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Objective: To examine the feasibility and technical considerations of thorough debridement using uniportal thoracoscopic surgery for tuberculous empyema complicated by chest wall tuberculosis. Methods: A retrospective analysis was conducted on 38 patients who underwent comprehensive uniportal thoracoscopy debridement for empyema complicated by chest wall tuberculosis in the Department of Thoracic Surgery, Shanghai Pulmonary Hospital, from March 2019 to August 2021. There were 23 males and 15 females, aged (M(IQR)) 30 (25) years (range: 18 to 78 years). The patients were cleared of chest wall tuberculosis under general anesthesia and underwent an incision through the intercostal sinus, followed by the whole fiberboard decortication method. Chest tube drainage was used for pleural cavity disease and negative pressure drainage for chest wall tuberculosis with SB tube, and without muscle flap filling and pressure bandaging. If there was no air leakage, the chest tube was removed first, followed by the removal of the SB tube after 2 to 7 days if there was no obvious residual cavity on the CT scan. The patients were followed up in outpatient clinics and by telephone until October 2022. Results: The operation time was 2.0 (1.5) h (range: 1 to 5 h), and blood loss during the operation was 100 (175) ml (range: 100 to 1 200 ml). The most common postoperative complication was prolonged air leak, with an incidence rate of 81.6% (31/38). The postoperative drainage time of the chest tube was 14 (12) days (range: 2 to 31 days) and the postoperative drainage time of the SB tube was 21 (14) days (range: 4 to 40 days). The follow-up time was 25 (11) months (range: 13 to 42 months). All patients had primary healing of their incisions and there was no tuberculosis recurrence during the follow-up period. Conclusion: Uniportal thoracoscopic thorough debridement combined with postoperative standardized antituberculosis treatment is safe and feasible for the treatment of tuberculous empyema with chest wall tuberculosis, which could achieve a good long-term recovery effect.
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Objective:To explore the application effect of immersive experiential teaching strategies in the teaching of clinical anesthesiology for undergraduates.Methods:Undergraduates majoring in 5-year clinical medicine in Air Force Medical University from January 2022 to May 2022 were enrolled as the research objects. Students were randomly divided into the immersive teaching group and the traditional teaching group, with 35 students in each. Students in the immersive teaching group underwent immersive experiential teaching strategies and the traditional teaching group received lecture-based teaching strategies. After classes, all students in these two groups took the same theoretical and operational examination, and conducted a teaching satisfaction survey and a comprehensive ability evaluation. The results were analyzed by t-test and Chi-square test using SPSS 22.0 software. Results:Students in the immersive teaching group were more satisfied with teaching (88.32±7.28 vs.70.15±7.11) ( P=0.001), and had higher scores of theorical examination (86.34±7.42 vs. 77.31±5.32) ( P=0.020) and operational examination (92.23±5.33 vs. 81.21±4.98) ( P=0.022) than those in the traditional teaching group. In addition, the scores of communication ability ( P=0.026), response ability ( P<0.001) adaptability ( P=0.007), and critical thinking ( P<0.001) in the immersive teaching group were higher than those in the traditional teaching group. Conclusion:The immersive experiential teaching strategies can effectively improve the theoretical and practical operational ability of undergraduates after completing courses of clinical anesthesiology, and can effectively stimulate the enthusiasm of students. It is worthy to be popularized in subsequent teaching abilities.
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Objective:To compare and analyze the relationship between average glandular dose (AGD) and breast density and compression thickness in digital breast tomosynthesis(DBT)/full-field digital mammography(FFDM), and to explore the optimal selection and application of imaging parameters for different types of breast (thickness and density) in specific situations.Methods:The clinical data of 229 cases of breast Combo (DBT+ FFDM) were retrospectively analyzed. The compression thickness, AGD, kVp and type of quantified breast density (Q_abd) of CC and MLO view were collected respectively. The relationship between the AGD and the breast compression thickness and Q_abd density classification was analyzed.Results:There was a positive correlation between AGD and compression thickness (CC: r =0.55, 0.53, P< 0.001; MLO: r =0.62, 0.48, P< 0.001) and breast density(CC: r =0.36, 0.39, P< 0.001; MLO: r =0.16, 0.30, P < 0.001) in DBT/FFDM. The difference between groups for AGD was little in CC of DBT, but significant in CC of FFDM(groups by thickness, CC: F =35.29, 31.32, P<0.005; MLO: F =44.83, 27.02, P<0.005; groups by Q_abd, CC: F =18.68, 19.76, P<0.005, MLO: F=4.58, 10.52, P<0.005); the breast Q_abd was inversely proportion to the mean compression thickness (CC: F =16.28, P<0.005; MLO: F =17.81, P<0.005). At the same time, the interaction effect on AGD between the breast density and thickness was considered, and only for the MLO in FFDM mode they had an interaction on AGD ( F =3.16, P =0.005). Conclusions:The cumulative dose of DBT and FFDM may increase the radiation risk. Single-view CC/MLO-DBT or CC/MLO-(DBT+ FFDM)+ single-view MLO/CC-FFDM mode is preferred for mammography, which plays a positive role in radiation risk reduction.
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Objective:To investigate the correlation between serum thyroglobulin antibody (TG-Ab) and thyroid peroxidase antibody (TPO-Ab) cconcentrations and arteriosclerosis development in middle-aged and older adult patients with depression.Methods:A total of 200 middle-aged and older adult patients with depression who received treatment in the Third People's Hospital of Huzhou from January 2018 to October 2019 were included in this study. They were divided into four groups ( n = 50/group) according to TG-Ab and TPO-Ab test results: TG-Ab-positive (group 1), TPO-Ab-positive (group 2), TG-Ab-positive and TPO-Ab-positive (group 3), TG-Ab-negative and TPO-Ab-negative (control group). Serum thyroid hormone level, ankle-brachial pressure index (ABI), brachial-ankle pulse wave velocity, and the incidences of intima-media thickening and plaque formation in the lower extremity arteries were compared between groups. Results:Total thyroxine concentration in the control group, groups 1, 2 and 3 was (89.96 ± 2.45) nmol/L, (101.29 ± 3.35) nmol/L, (90.09 ± 2.70) nmol/L, (97.55 ± 2.57) nmol/L, respectively. There was a significant difference in total thyroxine concentration between groups ( F = 3.85, P < 0.05). Brachial-ankle pulse wave velocity in the control group, groups 1, 2, and 3 was (1 327.55 ± 67.78) cm/s, (1 510.36 ± 83.05) cm/s, (1 422.71 ± 71.40) cm/s, (1 533.95 ± 87.01) cm/s, respectively. There was a significant difference in brachial-ankle pulse wave velocity between groups ( F = 65.12, P < 0.05). The incidence of intima-media thickening in the control group, groups 1, 2, and 3 was 18% (9/50), 50% (25/50), 32% (16/50), 60% (30/50), respectively. The incidence of plaque formation in the control group, groups 1, 2, and 3 was 22% (11/50), 56% (28/50), 40% (20/50), 70% (35/50), respectively. There were significant differences in intima-media thickening and plaque formation between groups ( χ2 = 21.83, 25.77, all P < 0.001). Logistic multivariate regression analysis showed that age ( OR = 0.953) and TG-Ab ( OR = 1.116) were independent risk factors for developing arteriosclerosis in middle-aged and older adult patients with depression ( P < 0.05). Conclusion:TG-Ab-positive results are an independent risk factor for developing arteriosclerosis in middle-aged and older adult patients with depression. TPO-Ab-positive results have a synergistic effect on the occurrence and development of arteriosclerosis in middle-aged and older adult patients with depression. Monitoring serum TG-Ab and TPO-Ab concentrations is of great clinical significance for the prevention and treatment of arteriosclerosis in middle-aged and older adult patients with depression.
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ObjectiveTo investigate the effect of quantitative pulmonary administration of the essential oil from Alpiniae Zerumbet Fructus （EOAZF） on porcine pancreatic elastase （PPE）-induced emphysema in mice and explore its action mechanism. MethodC57BL/6J mice were randomly divided into five group， namely the control group， model group， low- （2 mg·kg-1） and high-dose （20 mg·kg-1） EOFAZ groups， and positive control dexamethasone （DEX，1 mg·kg-1） group. The mice were treated with pulmonary administration of PPE using a microsprayer aerosolizer， once every seven days， for four times in total， for inducing emphysema. During this period， EOFAZ were administered with a quantitative microsprayer aerosolizer once every other day， for 14 times. The lung tissues were then sampled and stained with hematoxylin-eosin （HE） for observing the morphological changes and calculating the pulmonary mean linear intercept （MLI）. The concentrations of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in the plasma were determined by enzyme-linked immunosorbent assay （ELISA）. The activities of superoxide dismutase （SOD） and catalase （CAT） and the content of malondialdehyde （MDA） in the lung tissues were measured using the biochemical assay kits. The protein expression levels of nuclear factor E2-related factor 2 （Nrf2）， quinone oxidoreductase1 （NQO1）， B cell lymphoma-2 （Bcl-2）-associated X protein （Bax）， and Bcl-2 in lung tissues were detected by Western blot. ResultThe results of lung morphological observation and MLI detection showed that compared with the control group， the model group showed obvious inflammatory infiltration， alveolar enlargement and fusion， and increased MLI （P<0.05）. Compared with the model group， EOFAZ effectively alleviated the pathological changes such as alveolar dilatation， pulmonary inflammatory cell infiltration， and lung cell apoptosis caused by PPE， and decreased the MLI （P<0.05）. As revealed by ELISA， the inflammatory level of mice in the model group increased significantly （P<0.01）， while the TNF-α， IL-1β， and IL-6 levels in the plasma were decreased after quantitative administration of EOFAZ （P<0.01）. Compared with the control group， the model group exhibited significantly enhanced oxidative stress （P<0.01）. After treatment with EOFAZ by quantitative administration， the activities of SOD and CAT in the lung tissue were increased （P<0.01） and the content of MDA was decreased （P<0.01）. Western blot results demonstrated that the apoptosis-related protein expression in the model group was increased significantly as compared with that in the control group （P<0.01）， whereas the expression levels of antioxidant stress proteins Nrf2 and NQO1 declined （P<0.05）. The relative protein expression of apoptosis-related proteins Bax/Bcl-2 in the EOFAZ groups was lower than that in the model group （P<0.01）， while the expression of antioxidant stress proteins Nrf2 and NQO1 was higher （P<0.05）. ConclusionQuantitative pulmonary administration of EOFAZ effectively alleviates the inflammation and oxidative stress， reduces lung cell apoptosis， and hinders the occurrence and development of emphysema. Its antioxidant mechanism is closely related to the up-regulation of Nrf2 and its downstream NQO1.
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Post-traumatic stress disorder(PTSD) caused by various natural disasters and man-made events has gradually become the highlight of neuroscientists. Sleep disorders after PTSD can impair the effect of treatment and affect the patient's prognosis. In addition, treatment for sleep problems can be effective in improving outcomes for people with PTSD, which indicates that it is significant to pay attention to sleep disorders after PTSD. However, current studies have focused more on the incidence of PTSD and severity of related symptoms after a traumatic event, and less on the occurrence and mechanism of sleep disorders after PTSD. A number of articles on stress and sleep disorders published in recent years provide reliable clues to understand the probable mechanisms of sleep disorders after PTSD. After summarizing the latest research results, this article finds that the occurrence of sleep disorder after PTSD may be related to the changes of connectivity between insula, hippocampus and medial-prefrontal cortex. Apart from that, decline in the mean phase difference of slow spindles in PTSD patients may reflect pathological changes in the thalamic cortical circuit, which may contribute to the objective diagnosis of PTSD and the development of sleep-focused interventions. This paper provides a systematic review of changes in sleep characteristics and possible neural circuitry mechanisms after PTSD from clinical and basic perspectives, which may provide potential directions for future researches on the pathological mechanism of sleep disorders after PTSD and screening novel intervention targets.
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PURPOSE@#Wallerian degeneration (WD) is an antegrade degenerative process distal to peripheral nerve injury. Numerous genes are differentially regulated in response to the process. However, the underlying mechanism is unclear, especially the early response. We aimed at investigating the effects of sciatic nerve injury on WD via CLDN 14/15 interactions in vivo and in vitro.@*METHODS@#Using the methods of molecular biology and bioinformatics analysis, we investigated the molecular mechanism by which claudin 14/15 participate in WD. Our previous study showed that claudins 14 and 15 trigger the early signal flow and pathway in damaged sciatic nerves. Here, we report the effects of the interaction between claudin 14 and claudin 15 on nerve degeneration and regeneration during early WD.@*RESULTS@#It was found that claudin 14/15 were upregulated in the sciatic nerve in WD. Claudin 14/15 promoted Schwann cell proliferation, migration and anti-apoptosis in vitro. PKCα, NT3, NF2, and bFGF were significantly upregulated in transfected Schwann cells. Moreover, the expression levels of the β-catenin, p-AKT/AKT, p-c-jun/c-jun, and p-ERK/ERK signaling pathways were also significantly altered.@*CONCLUSION@#Claudin 14/15 affect Schwann cell proliferation, migration, and anti-apoptosis via the β-catenin, p-AKT/AKT, p-c-jun/c-jun, and p-ERK/ERK pathways in vitro and in vivo. The results of this study may help elucidate the molecular mechanisms of the tight junction signaling pathway underlying peripheral nerve degeneration.
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Animals , Rats , Claudins , Nerve Regeneration , Peripheral Nerve Injuries , Schwann Cells/pathology , Sciatic Nerve , Wallerian Degeneration/pathologyABSTRACT
Objective@#This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease (CKD) in Shanghai community residents.@*Methods@#We used data from a cohort study of community residents who participated in three examinations in 2008, 2009, and 2013, respectively. Fasting plasma glucose (FPG) level, blood pressure (BP), and lipid levels were determined in 2,109 participants at all three visits, and CKD was evaluated between the second and the third visits. Visit-to-visit variabilities in metabolic factors were described by coefficients of variation (CV) at three visits. A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV. CKD was defined as the estimated glomerular filtration rate < 60 mL/min per 1.73 m @*Results@#A total of 200 (9.5%) participants had CKD at the third visit. Compared with the lowest quartile of CV, the highest quartile was associated with a 70% increased risk of CKD for FPG [odds ratio, @*Conclusion@#The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , China/epidemiology , Cohort Studies , Glomerular Filtration Rate , Incidence , Renal Insufficiency, Chronic/physiopathologyABSTRACT
Objective:To investigate nursing students' attitudes toward death and hospice care before they start clinical practice, analyze the correlation between the two attitudes and compare their differences in junior and regular nursing college students.Methods:A cross-sectional study was adopted to investigate the attitudes toward death and hospice care in 232 senior nursing students at school. Instruments included the Chinese version of the Death Attitude Profile-Revised (DAP-R) and the Chinese version of the Frommelt Attitude Toward Care of the Dying Scale-Form B (FATCOD-B). Pearson correlation analysis and independent t-test were used to analyze the data.Results:The mean scores of the 5 dimensions of death attitude were neutral acceptance (4.10±0.43), fear of death (2.76±0.66), death avoidance (2.73±0.74), approach acceptance (2.61±0.58), and escape acceptance (2.48±0.75), respectively. The total score of hospice care attitude was (107.63±8.45), which was negatively correlated with fear of death ( r=-0.247, P<0.01), death avoidance ( r=-0.278, P<0.01), and escape acceptance ( r=-0.145, P<0.05) scores and positively correlated with neutral acceptance score ( r=0.405, P<0.01). The death avoidance score of regular nursing college students was significantly lower than that of junior nursing college students ( t=-2.043, P<0.05), and the hospice care attitude score of regular nursing college students was significantly higher that of junior nursing college students ( t=2.639, P<0.01). Conclusion:There is a big room to improve nursing students' attitudes toward death and hospice care. Strengthening end-of-life care education is imperative.
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Background@#Diabetes can complicate hypertension management by increasing the risk of cardiovascular disease (CVD) and all-cause mortality. Studies targeting diabetes detection in hypertensive individuals demonstrating an increased risk of diabetes are lacking.We aimed to assess the performance of hemoglobin A1c (HbA1c) and its cut-off point in detecting diabetes in the abovementioned population. @*Methods@#Data from 4,096 community-dwellers with hypertension but without known diabetes were obtained from the Study on Evaluation of iNnovated Screening tools and determInation of optimal diagnostic cut-off points for type 2 diaBetes in Chinese muLti-Ethnic (SENSIBLE) study; these data were randomly split into exploration (70% of the sample) and internal validation (the remaining 30%) datasets. The optimal HbA1c cut-off point was derived from the exploration dataset and externally validated using another dataset from 2,431 hypertensive individuals. The oral glucose tolerance test was considered the goldstandard for confirming diabetes. @*Results@#The areas under the ROC curves for HbA1c to detect diabetes were 0.842, 0.832, and 0.829 for the exploration, internal validation, and external validation datasets, respectively. An optimal HbA1c cut-off point of 5.8% (40 mmol/mol) yielded a sensitivity of 76.2% and a specificity of 74.5%. Individuals who were not diagnosed as having diabetes by HbA1c at 5.8% (40 mmol/mol) had a lower 10-year CVD risk score than those diagnosed as having diabetes (P = 0.01). HbA1c ≤ 5.1% (32 mmol/mol) and ≥ 6.4% (46 mmol/mol) could indicate the absence and presence of diabetes, respectively. @*Conclusions@#HbA1c could detect diabetes effectively in community-dwellers with hypertension.
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Objective@#To investigate the current status and influencing factors of geriatric nursing competence of clinical nurses from grade A tertiary hospitals in Guangdong Province, and provide basic materials and evidence-based reference for the set of suitable allocation of geriatric nursing competence training plan.@*Methods@#By convenience sampling, a total of 2 067 clinical nurses from 40 grade A tertiary hospitals in 16 prefecture-level cities in Guangdong Province were investigated with general information questionnaire and self-made geriatric nursing competence scale for clinical nurses.@*Results@#The item average score was 2.30±0.71. Among three domains, professional literacy scored the highest, followed by professional practice and professional development. Among ten sub-domains, the top three scored were law and ethic, critical thinking and safe management while the bottom three were coaching and mentoring, professional learning, research and innovation. Multiple linear regression showed that the influencing factors of geriatric nursing competence were nursing age (B=0.011, 95%CI 0.006-0.015, P<0.01), professional title (B=0.031, 95%CI 0.002-0.066, P<0.05), interest in aged care (B=0.214, 95%CI0.179-0.250, P<0.01) and experience regarding geriatric specialized or professional nurses qualification training(B=0.250, 95%CI 0.152-0.349, P<0.01).@*Conclusions@#The geriatric nursing competence of clinical nurses from grade A tertiary hospital in Guangdong Province is in the middle level. Interventions to improve the professional development competence of clinical nurses is thus much needed. Hospital managers should establish the talent team according to geriatric nursing competence of clinical nurses, and take related training.
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Objective@#To study the incidence and clinicopathological features of intermediate fibroblastic/myofibroblastic tumors(IF/MFT) in infants and the young children.@*Methods@#All available cases with soft tissue tumors in infants and children were retrieved from the files of Women and Children′s Hospital Affiliated to Qingdao University, from January 2012 to December 2017.The incidence rate of IF/MFT was observed.Cases of IF/MFT were identified and investigated by light microscopy and immunohistochemistry by reviewing the related literature.@*Results@#Among 290 soft tissue tumors, 15 cases(5.2%) were IF/MFT, accounted for 88.2%(15/17 cases) of borderline soft tissue tumors.Twelve cases were male, 3 cases were female, the median age was 8 months, and 4 cases were congenital.Clinically, 11 cases were presented with slow-growing painless masses located in the trunk or extremities.According to histopathology, 9 cases(60.0%) were categorized as infantile fibromatosis(IFM), including 5 cases(33.3%) desmoid-type and 4 cases(26.7%) diffuse-type; 3 cases(20.0%) as lipofibromatosis(LFM); 2 cases(13.3%) as infantile fibrosarcoma(IFS) and 1 case(6.7%) as giant cell fibroblastoma(GCF). All 15 tumors were characterized by the presence of spindle fibroblasts and myofibroblasts with infiltration of the surrounding structures.Immunohistochemically, all the 15 cases were diffusely positive for Vimentin(Vim), but negative for Myogenin, MyoD1, Desmin and S-100.Smooth muscle actin(SMA), β-catenin and Bcl-2 were positive in some cases to a certain degree.The Ki-67 proliferation index was higher in diffuse-type IFM and IFS, the former was 5.0%-20.0%, and the latter was about 20.0%, however, the other cases showed Ki-67 <5.0%.The main clinical treatment was complete or extensive excision.@*Conclusions@#IF/MFT accounts for a high proportion of intermediate soft tissue tumors in infants and young children, mostly seen in male children, and IFM and LFM are the main types.The clinical signs and symptoms associated with these tumors are often nonspecific, and their histopathologic manifestations may overlap.The final diagnosis of IF/MFT must depend on the characteristics of age, location, histopathologic changes and immunohistoche-mical findings.
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Objective To investigate the current status and influencing factors of geriatric nursing competence of clinical nurses from grade A tertiary hospitals in Guangdong Province, and provide basic materials and evidence-based reference for the set of suitable allocation of geriatric nursing competence training plan. Methods By convenience sampling, a total of 2 067 clinical nurses from 40 grade A tertiary hospitals in 16 prefecture-level cities in Guangdong Province were investigated with general information questionnaire and self-made geriatric nursing competence scale for clinical nurses. Results The item average score was 2.30 ± 0.71. Among three domains, professional literacy scored the highest, followed by professional practice and professional development. Among ten sub-domains, the top three scored were law and ethic, critical thinking and safe management while the bottom three were coaching and mentoring, professional learning, research and innovation. Multiple linear regression showed that the influencing factors of geriatric nursing competence were nursing age ( B=0.011, 95% CI 0.006-0.015, P＜0.01), professional title ( B=0.031, 95% CI 0.002-0.066, P＜0.05), interest in aged care ( B=0.214, 95% CI 0.179-0.250, P＜0.01) and experience regarding geriatric specialized or professional nurses qualification training( B=0.250, 95% CI 0.152-0.349, P＜0.01). Conclusions The geriatric nursing competence of clinical nurses from grade A tertiary hospital in Guangdong Province is in the middle level. Interventions to improve the professional development competence of clinical nurses is thus much needed. Hospital managers should establish the talent team according to geriatric nursing competence of clinical nurses, and take related training.
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Objective To detect the expression of AL136359.1 in cholangiocarcinoma tissues and cells and analyze its effect on proliferation and migration of cholangiocarcinoma cells.Methods The expression of AL136359.1 in 8 cholangiocarcinoma tissues and 4 cholangiocarcinoma cell lines (QBC939,RBE,HCCC-9810 and TFK-1) was detected by real-time quantitative PCR (qRT-PCR).Transfection of plasmid carrying AL136359.1 in the cholangiocarcinoma cell line with the lowest expression level of AL136359.1 were used to increase the expression of AL136359.1,and the transfection efficiency was verified by qRT-PCR.qRT-PCR and Western blot were used to detect the expression of AKR1 B10 at mRNA and protein levels.The cell counting kit (CCK-8) and transwell migration assay were used to detect the effect of high expression of AL136359.1 on the proliferation and migration ability of cholangiocarcinoma cells.Results The expression of AL136359.1 in cholangiocarcinoma tissues (0.41± 0.05) was significantly lower than that in adjacent tissues (2.94 ± 0.44,P ＜ 0.01).The expression of AL136359.1 in cholangiocarcinoma cells was significantly lower than that in human normal cholangioepithelial cells (P ＜0.01),and the QBC939 cells had the lowest expression (P ＜ 0.01).High expression of AL136359.1 caused an increase in the expression of AKR1 B10 at mRNA and protein levels (P ＜ 0.01).High expression of AL136359.1 could significantly inhibit the proliferation and migration of cholangiocarcinoma cells (P ＜0.01).Conclusions The expression of AL136359.1 were decreased in cholangiocarcinoma tissues and cell line.The high expression of AL136359.1 could up-regulate the mRNA expression of AKR1B10 gene,which was involved in inhibiting the proliferation and migration of QBC939 cells.
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We report a case of intractable circulatory failure event in a hypertensive patient during laparoscopy hepatectomy and analyze the diagnosis and treatment by multidisciplinary physicians. This case suggests that both surgeons and anesthesiologists should give attention to oral angiotensin II receptor antagonist during the preoperative period to avoid refractory hypotension. In addition, the use of EV1000 hemodynamic monitoring system in intensive care provides more convenience for clinical liquid management.
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<p><b>OBJECTIVE</b>To investigate the effect of minimally invasive mini-incision and instrumented reduction combined with interlocking intramedullary nailing in the treatment of patients with multi-segment fracture of complex femoral shaft.</p><p><b>METHODS</b>From January 2013 to January 2016, 32 patients with multiple fractures segments of femoral shaft were treated with instrumentation-assisted reduction combined with interlocking intramedullary nailing, including 22 males and 10 females with an average age of 45 years old ranging 17 to 68 years old. The time from injured to operation was 5 to 10 days with an average of 7 days. After admission, routine tibial tubercle or supracondylar bone traction was performed. The patient's general condition was evaluated, the operation time and intraoperative blood loss were recorded. According to Thorsen femoral fracture morphology evaluation criteria and Hohl knee function evaluation of postoperative efficacy, postoperative fracture healing, complications and postoperative recovery of limb function were observed.</p><p><b>RESULTS</b>All patients were followed up for 6 to 24 months with an average of 12 months. The operative time ranged from 48 to 76 minutes with an average of 67 min. The intraoperative blood loss was 150 to 400 ml with an average of 220 ml. The surgical incisions all achieved grade A healing. The fractures reached the clinical standard of healing. The fracture healing time ranged from 4.2 to 10.8 months with an average of 5.7 months. There were no nonunion, incision infection and internal fixation fracture, failure and other complications. According to Thorsen femoral fracture morphology evaluation criteria, the result was excellent in 28 cases, good in 3 cases, fair in 1 case. According to Hohl knee function evaluation criteria, the result was excellent in 30 cases, good in 2 cases.</p><p><b>CONCLUSIONS</b>Instrument-assisted reduction combined with interlocking intramedullary nail fixation is a safe and effective method for the treatment of complex femoral shaft fractures. It has advantages of small trauma, fixed fixation, quick recovery, early postoperative functional exercise.</p>
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<p><b>Background</b>Although fasting plasma glucose (FPG) has been highly recommended as the sole test for diabetes screening, the efficacy of FPG alone for diabetes screening is potentially limited due to its low sensitivity. The aim of this study was to improve the efficacy of FPG for diabetes screening using urinary glucose (UG).</p><p><b>Methods</b>This study was initiated on November 12, 2015, and ended on June 28, 2016. A representative sample of individuals aged between 18 and 65 years, with no history of diabetes, from 6 cities in Jiangsu Province participated in this study. A 75-g oral glucose tolerance test was used to diagnose diabetes. All urine samples were collected within 2 h of oral glucose loading to measure UG. Partial correlation analyses were used to evaluate the associations between UG and other glycemic variables, including FPG, 2-h plasma glucose (2h-PG), and glycated hemoglobin A1c, after adjustment for age. The performance of UG was evaluated using a receiver operating characteristic (ROC) curve analysis.</p><p><b>Results</b>Of the 7485 individuals included, 8% were newly diagnosed with diabetes and 48.7% had prediabetes. The areas under the ROC curves for UG were 0.75 for estimation of 2h-PG ≥7.8 mmol/L and 0.90 for 2h-PG ≥11.1 mmol/L, respectively. The sensitivity and specificity of UG were 52.3% and 87.8%, respectively, for 2h-PG ≥7.8 mmol/L (cutoff point ≥130 mg), and 83.5% and 87.5%, respectively, for 2h-PG ≥11.1 mmol/L (cutoff point ≥178.5 mg). The combination of FPG and UG demonstrated a significantly higher sensitivity than that of FPG alone for the identification of diabetes ([483/597] 80.9% vs. [335/597] 56.1%, χ = 85.0, P < 0.001) and glucose abnormalities ([2643/4242] 62.3% vs. [2365/4242] 55.8%, χ = 37.7, P < 0.001).</p><p><b>Conclusions</b>The combination of UG and FPG substantially improves the efficacy of using FPG alone for diabetes screening; this combination might be a practical screening tool and is worth being recommended in the future.</p>
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The aim of this study was to evaluate the seed quality of C.deserticola and establish quality grading rules of seeds by detecting the impacts of different processing methods on the contents of the effective components of C.deserticola for optimizing the suitable processing method.The seed quality was judged by thousand-kernel weight,empty embryo rate and water content.The samples were preliminary processed by freeze-drying,natural drying and hot air circulation drying respectively,and the content of phenylethanoid glycosides was determined by HPLC-UV.The seed quality classification standard of C.deserticola was established,and the seeds were divided into three grades based on the standard.It was found that freeze-drying method was optimum,featuring less effective component loss,beautiful appearance of herbal piece,crisp texture and fast drying.In conclusion,this study laid a foundation for the quality control of the seeds of C.deserticola with the provision of scientific evidence for the initial processing of the fresh product.
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The present study was designed to investigate the anti-sepsis effects of physcion 8-O-β-glucopyranoside (POG) isolated from Rumex japonicas and explore its possible pharmacological mechanisms. POG was extracted from R. japonicas by bioactivity-guided isolation with the anti-sepsis agents. Survival analysis in septic mouse induced by LPS and heat-killed Escherichia coli were used to evaluate the protective effect of POG (40 mg·kg, i.p.) on sepsis. Cytokines including TNF-α, IL-1β and IL-6 in RAW 264.7 cells induced by LPS (100 ng·mL) were determined by ELISA. In addition, the proteins expressions of TLR2 and TLR4 were determined by Western blotting assay. Our results demonstrated that POG (40 mg·kg, i.p.) possessed significant protective activity on the endotoxemic mice. The POG treatment (20, 40, and 80 μg·mL) significantly decreased the TNF-α, IL-1β and IL-6 induced by LPS (P < 0.01) in a concentration-dependent manner. Furthermore, the TLR4 and TLR2 proteins were also down-regulated by POG at 20 (P < 0.01), 40 (P < 0.01), and 80 μg·mL (P < 0.01). The present study demonstrated that the POG extracted from R. japonicas possessed significant anti-sepsis effect on endotoxemic mice, and can be developed as a novel drug for treating sepsis in the future.
Subject(s)
Animals , Humans , Male , Mice , Anti-Inflammatory Agents , Drugs, Chinese Herbal , Emodin , Glucosides , Interleukin-1beta , Genetics , Allergy and Immunology , Interleukin-6 , Genetics , Allergy and Immunology , Interleukin-8 , Genetics , Allergy and Immunology , Macrophages , Allergy and Immunology , Mice, Inbred ICR , Rumex , Chemistry , Sepsis , Drug Therapy , Genetics , Allergy and Immunology , Tumor Necrosis Factor-alpha , Genetics , Allergy and ImmunologyABSTRACT
Objective To improve the quality standard of Reduqing Oral Liquid. Methods TLC was used to identify the featured spots of Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Scutellariae Radix;HPLC method was usded to detect the contents of Baicalin in Reduqing Oral Liquid. Results TLC could identify the featured spots of Glycyrrhizae Radix et Rhizoma, Belamcandae Rhizoma and Scutellariae Radix; Baicalin was detected in range of 53.60–536.00 μg/mL with good linear relationship (r=0.999 99), the average recovery rate was 99.85%, and RSD was 0.63%(n=6). Conclusion The method is simple, accurate and reliable, which can be applied to the quality control of Reduqing Oral Liquid.