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The Coronavirus disease 2019 (COVID-19) has spread globally. Although mixed liver impairment has been reported in COVID-19 patients, the association of liver injury caused by specific subtype especially chronic hepatitis B (CHB) with COVID-19 has not been elucidated. In this multi-center, retrospective, and observational cohort study, 109 CHB and 327 non-CHB patients with COVID-19 were propensity score matched at an approximate ratio of 3:1 on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, disease severity, and clinical outcomes were compared. Furthermore, univariable and multivariable logistic and Cox regression models were used to explore the risk factors for disease severity and mortality, respectively. A higher proportion of CHB patients (30 of 109 (27.52%)) developed into severe status than non-CHB patients (17 of 327 (5.20%)). In addition to previously reported liver impairment markers, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin, we identified several novel risk factors including elevated lactate dehydrogenase (⩾ 245 U/L, hazard ratio (HR) = 8.639, 95% confidence interval (CI) = 2.528-29.523; P < 0.001) and coagulation-related biomarker D-dimer (⩾ 0.5 µg/mL, HR = 4.321, 95% CI = 1.443-12.939; P = 0.009) and decreased albumin (< 35 g/L, HR = 0.131, 95% CI = 0.048-0.361; P < 0.001) and albumin/globulin ratio (< 1.5, HR = 0.123, 95% CI = 0.017-0.918; P = 0.041). In conclusion, COVID-19 patients with CHB were more likely to develop into severe illness and die. The risk factors that we identified may be helpful for early clinical surveillance of critical progression.
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Humans , COVID-19 , Cohort Studies , Hepatitis B, Chronic/epidemiology , Retrospective Studies , Risk FactorsABSTRACT
Objective:To evaluate the safety of pregnancy after kidney transplantation and summarize the optimal timing of pregnancy and the experience in the management during pregnancy and peripartum.Methods:A total of 25 kidney transplant recipients were pregnant during March 2013 to February 2020. A matched cohort of 75 general pregnant women wasincluded as control.Results:Twenty-five women successfully delivered healthy babies in the transplant group. The mean age at kidney transplantationwas (25.6 ±3.2) years old, and the mean interval between transplantation and conception was (54.0±23.1) months. 92% (23 / 25) of recipients had cesarean surgery and all infants were singletons.During pregnancy, the incidence of preeclampsia was significantly higher in the transplant group(20.0%VS. 1.3%, P=0.001)compared with matched control. Compared with pre-pregnancy, the serum creatinine levels of the recipients decreased in the second trimester( P<0.001)and increased in the third trimester( P=0.019), which was similar with the control group. In the third trimester, 40%(10/25)of recipients in the transplant group had proteinuria, which decreased to negative(5/10) or 1+ (4/10) within 6 months after delivery. No rejection occurred in all patients during pregnancy and 6 months after delivery. A higher dose of tacrolimus was needed to maintain the normal trough level after pregnancy, which returned to routine dose postpartum. Conclusions:Although the risk of pregnancy was higher in kidney transplant recipients than that in non-transplant women, the overall risk was acceptable. Strict screening of patients preparing for pregnancy, adjustment of immunosuppressive drugs, and multi-disciplinary collaboration are important for safe pregnancy and delivery.
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Objective:To investigate the effect of electroacupuncture at Fengchi (GB20) on astrocytes and neurons in rats with acute cerebral infarction. Methods:A total of 64 male Sprague-Dawley rats were randomly divided into sham group (n = 16), model group (n = 16), non-acupoint group (n = 16) and Fengchi group (n = 16). The latter three groups were modeled with middle cerebral artery occlusion (MCAO), and the latter two groups were treated with electroacupuncture after modeling, at the point near Fengchi and Fengchi, respectively, for seven days. All the rats were assessed with neurological deficit score after treatment, while the cerebral infarction area and water content were measured, the histopathology of hippocampus was observed by HE staining, the expression levels of brain-derived neurotrophic factor (BDNF), glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE) in hippocampus were detected with ELISA, the apoptosis of brain neurons were measured with TUNEL, and the expression levels of caspase-3 and Bcl-2 in brain homogenate were detected with Western blotting and reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR). Results:Compared with the sham group, the neurological deficit score, cerebral infarction area and water content increased significantly (P < 0.05) in the other groups; while the the expression of GFAP and NSE in hippocampus increased (P < 0.05) and the expression of BDNF decreased (P < 0.05); the number of apoptosis in hippocampus increased (P < 0.05), and the expression of caspase-3 increased (P < 0.05) and the expression of Bcl-2 decreased (P < 0.05). Compared with the model group and non-acupoint group, the neurological deficit score, cerebral infarction area and water content decreased in the Fengchi group (P < 0.05); while the the expression of GFAP and NSE in hippocampus decreased (P < 0.05) and the expression of BDNF increased (P < 0.05); the number of apoptosis in hippocampus decreased (P < 0.05), and the expression of caspase-3 decreased (P < 0.05) and the expression of Bcl-2 increased (P < 0.05). Conclusion:Electroacupuncture at Fengchi can protect the brain from acute cerebral infarction, adjust the expression of GFAP, NSE and BDNF, and reduce the neuronal apoptosis.
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BACKGROUND@#The catheter-tissue contact force (CF) is one of the significant determinants of lesion size and thus has a considerable impact on the effectiveness of ablation procedures. This study aimed to evaluate the impact of CF on the lesion size during right ventricular outflow tract (RVOT) ablation in a swine model.@*METHODS@#Twelve Guangxi Bama miniature male pigs weighing 40 to 50 kg were studied. After general anesthesia, a ThermoCool SmartTouch contact-sensing ablation catheter was introduced to the RVOT via the femoral vein under the guidance of the CARTO 3 system. The local ventricular voltage amplitude and impedance were measured using different CF levels. We randomly divided the animals into the following four groups according to the different CF levels: group A (3-9 g); group B (10-19 g); group C (20-29 g); and group D (30-39 g). Radiofrequency ablations were performed at three points in the free wall and septum of the RVOT in power control mode at 30 W for 30 s while maintaining the saline irrigation rate at 17 mL/min. At the end of the procedures, the maximum depth, surface diameter, and lesion volume were measured and recorded. A linear regression analysis was performed to determine the relationship between continuous variables.@*RESULTS@#A total of 72 ablation lesions were created in the RVOT of the 12 Bama pigs. The maximum depth, surface diameter, and volume of the lesions measured were well correlated with the CF (free wall: β = 0.105, β = 0.162, β = 3.355, respectively, P < 0.001; septum: β = 0.093, β = 0.150, β = 3.712, respectively, P < 0.001). The regional ventricular bipolar voltage amplitude, unipolar voltage amplitude, and impedance were weakly positively associated with the CF (β = 0.065, β = 0.125, and β = 1.054, respectively, P < 0.001). There was a significant difference in the incidence of steam pops among groups A, B, C, and D (free wall: F = 7.3, P = 0.032; septum: F = 10.5, P = 0.009); and steam pops occurred only when the CF exceeded 20 g. Trans-mural lesions were observed when the CF exceeded 10 g in the free wall, while the lesions in the septum were non-trans-mural even though the CF reached 30 g.@*CONCLUSIONS@#CF seems to be a leading predictive factor for the size of formed lesions in RVOT ablation. Maintaining the CF value between 3 and 10 g may be reasonable and effective for creating the necessary lesion size and reducing the risk of complications, such as steam pops and perforations.
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Objective:To quantify the fat of extraocular muscle in TAO patients with MRI fat-water separation technique.Methods:66 patients (129 eyes) with TAO were included in this study from November 2017 to July 2019. The age, gender, course of disease, disease activity and severity were collected. Fat fraction(FF) of the heaviest inflamed extraocular muscle was used as FFmax, the average FF of each orbital was recorded as FFmean. FF differences between groups of severity and activity were compared, the correlation between FF and clinical characteristics was also analyzed. Meanwhile, the changes of FF in follow-up patients before and after treatment were compared.Results:FFmean and FFmax of mild group were higher than moderate-to-severe as well as sight-threatening group. In male patients, active group′s FFmean and FFmax were lower. FF was different in groups which based on disease course ( P<0.05). Spearman correlation analysis showed a positive correlation between FF and disease course. Besides, there was a negative correlation between FF, disease activity, and disease severity ( P < 0.05). FF increased after treatment(FFmean: 34.03%±6.75% vs 32.26%±6.06%, P=0.040; FFmax: 33.43%±9.44% vs 29.04%±8.45%, P=0.006). Conclusion:MRI fat fraction can quickly and objectively quantify the fat of extraocular muscle, providing a new reference index for TAO′s disease evaluation.
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Objective To evaluate life quality of Graves orbitopathy (GO) patients using Graves orbitopathy quality-of-life questionnaire (GO-QOL) and explore the influence factors of the quality of life of GO patients.Methods This was a cross-sectional study conducted at The Third Affiliated Hospital of Southern Medical University including 145 newly diagnosed GO patients.All the patient answered the GO-QOL and underwent ophthalmic and endocrine assessments.The main outcome measures were the scores on GO-QOL 2 subscales:visual functioning and appearance.Based on the classification in the guideline of European Group on Graves Orbitopathy (EUGOGO),the patients were divided into two groups:mild and moderate to severe groups.Then the scales between these two groups were compared and influencing factors were analyzed.Finally,the floor and ceiling effects were assessed.Results The GO-QOL scores for the subscales of visual functioning and appearance were 70.91±27.83 and 61.29±26.37 respectively in 145 GO patients.Visual functioning and appearance were lower in moderate to severe group (62.71 ±28.77 and 57.52 ± 26.49,respectively) than in mild group (85.58 ± 18.77 and 68.02 ±24.99,respectively).The GO-QOL scores for the visual functioning subscale were significantly correlated with age (P =0.002),clinical active score (P =0.011) and the degree of diplopia (P =0.00,R2=0.373).The GO-QOL scores for the appearance were significantly correlated with sex (P =0.05) and thyroid-stimulating hormone levels (P =0.001,R2 =0.231).No significant ceiling or floor effects were observed for either subscale of the GO-QOL.Conclusions With the aggravation of the disease,the quality of life of GO patients is getting worse and worse.The main influencing factors of the quality of life of GO patients include age,gender,diplopia,clinical active score and thyroid-stimulating hormone levels.Close attention needs to be paid to the quality of life of GO patients.
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Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.
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Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.
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Photo-sensitive reactive oxygen species (ROS) responsive liposomes loaded with 1,4,8,11,15, 18,22,25-octabutoxypalladium phthalocyanine[PdPC(OBu)8] and doxorubicin hydrochloride (DOX) (LPD) were prepared by (NH4)2SO4-gradient method. LPD was characterized with transmission electron microscopy (TEM), dynamic light scattering particle size, zeta potentials, photo-sensitive ROS-responsive DOX release behaviors and the serum stability in vitro. LPD cytotoxicity, DOX uptake and singlet oxygen production in MCF-7 cells were evaluated. The results showed that the particle size of LPD was (169.3 ±1.2) nm, PDI of LPD was 0.198 ±0.003 and zeta potentials of LPD was (-39.8 ±0.8) mV. The accumulated release of DOX reached 95.5% in 5 min under 730 nm laser irradiation (300 mW·cm-2). The DOX uptake of liposome was increased and 1O2 was generated. The half inhibition concentration (IC50) of DOX in LPD with irradiation group was decreased by 85.7% and no irradiation group was decreased by 67.9% compared with free DOX group in MCF-7 cells. Therefore, photo-sensitive ROS-responsive liposomes would be a promising drug delivery system for tumor therapy.
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Excessive reactive oxygen species (ROS) is associated with an array of pathological conditions, including cancer, diabetes, cardiovascular diseases, and neurodegenerative diseases. However, ROS-responsive materials have drawn attention in the development of drug delivery systems. There are many types of ROS-responsive materials explored in drug delivery applications, including sulfur-based responsive polymers, selenium-based responsive polymers, tellurium-based responsive polymers, oxalate ester-containing polymers, phenylboronic ester-containing polymers and unsaturated lipids. When integrated with ROS-responsive drug delivery systems, a photosensitizer is used as a light-sensitive element to generate ROS, mainly singlet oxygen (1O2), which in turn activates the ROS-triggered drug delivery.
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Objective To analyze the characteristics of rhabdomyolysis (RM) caused by alcohol withdrawal syndrome (AWS). Methods The clinical data of 7 patients with RM induced by AWS were analyzed retrospectively. Results All 7 patients were male;the age was 38-63 (51.3 ± 9.8) years. All of the 7 patients showed obvious myalgia and fatigue, of whom 4 patients had limb swelling, and 3 patients had epigastric pain. Creatine kinase and myoglobin levels of 7 cases were significantly increased. One case had acute renal failure. Seven patients were improved after treatment with a large amount of fluid infusion. Conclusions For patients with AWS who have generalized withdrawal seizures and epileptic seizures, muscle cells can be damaged due to prolonged muscle contraction, which can cause RM. Changes of myoglobin, creatine kinase, renal function and liver function in patients with AWS should be monitored at clinical admissions. If RM occurs, the patients should be given early fluid therapy.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of one dose tranexamic acid combined with temporary drain lamping in primary unilateral total knee arthroplasty.</p><p><b>METHODS</b>Total 160 patients undergoing unilateral primary total knee arthroplasty between January 2012 and December 2013 were randomly divided into four groups(40 cases in each group):group A (the drain was clamped for 2 hours after the operation and the patients received 20 ml physiological saline), group B(the drain was clamped for 2 hours after the operation and the patients received 10 ml tranexamic acid and 10 ml physiological saline), group C (the drain was clamped for 4 hours after the operation and the patients received 20 ml physiological saline) and group D(the drain was clamped for 4 hours after the operation and the patients received 10 ml tranexamic acid and 10 ml physiological saline). The postoperative hemoglobin level, maximum hemoglobin loss, wound drainage, blood loss, the volume of blood transfusion, the number of patients inquiring blood transfusion, venous thrombo embolism rate, and ecchymosis rate were recorded and compared among the four groups.</p><p><b>RESULTS</b>There was no incision infection, severe hypoxia, and symptomatic pulmonary embolism in these groups. There were significant differences in hemoglobin content one day after operation in each group(=12.26,=0.000), in the hemoglobin content 7 days after operation in each group(=20.74,=0.000), in postoperative drainage in each group(=38.71,=0.000);in the amount of invisible red blood cell loss in each group(=83.41,=0.000), and in total red blood cell loss in each group(=102.68,=0.000). Color Doppler ultrasound examination found that the total incidence of VTE was 3%(5/160) and there were no significant differences in each group(=0.892). There were no significant differences in postoperative subcutaneous ecchymosis area>1% incidence(=0.143).</p><p><b>CONCLUSIONS</b>Topical tranexami acid treatment combined with temporary clamping of drain for 4 hours could reduce postoperative blood loss, blood transfusion, and ecchymosis rate without increasing the risk of thromboembolic event after total knee arthroplasty.</p>
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Objective To explore the expression of Twist protein in the colorectal cancer (CRC) and its relationship between clinicopathological factors and prognosis of patients.Methods The clinical data of 45 patients with colorectal cancer who were admitted to the First People's Hospital of Shunde from June 2005 to September 2005 were retrospectively analyzed.The colorectal tissue specimens from surgical resection were collected.The expressions of Twist protein in the cancer and paracarcinoma tissues were examined by the immunohistochemistry,and their relationship with clinicopathological factors and prognosis of patients was analyzed.Patients were followed up by outpatient examination and telephone interview until September 2013.The count data were analyzed using the chi-square test and Fisher exact probability.The survival curve was generated using the Kaplan-Meier method,and the survival analysis was conducted using the Log-rank test.The prognosis factors were analyzed by the COX univariate analysis and multivariate analysis.Results The expression of Twist protein in CRC was predominantly detected in the cytoplasm of the tumor cells.The positive expression rates of Twist protein in the CRC and paracarcinoma tissues were 62.2％ (28/45) and 20.0％ (9/45),respectively,with a significant difference (x2 =18.383,P ＜0.05).The positive expression rates of Twist protein were 42.1％ in patients with Ⅰ-Ⅱ stage of CRC and 76.9％ in patients with Ⅲ-Ⅳ stage of CRC.The positive expression rates of Twist protein were 41.7％in patients with N0 stage of CRC and 85.7％ in patients with N1-N2 stage of CRC.The expression of Twist protein in patients with CRC was however associated with the TNM stage and lymph node metastasis (x2=5.662,9.244,P ＜ 0.05).A total of 45 patients were followed up for 10-96 months (median,54 months).The median survival time and 5-year cumulative survival rate in 45 patients with positive expression of Twist protein were 44 months and 10.7％,which were compared with 69 months and 82.4％ in 45 patients with negative expression of Twist protein,with a statical significance in the survival (x2 =26.147,P ＜ 0.05).The results of univariate analysis showed that the expression of Twist protein was an related factor affecting the prognosis of patients [HR =8.669,95％ confidence interval (CI):2.959-25.390,P ＜0.05].The results of multivariate analysis showed that the positive expression of Twist protein was an independent risk factor affecting the prognosis of patients (HR =5.059,95 ％ CI:2.888-8.863,P ＜ 0.05).Conclusiors The increasing expression of Twist protein in the CRC is positively correlated with the occurrence and development of CRC.The positive expression of Twist protein is an independent risk factor affecting the prognosis of patients with CRC.
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Objective: To explore the expression level of serum interleukin (IL)-7 in patients with acute coronary syndrome (ACS) and analyze the relationship between IL-7 level and prognosis. Methods: A total of 130 ACS patients [ACS group, including 70 cases with acute myocardial infarction (AMI) and 60 cases with unstable angina pectoris (UAP)], 33 cases with stable angina pectoris (SAP，SAP group) and 89 healthy subjects (healthy control group) were selected. IL-7 level was measured using enzyme linked immunosorbent assay (ELISA) and compared among all groups. The 130 ACS patients were followed up, and Logistic regression analysis was used to analyze the relationship between IL-7 level and prognosis. Results: Compared with healthy control group and SAP group, there was significant rise in IL-7 level in UAP group and AMI group [(1.84±0.47) pg/ml, (2.11±0.63) pg/ml vs. (4.87±0.52) pg/ml, (5.15±0.71) pg/ml, P0.05 both); Logistic regression analysis indicated that expression level of serum IL-7 was an independent risk factor for adverse cardiovascular events in ACS patients (OR=1.212, 95%CI:1.061-1.418). Conclusion: Interleukin-7, as an important inflammatory cytokines, its serum level abnormally elevated in patients with acute coronary syndrome, it may have important prognostic value.
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This study was aimed to explore the role of full-automatic blood analyzer Sysmex XE-2100 in early screening and diagnosing the hematologic malignancies. A total of 288 samples of the patients with hematologic malignancies was examined. Then, the scatter plots, alarm information and blood smears were analyzed. The results indicated that 76% of these samples showed abnormal scatter plots. CMML and AML-M3 patients had their own characteristic scatter plots, while others hadnt's. The coincident rate of CMML and AML-M3 determined by scatter plots with practical diseases was 100%; the coincident rate of ALL determined by scatter plots with practical disease was 67%. The coincident rate of alarm information of blast cells was 92.5%, the coincident rate of immature granulocytes was 77.1%, the coincident rate of nucleated red blood cells was 33.3%, the coincident rate of atypical lymphocytes was 31.3%. It is concluded that the abnormal scatter plots and alarm information are very important for finding the patients with hematologic malignancies and determining the disease type. The alarm information has high reliability for blast cells and immature granulocytes, but has only mirror value for nucleated red blood cells and atypical lymphocytes.
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Hematologic Neoplasms , Blood , Hematologic Tests , Methods , Leukocyte Count , Reproducibility of ResultsABSTRACT
s: The onset of Crohn’s disease (CD) is the interaction of environment, heredity, infection, immune and other factors. It is also closely related to abnormal immune functions. Without special treatment, CD is identified as a modern refractory disease. By syndrome differentiation and treatment, traditional Chinese medicine (TCM) can effectively relieve disease conditions, improve the quality of life and reduce side effects of modern medication. The core compatibility ofBai-Zhu andFu-Ling can reinforce spleen-qi and dispel dampness, which met the common pathogenesis of CD. Therefore, the combination is comprehensively used in the compound prescription. Our previous study found thatBai-Zhu Fu-Ling decoctioncan reduce the vasoactive intestinal peptide (VIP) of animal model of spleen-qi deficiency, downregulate VIP receptors, decrease the affinity of VIP receptors and improve animal model’s sIgA. To further clarify the effects about neurotransmitters and their correlation with the immune system in the pathogenesis of CD and the intervention mechanism treated by different proportional compatibility ofBai-Zhu Fu-Ling decoction, we studied influences of the decoction on related transmitters of nerve- immune network and functions of receptors, as well as cytokine secretion and signal transduction of TLR4-NF-κB. Our studies can provide references and foundations to further explore TCM treatment of CD.
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<p><b>OBJECTIVE</b>To observe postoperative glucose tolerance, gastric inhibitory polypeptide (GIP) , and glucogan-like peptide-1 (GLP-1) in normal glucose level dogs after undergoing gastric bypass procedures, and to explore the mechanism of gastric bypass procedures to treat type 2 diabetes.</p><p><b>METHODS</b>The 6 dogs with normal glucose tolerance had undergone gastric bypass procedures, and measure preoperative and postoperative oral and intravenous glucose tolerance (at time points 1, 2, and 4 weeks) through changes in blood glucose, insulin, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1), and measure preoperative and postoperative week 4 pancreatic tissue morphology.</p><p><b>RESULTS</b>Second weeks after operation, the fasting blood sugar was (3.58 ± 0.33) mmol/L, and significantly lower than preoperative (t = 3.571, P < 0.05). The GLP-1 level before oral glucose tolerance test (OGTT) and 30 minutes after OGTT were (0.90 ± 0.21) and (0.91 ± 0.19) pmol/L respectively, and significantly higher than preoperative (t value were -3.660 and -2.971, P < 0.05). GLP-1 levels began to decrease in the second week after surgery. After 4 weeks, the index recovered to the preoperative level. Four weeks after surgery when compared with preoperative, islet morphology, islet number (6.8 ± 0.8 and 7.1 ± 0.8 respectively) and islet cells (16.7 ± 2.5 and 16.3 ± 3.1 respectively) did not change significantly (P > 0.05).</p><p><b>CONCLUSION</b>Gastric bypass procedures could be briefly affect normal glucose tolerance in dogs' blood glucose, insulin and diabetes-related gastrointestinal hormones.</p>
Subject(s)
Animals , Dogs , Blood Glucose , Diabetes Mellitus, Type 2 , Gastric Bypass , Gastric Inhibitory Polypeptide , Glucagon , Glucagon-Like Peptide 1 , Blood , Glucose , Insulin , BloodABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of cardiac resynchronization therapy (CRT) alone or in combination with implantable cardioversion defibrillation (ICD) in patients with mild to severe heart failure.</p><p><b>METHOD</b>Electronic searches of MEDLINE, EMBASE, CENTREN and affiliated clinical trial registration data center, US Food and Drug Administration reports, CBMdisc, VIP, and CNKI databases from establishment to Dec 2010, using the search terms "CRT, heart failure", "biventricular pacer, heart failure", "biventricular pacing, heart failure", and "biventricular pacemaker, heart failure", were performed to identify randomized controlled trials (RCTs). Meta-analysis was performed by using RevMan 5.0 software after the strict evaluation of the methodological quality of the included RCTs.</p><p><b>RESULTS</b>A total of 23 trials including 8521 patients were included. In patients with New York Heart Association (NYHA) class I/II, CRT improved left ventricular ejection fraction (LVEF) [weighted mean difference (WMD) = 0.05, 95% CI 0.01 - 0.08], reduced heart failure hospitalizations [risk ratio (RR) = 0.70, 95%CI 0.61 - 0.81] and all-cause mortality (RR = 0.78, 95%CI 0.65 - 0.93) with increasing complications (RR = 1.74, 95%CI 1.42 - 2.13). In patients with NYHA class III/IV, CRT improved LVEF (WMD = 0.03, 95%CI 0.01 - 0.05), reduced both heart failure hospitalizations (RR = 0.64, 95%CI 0.55 - 0.73) and all-cause mortality (RR = 0.80, 95%CI 0.70 - 0.91) without increasing complications (RR = 1.01, 95%CI 0.91 - 1.12). Compared with ICD alone, CRT in combination with ICD significantly improved LVEF (WMD = 0.03, 95%CI 0.00 - 0.06), reduced heart failure hospitalizations (RR = 0.73, 95%CI 0.64 - 0.82) and all-cause mortality (RR = 0.82, 95%CI 0.72 - 0.95) without increasing complications (RR = 1.36, 95%CI 0.91 - 2.03) in patients with NYHA class I-IV symptoms.</p><p><b>CONCLUSIONS</b>CRT offered additional benefits on top of standard medication for heart failure patients with ventricular dyssynchrony in terms of improving LV function, and reducing heart failure hospitalization and all-cause mortality, regardless of NYHA class. CRT offers also additional benefit in heart failure patients implanted with ICD. However, CRT is associated with more adverse events in patients with NYHA class I/II.</p>
Subject(s)
Humans , Cardiac Resynchronization Therapy , Defibrillators, Implantable , Heart Failure , Therapeutics , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the application of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass (LRYGB).</p><p><b>METHODS</b>Clinical data of 29 patients with type 2 diabetes mellitus (T2DM) undergoing side to side anastomosis of the lesser curvature of stomach and jejunum in LRYGB from May 2012 to November 2012 in Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University were analyzed retrospectively.</p><p><b>RESULTS</b>All the procedures were successfully completed without conversion to laparotomy. The side-to-side anastomosis of the lesser curvature of stomach and jejunum avoided the laparoscopic suture. No gastrojejunostomy anastomotic bleeding, fistula, obstruction and other complications occurred after operation and no complications of gastrojejunostomy anastomosis were found during a follow up of 1 to 7 months.</p><p><b>CONCLUSIONS</b>Side-to-side anastomosis of the lesser curvature of stomach and jejunum in LRYGB can manipulate the size of anastomosis accurately and avoid the laparoscopic suturing. It is simple and easy to learn.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Diabetes Mellitus, Type 2 , General Surgery , Follow-Up Studies , Gastric Bypass , Methods , Jejunum , General Surgery , Laparoscopy , Methods , Retrospective Studies , Stomach , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate mitochondrial oxidative stress on cardiomyocyte apoptosis and the expression of Bcl-2 and Bax proteins in cardiac sarcolemma and mitochondria after application of hypoxia postconditioning and free radical scavengers.</p><p><b>METHODS</b>Primary cultured neonatal rat cardiomyocytes were exposed to 3 h hypoxia (H) followed by (1) 6 h of reoxygenation (R) (H/R), (2) 3 intermittent cycles of 5 min H and R before 6 h of R (PC), (3) application of superoxide dismutase (SOD) before PC (SOD+PC), (4) application of catalase (CAT) before PC (CAT+PC), and (5) application of SOD plus CAT before PC (SOD+CAT+PC). Cardiac sarcolemma and mitochondria were isolated by differential centrifugation. Mitochondrial reactive oxygen species (ROS) was detected with fluorescent probes (DCFH-DA) and cardiomyocyte apoptosis was detected with flow cytometry. The expressions of Bcl-2 and Bax proteins in cardiac sarcolemma and mitochondria were measured by Western blot.</p><p><b>RESULTS</b>Mitochondrial ROS reduced significantly in PC, SOD+PC, CAT+PC and especially in SOD+CAT+PC groups (all P<0.01). The number of apoptotic cardiomyocytes reduced significantly in PC, SOD+PC and CAT+PC (all P<0.01) but not in SOD+CAT+PC groups. Bcl-2 levels increased while Bax levels decreased in cardiac sarcolemma and mitochondria in PC, SOD+PC and CAT+PC groups (all P<0.01), Bcl-2 levels decreased and Bax levels increased in H/R and PC+SOD+CAT groups (all P<0.01).</p><p><b>CONCLUSIONS</b>PC attenuated H/R induced ROS and cardiomyocyte apoptosis, which might be mediated by upregulating the expression of Bcl-2 and downregulating the Bax in mitochondria and sarcolemma; SOD or CAT alone did not but SOD plus CAT attenuate the anti-apoptotic effect of hypoxia postconditioning; mitochondrial ROS thus plays an important role in PC's cardioprotection.</p>