and gave birth to a healthy newborn vaginally at 40 +4 gestational weeks. A smooth oval-shaped nodule covered by skin was visualized at the edge of the placenta, and pathological results suggested a mature cystic teratoma. The causes of placental teratoma remain unclear, and no obvious clinical symptoms are identified. Typically, it has no adverse effects on the mother and baby. A combination of ultrasound and MRI is critical to determine the nature of the tumor prenatally, but the gold standard for diagnosis relies on placental pathology.
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Objective:To explore the difference in the proliferation, migration and ultraviolet radiation effect between double-head and unilateral pterygium fibroblasts (HPFs) cultured in vitro. Methods:Pterygium tissue was obtained from patients who underwent pterygium excision with conjunctival transposition from March 2017 to March 2018 in the Second Affiliated Hospital of Guangzhou Medical University.Nineteen cases with bilateral pterygium and 19 cases with unilateral pterygium were selected for this research.Twelve cases of normal conjunctival tissue were obtained from donor eyes.The fibroblasts were divided into HPFs-nasal (HPFs-N), HPFs-temporal (HPFs-T), unilateral HPFs and human conjunctiva fibroblasts (HCFs), which was taken from the nasal side of the bilateral pterygium, the temporal side of the bilateral pterygium, the unilateral pterygium and the normal conjunctiva, respectively.Human pterygium and normal conjunctival fibroblasts were isolated and cultured by tissue culture method.The fibroblasts were divided into an ultraviolet irradiation group and a normal light illumination group.The cell growth curve was detected by methyl thiazolyl tetrazolium (MTT) assay.The cell scratch healing rate was detected by the cell scratch test after 48 hours.The expression of α-smooth muscle actin αwas detected by immunofluorescence staining, and the number of positive cells in each group was compared.The fibroblasts cultured in vitro were irradiated with ultraviolet irradiation, and the cell scratch healing rate, growth curve and expression of α-SMA were observed.The study protocol was approved by the Ethics Committee of the Second Affiliated Hospital of Guangzhou Medical University.Written informed consent was obtained from each subject. Results:The pterygium and conjunctival fibroblasts were spindle shaped, and the growth rate was gradually increased from day 1 to day 7.The growth rate of HPFs-N was the fastest, and the growth rate of HCFs was the slowest.The growth rate of the four types of fibroblasts was significantly increased after exposure to ultraviolet.There were significant differences in the cell scratch healing rates and α-SMA positive cell expression rates among the four fibroblast types under different lighting conditions ( Fgroup=158.064, P<0.05; Fcell type=326.582, P<0.05. Fgroup=4.731, P<0.05; Fcell type=172.813, P<0.05), of which the scratches healing rate in the HPFs-N cells after 48 hours under the normal light conditions was (79.67±0.86)%, which was significantly higher than HPFs-T ([54.04±0.33]%), unilateral HPFs ([64.12±0.21]%) and HCFs ([58.86±0.41]%), the α-SMA positive cell expression rate in the HPFs-N cells after 48 hours under the normal light conditions was (28.87±1.02)%, which was significantly higher than that in HPFs-T ([13.67±0.23]%), unilateral HPFs ([20.35±1.72]%) and HCFs ([5.12±0.45]%) (all at P<0.05); the cell scratch healing rates and α-SMA positive cell expression rates were significantly increased in the ultraviolet irradiation group than those in the normal light illumination group (all at P<0.05). Conclusions:The nasal side of double-head pterygium fibroblasts is more proliferous and more migratory than that of the unilateral pterygium, the expression of α-SMA is also increased, which can be further enhanced by ultraviolet irradiation.
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Objective:Potential targets and pathways of Qingfei Paidu decoction（QFPD）for treating coronavirus disease-2019（COVID-19） were analyzed based on the integrative pharmacology，the efficacy and material basis was predicted.This study provide a reference for the development and clinical application of QFPD. Method:Based on the integrative pharmacology of traditional Chinese medicine（TCMIP V2.0），the key targets and pathways of the intervention of QFPD on COVID-19 were enriched，the interaction network of "formula-herb-disease-targets-pathways" was constructed to explored the molecular mechanism of QFPD for the treatment of COVID-19. Result:The research results show that key-targets such as cell tumor antigen p53（tp53），protein kinase B1（Akt1），Nuclear factor nuclear transcription factor-κB（NF-κB）p105 subunit（NFKB1），nuclear factor p65 subunit（RELA），human NF-κB inhibited protein α（NFKBIA），ect.Closely associated with lung damage.The pathways such as interleukin signaling，adrenoceptors，7 members of the family of c-type lectin domains A（CLEC7A）/inflammasome pathway，phosphoinositide-3-kinase（PI3K）/protein kinase B（Akt）inflammatory signaling pathway，tp53 regulates transcription of DNA repair ect. may be the key pathways related with QFPD's effect on the treatment of COVID-19 accompany with lung injury， fever， cough and other symptoms.The results show that QFPD has many clinical effects， such as anti-inflammatory， anti-virus， strengthening immunity， inhibit the development of pulmonary fibrosis， protecting heart and lungs， treating asthma， regulating gastrointestinal tract， etc.In addition， there is a good synergism between the original prescription and the combined prescription， and each original prescription has its own emphasiscan prevention and treatment of COVID-19. Conclusion:QFPD plays a role in balancing immunity and eliminating inflammation，and it can treat COVID-19 by multi-pathway，multi-channel，multi-target and multi-link.This study also provides a new idea for the research of prevention and treatment of modern infectious diseases by use the traditional Chinese medicine.
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Objective:To investigate any effect of electro-acupuncture stimulation on the expression of the silence regulator homolog 1 (SIRT1) and p53 tumor suppressor genes in chondrocytes of persons with osteoarthritis (OA).Methods:Thirty-six experimental rabbits were randomly divided into a control group, a model group and an electro-acupuncture group, each of 12. One knee of each rabbit in the model and electro-acupuncture groups was fixed for 6 weeks to induce OA, while the control group was not given any intervention. The rabbits in the electro-acupuncture group were then treated with electro-acupuncture for 16 days; the model group rabbits were fixed to the treatment table but were not given electro-acupuncture. At the end of the experiment, the articular cartilage was hematoxylin-eosin (HE) stained for microscopic examination and Mankin scoring. The chondrocytes′ gray values after immunohistochemical staining allowed determination of the SIRT1 and p53 expression levels.Results:The average histopathological grade, Mankin score and stained Mankin score of the electro-acupuncture group were all superior to the model group′s averages. SIRT1 and p53 expression were detected in all three groups, but the SIRT1 gray value of the model group was significantly higher than the other two groups′ averages. The average p53 gray value in the model group was significantly lower.Conclusions:Electro-acupuncture can effectively alleviate the symptoms of knee OA, perhaps by up-regulating SIRT1 expression in the cartilage, inhibiting apoptosis of articular chondrocytes and generally promoting cell regeneration.
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Objective To investigate the effect of early intervention with mirror therapy on hemiparetie survivors of ischemic stroke.Methods Thirty-six hemiplegic patients within one month after a stroke were randomly divided into a mirror therapy group (MT group,n=18) and a routine rehabilitation control group (RRC group,n=18).The participants in the MT group received MT for 45 min/d,5 d/wk for 3 weeks in addition to conventional stroke rehabilitation.Those in the RRC group received exercise therapy at the same frequency without the mirror protocol.The Fugl-Meyer assessment (FMA),Wolf motor function test (WMFT),functional ambulation category scale (FAC),Brunnstrom stages of motor recovery,and the modified Ashworth scale (MAS) were used to assess changes in the upper limb,gross hand dexterity and lower limb recovery before and right after the interventions,as well as one and two months after the treatment.Results Significant improvement was observed in the limb function of both groups after the treatment.Compared with the RRC group,there was significantly greater improvement observed in the MT group.This was true of the FMA ratings at all time points,the average WMFT scores one and two months after the intervention,the FAC ratings two months after the intervention,and the Brunnstrom stages at both one and two months after the intervention.However,no significant difference between the two groups in terms of the average MAS scores was observed at any time point.Conclusion Early intervention with MT can significantly accelerate the recovery of a paretic upper limb aud improve walking ability after stroke.Such intervention is worthy of promotion and application in clinical practice.
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Objective: The classical formula of Dingxiang Shiditang can be used for hiccup and vomit which caused by many reasons,its molecular mechanism of this formula was investigated.Method: Based on the integrated pharmacology platform of traditional Chinese medicine,the potential molecular mechanism of Dingxiang Shiditang was revealed from the dimensions of multi-components and multi-targets.Result: There were 89 compounds related to hiccup and vomit of Dingxiang Shiditang,and there was 1 common target[cannabinoid receptor 1(CNR1)].On the one hand,CNR1 could inhibit the occurrence of hiccup and vomit by inhibiting the release of γ-aminobutyric acid(GABA),dopamine,5-hydroxytryptamine(5-HT);on the other hand,CNR1 could inhibit gastrointestinal motility and delay gastric emptying,and it was speculated that CNR1 may play a role in regulating gastrointestinal motility through brain-gut axis.Meanwhile,the mechanism of Dingxiang Shiditang may be related to nucleotide metabolism and nervous system.Conclusion: Dingxiang Shiditang may regulate gastrointestinal motility by affecting the release of neurotransmitters,mitochondrial energy metabolism,and achieve its effect on hiccup and vomit based on the joint intervention of multiple targets and multiple pathways.
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By using the integrated pharmacology platform and the big data of traditional Chinese medicine combined with the pharmacology thinking of "principle-recipe-composition-target-pathway-activity" in this study, we predicted the material basis and mechanisms of Bupleuri Radix and Scutellariae Radix drug pair for the treatment of diabetes. Fifty-nine active components were predicted, which included saponins, flavones, essential oil, fatty acids and so on. They acted on twenty-two direct targets and twenty-six main pathways respectively.The known disease targets of diabetes include arginine vasopressin receptor gene (AVP), retinoblastoma (RB1), receptor active modified protein (RAMP), platelet growth factor receptor (PDGFR), insulin receptor (INSR), α-glucosidase (GAA), etc. The pathways with diabetes effect involves endocrine system, circulatory system, digestive system, thyroid hormone signaling pathway, ErbB signaling pathway, PI3K-Akt signaling pathway, lipid metabolism and other related biological processes and metabolic pathways. The results of virtual screening in molecular docking technology indicate that flavonoids from Bupleuri Radix and Scutellariae Radix drug pair can easily form good docking mode and high affinity with peroxisome proliferators activated receptor γ (PPAR-γ) and glycogen synthase kinase-3β (GSK-3β), showing antidiabetic activity. The study provides information for the treatment of diabetes by Bupleuri Radix and Scutellariae Radix drug pair, and a new thought for the study of drug pair and complex prescription.
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Objective To observe the clinical efficacy of prevention and treatment of chemotherapy induced peripheral neurpathy (CIPN) by vincristine via using TCM prescription of peripheral neuropathy hand-food soaking combined with mecobalamin. Methods Totally 120 patients with non-Hodgkin's lymphoma who all received chemotherapy drugs including vincristine were randomly divided into treatment group (36 cases), control group (36 cases) and combined treatment group (36 cases). All groups received routine treatment (all used CHOP, R-CHOP and H-CAVD plans for the first time), for 6 cycles of chemotherapy. The control group was given mecobalamin at the same time, 0.5 mg each time, oral administration, three times a day. The treatment group was given TCM prescription of peripheral neuropathy hand-foot soaking at the same time, hands first and feet later, 20 minutes each time, twice a day. The combined treatment group was given TCM prescription of peripheral neuropathy and mecobalamin at the same time, the same as the former method. 7 days were set as one treatment course, and all the treatment lasted for 6 cycles of chemotherapy. The incidence and degree of CIPN were evaluated in 2, 4, and 6 cycles of chemotherapy, and the satisfaction was compared. 50 patients of CIPN degree ≥Ⅱ were screened, paused chemotherapy, and participated in consolidation treatment research. The 50 patients were assigned into treatment group (25 cases) and control group (25 cases). The control group took oral mecobalamin, and the treatment group used TCM prescription of peripheral neuropathy hand-foot soaking; the methods were the same as former methods, for 20 d. Clinical efficacy and satisfaction of both groups were evaluated. Results After the second cycle of chemotherapy, the incidence of CIPN in the treatment group and the combined treatment group were obviously lower than the control group (P<0.05). After the fourth cycle of chemotherapy, the incidence of CIPN in the combined treatment group were obviously lower than the control group (P<0.01); the incidence of CIPN degree ≥Ⅱ in the treatment group and combined treatment group were obviously lower than the control group (P<0.05). After the sixth cycle of chemotherapy, the incidence of CIPN degree ≥Ⅱ in the treatment group and combined treatment group were obviously lower than the control group (P<0.01). The satisfaction rate of the treatment group was higher than the control group (P<0.01). For the consolidation therapy to patients of CIPN degree ≥Ⅱ, there was no statistical significance in clinical efficacy between the treatment group and the control group (P>0.05), but the satisfaction rate of the treatment group was higher than the control group (P<0.01). Conclusion TCM prescription of peripheral neuropathy hand-food soaking combined with mecobalamin can obviously relieve CIPN degree induced by vincristine, and improve the life quality of patients.
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Objective To evaluate systematically the efficacy of mirror therapy for improving the upper limb function, daily life and pain of stroke survivors. Methods The PubMed, EBSCO, Web of Science, Ovid, Co-chrane Library, Open Gray, China Biological Medicine, China National Knowledge Infrastructure, GoogleScholar, VIP and Wan Fang Data databases were searched for reports of randomized and controlled trials ( RCTs) of mirror therapy for improving the upper limb function of stroke survivors. Only papers published before December 2015 were surveyed. The relevant references of the primary studies were also searched. The literature screening, data extraction and assessments were conducted by two reviewers independently. The meta-analysis was performed using version 5.2 of the RevMan software. Results A total of 22 RCTs involving 823 patients were discovered, some not dealing with mirror therapy. Comparing the studies with and without visual feedback, there were significant differences in upper limb motor function as measured by the Fugl-Meyer, ARAT and Brunnstrom instruments. The average Barthel indexes and visual analogue scale were also significantly different. Conclusion Mirror therapy can improve upper limb function and ability in the activities of daily living, and also relieve pain among stroke survivors to some degree, though its long-term efficacy is still unclear. Large-sample, multi-center, high-quality RCTs are required to verify these conclusions.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the larvicidal effects of recombinant Escherichia coli expressing scorpion neurotoxin AaIT or Bacillus thuringiensis subsp israelensis (B.t.i) toxin Cyt2Ba against the second instar larvae of Culex pipiensquinquefasciatus and Aedes albopictus and compare different formulations for their larvicidal effects.</p><p><b>METHODS</b>The AaIT- or Cyt2Ba-coding sequences were cloned into pET28a(+) and the recombinant plasmids were transformed into E. coli BL21(DE3). After induction with IPTG, the recombinant proteins expressed by the recombinant E. coli were detected and identified by SDS-PAGE and Western blotting, respectively. The larvicidal activity of the bacterial suspension was tested at different concentrations against mosquitoes. The effective engineered bacteria were prepared into dry powder with different formulations, and their larvicidal activity was tested.</p><p><b>RESULTS</b>AaIT and Cyt2Ba proteins were successfully expressed in E. coli. The recombinant AaIT protein showed no virulence to the mosquito larvae. The suspension of the recombinant E. coli expressing Cyt2Ba protein exhibited a stronger killing effect on Aedes albopictus larvae than on Culex pipiens quinquefasciatus larvae at 48 h (P<0.001) with LCof 3.00×10cells/mL and 1.25×10cells/mL, respectively. The dry powder of the engineered bacteria formulated with yeast extract, wheat flour or white pepper powder at the mass ratio of 1:1 showed the strongest killing effect on mosquito larvae (P=0.044), and the formulation with white pepper powder produced a stronger killing effect than formulations with yeast extract or wheat flour (P=0.002).</p><p><b>CONCLUSION</b>The B.t.i Cyt2Ba protein expressed in E. coli BL21(DE3) shows a good larvicidal activity against mosquitoes, and appropriate formulations of the engineered bacteria can enhance its efficiency in mosquito control.</p>