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Objective:To investigate the association between cancer fatalism and optimistic attitudes among colorectal cancer patients, and how the above linkage is moderated by the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making.Methods:A cross-sectional survey was conducted on 64 patients diagnosed with colorectal cancer and awaiting radical colorectal cancer surgery in the Department of General Surgery of Beijing Friendship Hospital Affiliated to Capital Medical University, from January 2021 to December 2021. There were 38 males and 26 females, aged (61.2±13.0) years from 30 to 84 years. Cancer fatalism, optimism attitudes, and the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making were assessed. The patients′ cancer fatalism beliefs were measured by the " Chance" subscale of the Form C of the Multidimensional Health Locus of Control (MHLC-C), optimism attitudes were assessed by the Chinese version of the revised Life Orientation Test (CLOT-R), and the influence of patients′, family members′, and physicians′ opinions in the medical decision-making process was measured by a self-designed single factor scale. Measurement data of normal distribution were expressed as mean±standard deviation ( ± s). Measurement data of skewed distribution were expressed as M( Q1, Q3). Spearman correlation analysis and Chi-square test was used to examine the association between the main outcome variable (patients′ optimistic attitudes) and demographic and clinical characteristics. Interaction was examined by hierarchical linear regression analysis combined with simple slope tests. Results:Cancer fatalism was negatively associated with patients′ optimistic attitudes ( r=-0.35, P<0.01). Optimistic attitude of patients was significantly and negatively correlated with the influence of family members′ opinions on medical decision-making ( r=-0.25, P<0.05). There were significant positive correlations between the influence of patients′ and family members′ opinions ( r=0.50, P<0.01), family members′ and physicians′ opinions ( r=0.67, P<0.01), and physicians′ and patients′ opinions ( r=0.38, P<0.01) in medical decision making. Hierarchical linear regression analysis showed a negative association between cancer fatalism and optimism ( β=-0.32, P=0.01). This association was further moderated by the involvement of family members′ opinions ( β=-0.56, P<0.01) and the involvement of physicians′ opinions ( β=-0.36, P=0.04) in medical decision-making. Simple slope tests revealed that the negative impact of fatalistic attitudes on patients′ optimism attitudes may be potentiated when family members′ opinions have high influence on medical decision-making, while the negative impact may be buffered to some extent when physicians′ opinions have high influence on medical decision-making. Conclusions:Cancer fatalism had a negative effect on patients′ optimism. The high influence of physicians in treatment decision-making buffered the negative effect of cancer fatalism on optimism; the high influence of family members in treatment decision-making potentiated the negative effect of cancer fatalism on optimism. In the process of doctor-patient communication and shared decision-making, for patients with strong fatalistic attitudes, consideration should be given to appropriately increasing direct informational communication between physicians and patients and reducing excessive family intervention in medical decision-making, so as to enhance patients′ autonomy for treatment, promote optimism, and reduce the negative effects of cancer fatalism.
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Objective:To explore the difference of clinical characteristics between senile Parkinson's disease(PD)with depression and unipolar depression.Methods:From March 2019 to March 2020, 53 patients with Parkinson's disease depression and 57 patients with unipolar depression who were admitted to the neurology department of Beijing Hospital were continuously collected.The gender, age and education level of the patients were recorded.The course of disease and other general data of the patients with Parkinson's disease were also recorded.Depression and anxiety of the patients were evaluated by Beck Depression Inventory(BDI)and Generalized Anxiety Disorder Scale(GAD-7). Quality of life of patients with Parkinson's disease was evaluated by 8-item Parkinson's disease questionnaire(PDQ-8). Differences in the assessment results and quality of life scores between the two groups were analyzed.Results:The incidence of depression comorbid with anxiety in elderly PD patients was 52.8%(28/53), lower than that in elderly unipolar depression patients comorbid with anxiety [84.2%(48/57)]( χ2=12.664, P<0.001). The scores of activity inhibition [(1.8±0.8)points]and hyposexuality [(0.4±1.0)points]in elderly PD patients with comorbid depression were higher than that in patients with unipolar depression [(1.1±0.8)points, (0.0±0.0)points]( t=4.399, 2.942, P<0.001, =0.005). Moreover, the incidence of activity inhibition(98.1%)and hyposexuality(15.1%)in PD patients with comorbid depression was higher than that in patients with unipolar depression(78.9%, 0.0%)( χ2=9.680, 9.279, both P=0.002). The scores of self-blame [(1.0±0.8)points]and pain [(1.0±0.8)points]in elderly patients with unipolar depression were higher than those in PD patients with comorbid depression [(0.5±0.7)points, (0.9±0.7)points]( t=-3.902, -2.486, P<0.001, =0.014). Moreover, the incidence of self-blame(66.7%), irritability(78.9%)and image distortion(56.1%)in elderly patients with unipolar depression was higher than that in PD patients(35.8%, 56.6%, 35.8%)( χ2=10.447, 6.320, 4.547, P=0.001, 0.012, 0.033). The scores of PDQ-8 in PD patients with comorbid depression and anxiety [14.8(10.8, 19.0)points]( Z=-3.544, P<0.001)were higher than those in PD patients with depression only [7.0(4.8, 11.0)points]. Conclusions:The focus of depression in elderly PD patients is different from that in elderly unipolar depression patients.Elderly patients with unipolar depression are more likely to be comorbid with anxiety.Depression reduces the quality of life in PD patients, and the comorbidity of anxiety further reduces the overall quality of life in PD patients with depression.
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ObjectiveTo determine the level of anti-measles antibody and its fluctuation trend in children under 8 months old， which may provide evidence for enhancing the measles immunization strategy. MethodsA cross-sectional study was conducted to collect the serum of the children aged 1‒8 months in a children’s medical center in Shanghai. Serum concentration of anti-measles IgG antibody was determined by enzyme-linked immunosorbent assay （ELISA）， and dynamics of IgG antibody level was compared. ResultsA total of 837 children aged 1‒8 months were tested for anti-measles antibody， and there was no statistical difference in the antibody level between boys and girls （P>0.05）. In the age of 1 month children， the average geometric antibody concentration （GMC） was 529.66 IU‧L-1， and the antibody positive rate and protection rate were 86.07% and 29.51% respectively. After the age of 3 months， the antibody level dropped sharply in the age of 8 months children， the GMC decreased to 44.46 IU‧L-1. The positive rate was 12.00%， and the protection rate was 1.00%. The mathematical model of GMC reduction trend in children aged 1‒8 months was Ŷ=-0.144 8X+2.640（R2=0.911 3， P<0.001）. ConclusionThe low level of mother-transmitted protective antibody and its downward trend with age are the important factors leading to the incidence of measles in children aged1‒8 months. It is suggested that intensive immunization should be carried out for women of childbearing age to improve the level of mother-transmitted antibodies in her baby.
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Objective:To investigate the grey matter alterations of Parkinson′s disease (PD) patients with and without sleep disorders, and to explore the relationship between different sleep-related problems and clinical variables as well as grey matter volume (GMV) in PD.Methods:Forty-six PD patients and 38 healthy controls (HCs) were recruited from January 2018 to December 2021 in the Department of Neurology, Beijing Hospital. PD patients were divided into PD with sleep disorders (PD-S, n=26) and PD without sleep disorders (PD-nS, n=20) subgroups (cutoff points of 82 for Parkinson′s Disease Sleep Scale or less than 5 for each item was considered as an indicator of substantial sleep disorder). The Mini-Mental State Examination (MMSE), the third part of the Unified Parkinson′s Disease Rating Scale (UPDRS-Ⅲ), Hamilton Rating Scale for Anxiety (HAMA), Hamilton Rating Scale for Depression (HAMD), Non-Motor Symptoms Questionnaire (NMSQ), and Parkinson′s Disease Questionnaire-39 (PDQ-39) were used to evaluate cognitive function, motor symptoms, anxious and depressive symptoms, non-motor symptoms, and the quality of life of the patients. Optimized voxel-based morphometry was applied to the magnetic resonance imaging brain images in all participants,and multiple linear regression analysis was used to test the correlation between GMV and sleep quality in patients with PD. Results:Compared with the HCs, PD-nS patients showed decreased GMV in bilateral limbic lobe, parahippocampal gyrus, amygdala, cingulate gyrus, hippocampus, right cerebellum, bilateral frontotemporal lobe, bilateral occipital lobe and the left parietal lobe. PD-S group exhibited reduced GMV in bilateral limbic lobe, parahippocampal gyrus, amygdala, right cerebellum, bilateral frontotemporal lobe and bilateral parietal-occipital lobe, compared to the HCs. Compared with PD-nS, PD-S patients revealed higher depressive (HAMD score: 12.19±5.59 vs 6.95±3.19, t=-4.01, P<0.001), anxious (HAMA score: 12.04±5.32 vs 7.25±4.68, t=-3.18, P=0.003), and non-motor symptoms scores (NMSQ score: 12.92±5.18 vs 9.90±4.10, t=-2.14, P=0.038), poorer quality of life (PDQ-39 score: 35.31±22.01 vs 22.40±9.00, t=-2.71, P=0.010), and reduced GMV in the left insula, frontal, and parietal lobe ( P<0.001, uncorrected, cluster>100). There was a marked relationship between sleep quality and the reduced GMV of the right medial temporal gyrus (β=0.006, 95% CI 0.002-0.010, P=0.003), left middle frontal gyrus (β=0.006, 95% CI 0.002-0.010, P=0.002), the right cerebellum (β=0.014, 95% CI 0.005-0.023, P=0.003), and the right medial occipital gyrus (β=0.017, 95% CI 0.011-0.024, P<0.001). Significant grey matter changes were associated with nocturnal restlessness, mainly within the left limbic lobe, bilateral occipital lobe, the right cerebellum, and parietal lobe (β=0.008, 95% CI 0.006-0.010, P<0.001). Furthermore, nocturia in PD was related to certain grey matter atrophy, including bilateral limbic lobe, the right inferior parietal gyrus, and bilateral frontal lobe (β=0.010, 95% CI 0.008-0.013, P<0.001). The symptom of daytime dozing was correlated with GMV reduction in the right occipital lobe, the left temporal lobe (β=0.014, 95% CI 0.010-0.019, P<0.001). There were also several compensatory brain regions, including bilateral frontal lobe, the left limbic lobe and cingulate ( P<0.001, uncorrected, cluster>60). Conclusions:Sleep disturbance is common in PD, which is related to the anxious and depressive symptoms, non-motor symptoms, and the quality of life. PD patients with different sleep disorders show grey matter alterations in severeal brain regions, which are associated with sleep quality, nocturnal restlessness, psychosis, and daytime dozing.
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Objective:To evaluate the role of transient receptor potential vanilloid receptor 1 (TRPV1)/nuclear factor-κB (NF-κB) signaling pathway in dexmedetomidine-induced alleviation of ventilator-induced lung injury (VILI) in rats.Methods:One hundred clean-grade healthy male Sprague-Dawley rats, weighing 270-320 g, aged 4-5 months, were divided into 5 groups ( n=20 each) using a random number table method: control group (group C), VILI group (group V), AMG9810 group (group A), dexmedetomidine group (group D), and dexmedetomidine + RTX group (group DR). VILI model was prepared by mechanical ventilation with a tidal volume of 40 ml/kg for 4 h. In group A, TRPV1 inhibitor AMG9810 30 mg/kg was intraperitoneally injected at 1 h before mechanical ventilation.Dexmedetomidine 5.0 μg/kg was intravenously infused at 20 min before mechanical ventilation, and dexmedetomidine was intravenously infused at the rate of 5.0 μ g·kg -1·h -1 during ventilation in group D and group DR.In group DR, RTX 70 μ g/kg was intraperitoneally injected for 3 consecutive days before mechanical ventilation.At 4 h of mechanical ventilation, the concentrations of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and IL-6 in bronchoalveolar lavage fluid (BALF) were detected, oxygenation index (OI) and wet/dry lung weight (W/D) ratio were measured, the histopathological changes of lung tissues were observed, and lung injury was assessed and scored.The expression of TRPV1 and NF-κB in lung tissues was detected by Western blot, and real-time polymerase chain reaction was used to detect the expression of TRPV1 and NF-κB mRNA. Results:Compared with group C, the concentrations of IL-1β, TNF-α and IL-6 in BALF were significantly increased, OI was decreased, the W/D ratio and lung injury scores were increased, and the expression of TRPV1 and NF-κB protein and mRNA was up-regulated in group V ( P<0.05). Compared with group V, the concentrations of IL-1β, TNF-α and IL-6 in BALF were significantly decreased, OI was increased, the W/D ratio and lung injury scores were decreased, and the expression of TRPV1 and NF-κB protein and mRNA was down-regulated in A, D and DR groups ( P<0.05). Compared with group D, the concentrations of IL-1β, TNF-α and IL-6 in BALF were significantly increased, OI was decreased, the W/D ratio and lung injury scores were increased, and the expression of TRPV1 and NF-κB protein and mRNA was up-regulated in group DR ( P<0.05). Conclusions:The mechanism by which dexmedetomidine alleviates VILI is partially related to inhibition of the activation of TRPV1/NF-κB signaling pathway and inhibition of the inflammatory responses in lung tissues of rats.
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Objective:To evaluate the effects of dexmedetomidine on alveolar epithelial barrier function in rats with ventilator-induced lung injury (VILI), and the role of protein kinase C (PKC).Methods:One hundred clean-grade male Sprague-Dawley rats, weighing 270-320 g, aged 4-5 months, were divided into 5 groups ( n=20 each) using a random number table method: control group (group C), VILI group (group V), PKC inhibitor group (group B), dexmedetomidine group (group D), and dexmedetomidine plus PKC agonist group (DP group). The VILI model was developed by mechanical ventilation with a tidal volume of 40 ml/kg for 4 h in anesthetized animals.Group C breathed air autonomously for 4 h without mechanical ventilation.Group V was mechanically ventilated for 4 h. In group B, bisindolvlmaleimide I 0.12 mg/kg was injected intramuscularly 1 h before mechanical ventilation.In D and DP groups, dxmedetomidine 5.0 μg/kg was injected intravenously at 20 min before mechanical ventilation, and dexmedetomidine was intravenously infused at the rate of 5.0 μg·kg -1·h -1 during mechanical ventilation.In group DP, PKC agonist phorbol-12-myristic acid-13-acetate 15 μg/kg was intraperitoneally injected at 30 min before mechanical ventilation.At 4 h of mechanical ventilation, oxygenation index (OI), lung permeability index (LPI) and wet/dry lung weight (W/D) ratio were measured, the pathological changes of lung tissues were observed, and lung injury was assessed and scored.The expression of PKC, occludin and ZO-1 protein was detected by Western blot, and the expression of PKC mRNA, occludin mRNA and ZO-1 mRNA was determined by real-time polymerase chain reaction. Results:Compared with group C, OI was significantly decreased, LPI, W/D ratio and lung injury score were increased, the expression of PKC protein and mRNA was up-regulated, and the expression of occludin and ZO-1 protein and mRNA was down-regulated in V and DP groups ( P<0.05), and no significant change was found in the parameters mentioned above in B and D groups ( P>0.05). Compared with group V, OI was significantly increased, LPI, W/D ratio and lung injury score were decreased, the expression of PKC protein and mRNA was down-regulated, and the expression of occludin and ZO-1 protein and mRNA was up-regulated in B, D and DP groups ( P<0.05). Compared with group D, OI was significantly decreased, LPI, W/D ratio and lung injury score were increased, the expression of PKC protein and mRNA was up-regulated, and the expression of occludin and ZO-1 protein and mRNA was down-regulated in group DP ( P<0.05). Conclusions:Dexmedetomidine can reduce the damage to alveolar epithelial barrier function in rats with VILI, and the mechanism is related to inhibition of PKC activation and up-regulation of the expression of occludin and ZO-1.
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Objective To determine the epidemiological characteristics of measles in Jinshan District of Shanghai in 2002‒2019. Methods This study was a secondary data analysis using measles surveillance system and epidemiological case reports in Jinshan District from January 2002 through December 2019. Temporal characteristics of the disease onset was determined by a concentration method. ArcGis 10.4 and SaTScan 9.6 software were used for spatiotemporal clustering scanning analysis. Results From 2002 through 2019， a total of 289 cases of measles were reported in Jinshan District， Shanghai， with an average annual incidence of 2.24 per 105. The annual incidence fluctuated from 0 to 11.27 per 105. The highest incidence was recorded in 2005 （11.27 per 105）， followed by a decline； however， there was a rebound in 2008 （5.26 per 105） and 2015 （3.30 per 105）. The concentration M was determined to be 0.62， showing a clear seasonality concentrated in February to May. The spatiotemporal scan found that spatial and temporal clusters were more likely to occur in the areas with higher population density such as Zhujing Town and Shihua Community and between 2002 and 2009. The majority of measles cases were infants and children under the age of 1 and adults aged 20‒39 years. Approximately 66.78% of measles cases reported unknown vaccination history. In addition， in children aged 8 month to 4 years， the vaccination rate of measles-containing vaccines in the domestic migrants was much lower than the local residents （χ2=4.44， P=0.035）. Conclusion The incidence of measles in Jinshan District presents a downward trend. The population affected has a "two-way displacement"， which is concentrated in the more populated areas. It is necessary to strengthen measles surveillance and implement supplementary immunization programs with measles-containing vaccines for at-risk populations.
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The common clinical manifestations of spinocerebellar ataxia type 2 include ataxia, dysarthria, slower saccades, weakened or disappeared tendon reflexes, etc. It is relatively rare in patients with parkinsonism and cognitive impairment. Parkinsonism is rare in patients with spinocerebellar ataxia type 2, maybe because the degeneration of the substantia nigra striatum system is only manifested in the striatal presynaptic membrane, while the postsynaptic membrane receptors are relatively retained. At the same time, the degeneration of the subthalamic nucleus and the cerebellum prevents parkinsonism.The reason for cognitive decline may be related to the decrease in the network connection between the cerebellum and cerebral cortex in spinocerebellar ataxia type 2 patients.
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Objective:To investigate the accurrence and related factors of depression in patients with parkinson's disease (PD).Methods:One hundred PD patients with Parkinson′s disease (PD) were enrolled in Department of Neurology in Beijing Hospital from March to June 2019. The depressive mood, sleep status and health-related quality of life of PD patients were evaluated by Beck Depression Scale (BDI), Parkinson′s Disease Sleep Scale 2 (PDSS-2), and 8 items of Parkinson′s Disease Questionnaire (PDQ-8). Spearman correlation analysis and multivariate regression analysis were used to analyze the related factors of PD depression. Nonparametric test was used to analyze the differences between different sleep disorder domains in PD patients with depression.Results:The total score of BDI in 100 PD patients ranged from 0 to 44, with an average of 9.9±8.6 points; the total score of PDSS-2 ranged from 0 to 43, with an average of 12.0±9.2; the total scores of PDQ-8 ranged from 0 to 24, with an average of 6.4±6.0 points. The detection rate of depression in 100 PD patients was 42.0% (42/100), and the total BDI score of 22 patients with mild depression ranged from 10 to 15 with an average of 13.0±1.9; the total BDI score of 14 patients with moderate depression ranged from 16 to 25, with an average of 19.1±3.0; the total BDI score of 6 patients with major depression ranged from 28 to 44 points, with an average of 33.3±6.4. The depression in PD patients was positively correlated with PDQ-8 score ( t=8.908, P<0.01) and PDSS-2 score ( t=2.286, P=0.02); and 85.7% (36/42) of PD patients with depression had sleep disturbance. The score of sleep disturbance domain of PD patients with depression (9.8±3.9) was higher than that of nocturnal motor symptom domain (4.8±4.5) and nocturnal PD non-motor symptom domain (4.1±3.3) ( P<0.01). The scores of emotional health, relationship with loved ones, attention, communication ability dimensions of PDQ-8 were positively correlated with PD depression ( P<0.05). Conclusion:Depression is a common non-motor symptom of PD patients; and PD patients with depression suffer from reduced quality of life and are more prone to sleep disorders.
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Objective:To investigate the clinical features and associated chronic pain in corticobasal syndrome (CBS).Methods:Clinical data of 8 patients diagnosed as probable CBS or possible CBS admitted to Beijing Hospital during January 2010 to June 2020 were retrospectively analyzed. The clinical information included sex, age, course of disease, chief complaint, neurological examination, blood biochemistry, tumor marker, infection and other laboratory tests; the neuropsychological evaluation included Mini-Mental State Examination (MMSE) scale and Hamilton Depression Scale (HAMD); the imaging studies included cranial magnetic resonance imaging (MRI) and/or 18F-Fluorodeoxyglucose positron emission tomography ( 18F-FDG PET). Results:The main clinical manifestations were asymmetrical movement disorders, including rigidity, tremor, myoclonus and abnormalities in posture and gait. Patients showed poor response to levodopa treatment. Among 8 patients, 7 had apraxia, 5 patients had alien hand, and 5 patients had various degrees of cognitive dysfunction. The cranial MRI demonstrated mild cerebral atrophy which was slightly more severe in the contralateral side of the initially affected limb in 7 of the 8 patients. The 18F-FDG PET scan revealed asymmetric decreased metabolism in the frontal, parietal, temporal, and occipital lobe, as well as in basal ganglia, which was more severe in the contralateral side of the initially affected limb in 5 of the 8 patients. Six of the 8 patients were associated with pain, including dystonic pain in 3 patients, neuropathic pain in 1 patient, musculoskeletal pain in 1 patient, and unexplained pain in 1 patient. Pain was the onset symptom in 1 patient and pain was relieved by taking levodopa in another patient. Conclusions:CBS is characterized by asymmetric dyskinesia and cognitive impairment, and often associated with apraxia, cortical sensory deficits, and alien limb. The MRI and PET are helpful for CBS diagnosis. Pain may be one of the common non-motor symptoms in CBS.
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Objective To investigate measles antibody levels in healthy people in Jinshan District and their willingness to inoculate measles containing vaccines, and to explore the feasibility of supplementary immunization with adult measles vaccine. Methods People from 4 randomly selected community health service centers were enrolled and divided into groups of 15-19, 20-29, 30-39, and 40 years old and above. Serum was collected for measles antibody level detection and analysis according to the city and foreign household registration. In addition, a questionnaire survey on measles knowledge and vaccination willingness was conducted. Results Of the 234 participants for serum testing, the overall positive rate of measles antibodies (IgG) was 85.47%, and the protection rate was 35.47%. The difference in the positive rate of antibodies in different age groups was statistically significant (χ2=9.78, P=0.02), and the difference in the protection rate was also statistically significant (χ2=14.97, P<0.0012). The positive rate and protection rate were lowest in the group of 20-29 years old, which were 74.19% and 24.19%, respectively. A total of 490 questionnaires were sent out, and 477 questionnaires were effectively returned. Among the 5 questions about measles knowledge, the lowest correct rate was for the transmission route of measles, which was only 48.64%. The willingness to measles vaccination was 85.12%. Multivariate analysis showed that the willingness to vaccination was related to the level of awareness and health education. Conclusion The level of protective antibodies against measles was low in adults in Jinshan District. Health education on measles was insufficient. It is necessary to conduct measles health publicity in institutions with more concentrated personnel. In addition, appropriate measles serological monitoring and supplementary immunization should be carried out for key populations to increase the level of measles antibodies.
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BACKGROUND: Polyacrylamide hydrogels have good biocompatibility, but their mechanical properties are poor, which affect their application in the field of biomaterials. OBJECTIVE: To prepare the polyacrylamide-acrylic hydrogels with a particular size by micromolding graphical imprinting. METHODS: Polyacrylamide-acrylic hydrogel was prepared by sequentially mixing different volumes of polyacrylamide solution, acrylic acid and ammonium persulfate solution into an orifice plate containing a micromolded patterned seal. Group A: Polyacrylamide solution 1.4 mL, acrylic acid 0.1 mL; group B: Polyacrylamide solution 1.3 mL, acrylic acid 0.2 mL; group C: Polyacrylamide solution 1.2 mL, acrylic acid 0.3 mL; group D: Polyacrylamide solution 1.1 mL, acrylic acid 0.4 mL; group E: Polyacrylamide solution 1.0 mL, acrylic acid 0.5 mL; group F: Polyacrylamide solution 0.9 mL, acrylic acid 0.6 mL. Six groups of ammonium persulfate solution were all 50 µL. The patterned structure of the hydrogel was observed under a light microscope. The mechanical properties of the hydrogel were examined by an electronic universal testing machine. RESULTS AND CONCLUSION: Light microscope showed that the stripes on the surface of each group of hydrogels were clearly visible. The addition of acrylic acid effectively improved the mechanical properties of hydrogels. As the proportion of acrylic acid increased, the mechanical properties of hydrogels gradually increased. These results suggest that polyacrylic acid/acrylamide hydrogel has good mechanical properties and is expected to have good application prospects in the field of tissue engineering damage repair.
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Objective:To evaluate the effect of dexmedetomidine on the extracellular signal-regulated kinase(ERK)/sodium-potassium ATPase(Na + -K + -ATPase)signaing pathway in lung tissues of rats with mechanical ventilation-induced lung injury (VILI). Methods:Forty-eighty clean-grade male Sprague-Dawley rats, weighing 270-320 g, aged 4-5 months, were divided into 4 groups ( n=12 each) using a random number table method: control group (group C), VILI (alpha2-adrenergic receptor antagonist) group (group V), dexmedetomidine group (group D), and dexmedetomidine plus yohimbine group (group DY). Group C underwent no mechanical ventilation and breathed air spontaneously for 4 h. Mechanical ventilation (respiratory rate 40 breaths/min, tidal volume 40 ml/kg, inspiratory/expiratory ratio 1∶1, PEEP 0, fraction of inspired oxygen 21%) lasted 4 h in group V. Dexmedetomidine was infused intravenously in a dose of 5.0 μg/kg at 20 min before ventilation followed by an infusion of 5.0 μg·kg -1· h -1 throughout ventilation in group D. In group DY, yohimbine 0.1 mg/kg was injected intravenously at 10 min before dexmedetomidine, and the other treatments were similar to these previously described in group D. Blood samples and lung tissues were taken at 4 h of mechanical ventilation to determine the wet/dry weight ratio (W/D ratio), lung permeability index (LPI), alveolar fluid clearance rate (AFC), and expression of extracellular signal-regulated kinase (ERK), phosphorylated extracellular signal-regulated kinase (p-ERK), and Na + -K + -ATPase in lung tissues (by Western blot) and to observe pathological changes of lung tissues. Results:Compared with group C, LPI and W/D ratio were significantly increased, AFC was decreased, p-ERK expression was up-regulated, and Na + -K + -ATPase expression was down-regulated in group V and group DY ( P<0.05), and no significant change was found in the incidence of the parameters mentioned above in group D ( P>0.05). Compared with group V, LPI and W/D ratio were significantly decreased, AFC was increased, p-ERK expression was down-regulated, Na + -K + -ATPase expression was up-regulated ( P<0.05), and the pathological changes of lung tissues were significantly attenuated in group D, and no significant change was found in the incidence of the parameters mentioned above in group DY ( P>0.05). Compared with group D, LPI and W/D ratio were significantly increased, AFC was decreased, p-ERK expression was up-regulated, Na + -K + -ATPase expression was down-regulated ( P<0.05), and the pathological changes of lung tissues were accentuated in group DY. Conclusion:The mechanism by which dexmedetomidine alleviates VILI may be related to activating alpha2-adrenergic receptors and inhibiting ERK/Na + -K + -ATPase signaling pathway in rats.
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Objective:To investigate the characteristics of white matter lesions(WML)found by magnetic resonance imaging(MRI)and the relationship with clinical features in patients with Parkinson's disease(PD).Methods:This was a retrospective study by using a method of MRI T2WI-FLAIR.The WML in 87 PD patients were evaluated by using the Fazekas scale and Scheltens scale.Patients were divided into the early PD group[n=47, Hoehn-Yahr(H-Y)stage 1.0-2.0] vs.the middle-advanced PD group(n=40, H-Y stage 2.5-4.0), the non-depressed PD group(n=71) vs. the depressed PD group(n=16), the non-anxions PD group(n=62) vs.the anxions PD group(n=25). An ordinal regression model was used to investigate the correlations of WML with gender, age, Mini-Mental State Examination(MMSE)score, Unified Parkinson's disease Rating Scale-Ⅲ score(UPDRS-Ⅲ), Hamilton Rating Scale for Depression score(HAMD)and Hamilton Rating Scale for Anxiety score(HAMA). Results:Compared with the early PD group, the middle-advanced PD group showed that the WML were increased in lobe of brain(5.30±4.85 vs. 3.43±3.13, P<0.05), especially in the occipital lobe(0.48±0.99 vs. 0.11±0.31, P<0.05). There was no significant difference in the WML between the non-depressed/anxions and the depressed/anxions PD group.After being evaluated by the Scheltens scale, WML in periventricular hyperintensities(PVH)regions( OR=1.13, P<0.01), in brain lobe( OR=1.10, P<0.01)and in basal ganglia regions( OR=1.15, P<0.01)were correlated with age.WML in the brain besides the PV region were correlated with MMSE score( OR=0.68, P<0.01), especially in posterior horns( OR=0.60, P<0.01)and lateral ventricles( OR=0.68, P<0.05). WML in temporal lobe was correlated with MMSE score( OR=0.68, P<0.05). WML in brain lobe was correlated with H-Y stages( OR=2.10, P<0.05), especially in the occipital lobe( OR=3.33, P<0.05). WML in parietal lobe was associated with HAMD score( OR=1.13, P<0.05). WML in basal ganglia regions was related to diabetes( OR=6.34, P<0.05), especially in the putamen( OR=6.86, P<0.01). After being evaluated by the Fazekas scale, WML in PVH region( OR=1.16, P<0.01)and deep white matter hyperintensities( OR=1.13, P<0.01)were correlated with age.WML in PVH region were associated with MMSE score( OR=0.65, P<0.01). WML scores in PD patients had no correlation with gender, hypertension, coronary heart disease, hyperlipemia, UPDRS-Ⅲ score and HAMA score. Conclusions:The WML is present in PD patients, and it is correlated with age, diabetes, severity of disease, depression and cognitive function.
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Objective To analyze the impact of depressive symptoms on quality of life in patients with Parkinson's disease(PD)based on middle-and long-term follow-up study,and to explore predictors for the reduced quality of life in PD patients.Methods Clinical data of 80 PD patients were searched from the electronic database in our research center.Patients who had complete general information and the following data of unified Parkinson's disease rating scale(UPDRS),Hoehn and Yahr scale(HY),mini-mental state examination(MMSE),Hamilton depression rating scale(HAMD),Hamilton rating scale for anxiety(HAMA),the 39-item Parkinson's disease questionnaire(PDQ-39),etc.after one-year follow-up were included in this study.The differences in quality of life were analyzed and compared among the non-depression group (n =38),depression remission group (n =22) and depression group(n=20).A follow-up visit was conducted after four years.The disease progression and decline in quality of life were compared between the depression and non-depression groups according to the baseline value of the Hamilton Depression Rating Scale.According to the change in PDQ-39 value,cluster analysis was used to reclassify patients into fast-decline group and slow-decline group.Logistic regression analysis was used to determine independent risk factors for the decline of quality of life.Results At the end of 1 year follow-up,the quality of life was decreased in the depression group as compared with the baseline(P =0.017),and the score of PDQ-39 was higher in the depression group than in the non-depression group and depression remission group.At the end of 4-year follow-up,UPDRS total score,UPDRSⅢ score,HY stage and PDQ-39 score were increased as compared with the baseline,the quality of life decreased more significantly,and the disease progressed faster in the depression group than the other two groups(P ＜0.05).The differences in the disease course,total score of UPDRS,HY stage and HAMD score were statistically significant between the fast-decline group and slow-decline group(P =0.001,0.039,0.003 and ＜0.001,respectively).Logistic regression analysis showed that disease course (OR =1.254,P =0.020),and baseline HAMD score (OR =1.450,P =0.003) were the independent risk factors for the decline of quality of life.Conclusions The quality of life of PD patients is worse in the depression group than in the depression remission group and non-depression group.In PD patients with depressive symptoms,the illness progression is faster,and the quality of life is decreased more significantly.The disease course and depression can predict the decline of quality of life in PD patients.
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BACKGROUND: Clopidogrel is one of the most commonly used anti-platelet agents in cardiovascular diseases. We analyzed the relationship between the platelet function analyzer (PFA)-200 P2Y (INNOVANCE PFA-200 System, Siemens Healthcare, Germany) results and occurrence of major adverse cardiac events (MACEs) in Korean patients with recent-onset acute coronary syndrome (ACS) taking clopidogrel. METHODS: Between August 2013 and June 2016, we prospectively enrolled 106 patients with recent-onset ACS who had been treated with clopidogrel. We obtained blood samples and measured closure time (CT) using the PFA-200 P2Y test. Patients were divided into two groups on the basis of a CT cut-off value of 106 seconds. We compared patient characteristics and various MACEs that occurred during the follow-up period. RESULTS: The CTs for 78 patients exceeded the cut-off value. At the time of these analyses, 11 patients had been diagnosed with MACEs. In the time-to-event analysis, there was a difference between the two groups (P<0.001). After adjusting other variables associated with MACE occurrence, CT value was the strongest predictor of MACEs, with a 7.30-fold occurrence risk (P=0.002). CONCLUSIONS: We found a strong relationship between CT and MACE risk in Korean patients with recent-onset ACS taking clopidogrel. Accordingly, PFA-200 P2Y results could be used as a predictive marker for MACE risk in such patients.
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Humans , Acute Coronary Syndrome , Blood Platelets , Cardiovascular Diseases , Delivery of Health Care , Follow-Up Studies , Prospective StudiesABSTRACT
Objective@#To survey the prevalence and distribution of sleep disorders in patients with Parkinson disease (PD) and to analyze the influencing factors.@*Methods@#The prevalence and distribution of sleep disorders were surveyed with Parkinson Disease Sleep Scale (PDSS) among 206 PD patients. The association of sleep disorders with age, course of disease, cognitive function, motor function, depression, and the equivalent dose of levodopa (LED) was analyzed.@*Results@#The overall PDSS score in 206 patients was (116.9±21.4). The three most frequent items of sleep disorders were the overall sleep quality(181/206, 87.9%), difficulty in maintaining sleep(160/206, 77.7%)and nocturnal enuresis(151/206, 73.3%); the three least frequent items were early awaking(87/206, 42.2%), urinary incontinence(56/206, 27.2%)and hallucination(44/206, 21.4%). The three items with the lowest average scores were nocturnal enuresis(6.9±3.1), difficulty in maintaining of sleep(7.1±2.7)and overall sleep quality(7.1±2.0); three items with the highest average scores were audiovisual illusion(9.3±1.8), incontinence caused by motion disability(9.0±2.1) and early awaking with upper and lower limb pain(8.7±2.1). PD patients were divided into group 1 [Hoehn-Yahr(H&Y) stage 1.0-1.5], group 2 (H&Y stage 2.0-2.5) and group 3 (H&Y stage 3.0-4.0). One-way analysis of variance or non-parametric test showed that there were significant differences in the course of disease(F=21.91, P=0.00), total score and the subscale scores of Unified Parkinson Disease Rating Scale(UPDRS, UPDRS Ⅰ-Ⅳ) (F=90.67, χ2=12.86, F=31.20, F=60.17, χ2=24.01, all P<0.01), the Hamilton Rating Scale for Depression(HAMD) scores (χ2=11.06, P=0.00), LED (F=14.93, P=0.00) and Minimum Mental State Examination(MMSE) scores (χ2=9.81, P=0.01) among three groups. There was no significant difference in age and PDSS scores among three groups. The results showed that there were significant differences in terms of restless state and nocturnal dysphoria (F=5.12, P=0.01; F=3.27, P=0.04) between group 1 and group 3. The linear regression analysis showed that the HAMD and the LED scores had the greatest influence on PDSS score (R2=0.142, 0.196).@*Conclusion@#PD patients have a variety of sleep symptoms. The treatment of large doses of dopamine and depression contribute to the occurrence of PD sleep disorders.
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Objective To investigate the immunization coverage of oral live attenuated rotavirus vaccines and its influencing factors among children under 5 years old in Jinshan District of Shanghai in order to provide references for optimizing vaccination management in this area. Methods A cross-sectional study was conducted in 6 community vaccination clinics randomly selected from 12 vaccination clinics in Jinshan District. In each selected clinic,145 children under 5 years old were continuously recruited. Information on immunization status,demographics of children,family socioeconomic status and parents′knowledge of vacci-nation were collected through questionnaire interview. Logistic regression was used to analyze factors influen-cing immunization status by using SPSS22.0. Results Among the 863 participating children, the immuni-zation coverage rate of oral live attenuated rotavirus vaccines was 61.07%. Multivariate analysis revealed that children having an urban registration status (OR=2.21),better family income (OR=1.47) and par-ents with high recognition of rotavirus diarrhea (OR=8.56) and stronger intention to following "doctor′s suggestions" (OR=1.96) were more likely to accept oral live attenuated rotavirus vaccines, while those from families with a medical professional were less likely to be vaccinated (OR=0.57). Conclusion The immunization coverage rate of oral live attenuated rotavirus vaccines among children in Jinshan District were influenced by various factors such as children′s household registration status, household income, parents′knowledge regarding vaccination and doctors′suggestions. Health education on immunization should be strengthened and tailor-made to improve the coverage of oral rotavirus vaccination.
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Objective To analyze the clinical characteristics and related factors associated with impulse compulsive behaviors (ICBs) in Parkinson's disease (PD).Methods Two hundred and thirty-one PD outpatients were recruited from Beijing Hospital and Chinese Medicine Hospital of Pinggu District of Beijing from November 2012 to November 2015.Questionnaire for Impulse Compulsive Disorders in Parkinson's Disease (QUIP) was used to assess all subjects if they have ICBs or not.The general materials, medication utilized were recorded , and the related scales were used to evaluate PD patients.Intergroup analysis was made according to with or without ICBs.The Logistic regression analysis was adopted to analyze the relevance between incidence of ICBs and on-set age of PD, drinking tea or not, the 39-item Parkinson's Disease Questionnaire score, dosage of amantadine and dopamine agonist levodopa equivalent daily doses (DA-LEDD).Results Twenty-four cases of 231 outpatients were QUIP screening positive , and only 13 cases ( 5.63%) were diagnosed with ICBs as follows : hypersexuality in four ( 1.73%), compulsive shopping in two (0.87%), pathological gambling in one (0.43%), punding in eight(3.46%), dopamine dysregulation syndrome in two (0.87%) and with two or more ICBs in three (1.30%).Compared with non-ICBs group, ICBs group took more dopamine agonists (137.5(37.5, 175.0) mg/d vs 50.0(0, 125.0) mg/d, Z＝-2.175,P＝0.030), and had higher percentage of drinking tea (2/13 vs 3/218(1.4%),χ2＝11.369,P＝0.027).Logistic regression showed that higher dosage of dopamine agonist ( DA-LEDD≥100 mg/d,OR＝4.404, 95%CI 1.191-16.284,P＝0.026) was a risk factor for ICBs.Conclusions ICBs are not rare in Parkinson's disease, and punding is more common among the clinical phenotypes of ICBs. More dopamine agonists in PD (more than 100 mg/d) may be associated with about 4-fold increased odds of having ICBs.
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Objective To investigate the prevalence of depression in Parkinson's disease ( PD) patients, analyze the clinical features of depression in PD patients , and evaluate its impact on quality of life. Methods One hundred and ninety-five PD patients and 63 normol controls were recruited in this study.The detailed clinical information was documented.Unified Parkinson's Disease Rating Scale and Hoehn-Yahr stage were used to evaluate the severity of motor function impairment in PD patients.Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale were employed to assess the severity of depression and anxiety in PD patients.The 39-item Parkinson's Disease Questionnaire was applied to assess the quality of life.The cross-sectional data were calculated with SPSS 21.0 statistic software, and P ＜0.05 was considered statistically significant.Results The average score of HAMD was 8.74 ±5.51 in 195 PD patients.Depressive symptoms were found in 54.4%of the PD patients ( mild depression 48.7% and moderate depression 5.6%).Depression significantly impaired the quality of life in PD.Compared with PD without depression, PD with depression earned more scores in anxiety factor (4 (2, 5) vs 1(0, 2), Z＝ -8.69, P＝0.00), blocker factor (2 (1, 3) vs 0(0, 1), Z＝-7.95, P＝0.00), cognitive factor (1 (0, 2) vs 0(0, 0), Z＝-7.01, P＝0.00), sleep factor (2(1, 3) vs 0(0, 1), Z＝-6.42, P＝0.00) and despair factor (2 (1, 3) vs 1 (0, 1), Z＝-7.16, P＝0.00).There was no significant difference in day and night change (0(0, 0) vs 0(0, 0), Z＝-0.19, P＝0.85) and body weight (0(0, 0) vs 0(0, 0), Z＝-1.28, P＝0.20) between these two groups.The PD with depression obtained higher scores in total quality of life (30(22, 44) vs 14 (5, 24), Z＝-7.03, P＝0.00), motor function (6 (2, 13) vs 1 (0, 5), Z＝-3.67, P＝0.00), daily life ability (4 (1, 8) vs 1 (0, 4), Z＝-2.81, P＝0.01) , emotional health (5 (2, 11) vs 0 (0, 2), Z＝-5.82, P＝0.00), humiliation (2 (0, 5) vs 0 (0, 1), Z＝-3.10, P＝0.00), social support (0 (0, 1) vs 0 (0, 0), Z＝-2.86, P＝0.00), recognition function (4 (2, 6) vs 2 (0, 4), Z＝-2.87, P＝0.00), sociability(1(0, 3) vs 0(0, 1), Z＝-3.25, P＝0.00), and body pain (3 (1, 6) vs 1 (0, 2), Z＝-3.91, P＝0.00) than patients without depression.Conclusions Incidence of depression ( mainly mild ) in PD patients is high. Depressive symptoms significantly affect the quality of life of PD patients.