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Objective:To explore the scope, mode, anticoagulation mode and complications of blood purification in children with acute and critical illness.Methods:A total of 377 times of treatment of 102 children treated with blood purification in PICU at the First Affiliated Hospital of Xinxiang Medical College from January 2018 to December 2020 were retrospectively analyzed.Results:Among 102 critically ill children treated with blood purification, acute and chronic renal failure ranked the first in terms of disease distribution, with 23 cases in total, followed by 16 cases of severe viral encephalitis (meningoencephalitis), 11 cases of septic shock, seven cases of acute poisoning, five cases of severe allergic purpura, five cases of necrotic encephalopathy.In terms of clinical prognosis, 51(50.0%) cases were cured, 29(28.4%) cases were improved, 10(9.8%) cases died, and 12 cases abandoned treatment.In 2019, the blood purification application frequency was the highest, with a total of 47 cases, which was higher than those in 2018 and 2020( P<0.05). Continuous veno-venous hemofiltration was used in the largest number of children, with a total of 56 cases.There was a statistically significant difference in the application ratio of this mode during 3 years ( P<0.05), while there was no statistically significant difference in the application ratio of other modes.In terms of the selection of anticoagulation methods, the proportions of systemic anticoagulation and extracorporeal anticoagulation had significantly difference among different years( P<0.05), and the application of extracorporeal anticoagulation had increased year by year.There was no statistically significant difference in the proportion of patients without anticoagulants.The incidence of complications of blood purification was the highest in 2019, with catheter related thrombus in the majority (30 person-times), followed by hypothermia, catheter filter coagulation, hematoma formation, catheter related infection, hypotension, heparin-induced thrombocytopenia, etc.There was statistically significant difference in the total complications among different years( P<0.05). Conclusion:Blood purification is widely used in children with acute and critical illness, with a variety of diseases.The most commonly used mode is continuous veno-venous hemofiltration and in vitro anticoagulation.Catheter-related thrombosis is the most common complication.
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OBJECTIVE To optimize the preparation technology of baicalin （BCN）-glycyrrhizic acid （GA） solid nanocrystals （BCN-GA-SN）， to characterize them and investigate their in vitro release characteristics. METHODS According to the compatibility ratio of classic couplet medicinals “Scutellaria baicalensis-Glycyrrhiza uralensis”， the compatibility ratio of BCN and GA was determined as 6∶1 （m/m）； BCN-GA nanosuspension was prepared by precipitation method combined with high-pressure homogenization method. The preparation technology of BCN-GA nanosuspension was optimized by using mean particle size and polydispersity index （PDI） as indexes and with types and dosage of stabilizers， stirring speed and time， high-pressure homogenization pressure and frequency as factors. The freeze-dried consolidation process of BCN-GA nanosuspension was optimized to prepare BCN-GA-SN using average particle size， PDI and redispersibility index （RDI） as indicators， with the type and dosage of freeze-dried protective agents as factors； then， the physicochemical properties and in vitro release of BCN-GA-SN were investigated. RESULTS The optimal preparation technology of BCN-GA-SN was as follows： BCN-GA nanosuspension was prepared by using 15% sodium dodecyl sulfate as a stabilizer， stirring at 1 000 r/min for 15 minutes， and homogenizing at 100 MPa for 20 times； then， BCN-GA nanosuspension was freeze-dried and solidified with 5% mannitol （corresponding to the dosage of BCN）. The average particle size of prepared BCN-GA-SN was （442.2±5.7） nm with PDI of 0.225±0.015 and RDI of 1.055± 0.013. The prepared BCN-GA-SN presented as the irregularly spherical shape with more uniform size； the drug-loading amount of BCN in the nanocrystal was （62.5±0.7）%， and that of GA was （9.4±0.2）%； the in vitro release results showed that the cumulative dissolution of BCN-GA-SN was higher than that of the physical mixture of BCN and GA. CONCLUSIONS BCN-GA-SN is prepared successfully in this study with uniform particle size and even distribution， which can effectively improve the dissolution of BCN.
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Objective:To explore the local prevalence of early cognitive dysfunction after a stroke in some hospital of Qinghai province, analyze its risk factors and construct a risk factor model.Methods:A prospective cross-sectional survey was conducted among 854 stroke patients at 3 hospitals in Qinghai Province. The survey solicited demographic data, clinical data, and information about the respondents′ diet and leisure activities. Within 14 days after stroke onset, all of the participants′ cognitive performance was quantified using the Mini-Mental State Examination (MMSE). Those with scores ≤27 formed the cognitive impairment group ( n=569), while the rest were the normal cognition group ( n=285). Through univariate analysis and multivariate logistic regression analysis, the relationship between each factor and the outcome was clarified, and a prediction model was established in the form of a regression equation. The model′s receiver operating characteristics (ROC) curve was computed. Results:The incidence of acute cognitive impairment after stroke was 66.6%. Univariate analysis showed that there were significant differences between the two group in terms of age, sex, ethnicity, education, occupation, altitude, living with a spouse and social support. Stroke type, hemiplegia, a history of hypertension, and triglyceride and D-2 polymer levels were significant predictors, as were ADL score, leisure activity level, and weekly consumption of fruits, nuts and salt. The multivariate logistic regression analysis showed that age, being female, hemorrhagic stroke, hypertension, and living at high altitude were independent risk factors for cognitive impairment at the acute stage of stroke. However, education, occupation, leisure activity and consumption of triglycerides and nuts were independent protective factors. The prediction model showed an area under the ROC curve of 0.832, with sensitivity of 0.698 and specificity of 0.814.Conclusions:The prevalence of cognitive dysfunction in the acute stage of stroke is high in some hospital of Qinghai province. Age, being female, hemorrhagic stroke, hypertension and high altitude living are independent risk factors for stroke, while education, an occupation, leisure activity and triglyceride and nut consumption are protective factors. The risk factor model established in this study has good predictive ability with this population, with whom it can be used to formulate interventions to improve the life quality of stroke survivors.
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Objective:To evaluate the effect of superior cervical ganglion block (SCGB) on cardiac function and nucleotide like receptor protein 3 (NLRP3) signaling pathway in a rat model of myocardial ischemia-reperfusion (I/R).Methods:Sixty healthy SPF male Sprague-Dawley rats, weighing 250-300 g, aged 2-3 months, were divided into 4 groups ( n=15 each) using a random number table method: sham operation group (sham group), myocardial I/R group (IR group), myocardial I/R + normal saline group (IR+ NS group), and myocardial I/R + SCGB group (IR+ SCGB group). Myocardial I/R model was developed by ligation of the left anterior descending branch of the coronary artery for 45 min followed by restoration of blood flow in anesthetized aninals. IR+ SCGB group received SCGB (0.25% ropivacaine 0.1 ml) at 10 min before reperfusion once a day for 2 consecutive weeks, while 0.9% sodium chloride was given instead of ropivacaine in IR+ NS group. Blood samples were collected at 24 h and 14 days of reperfusion for determination of serum concentrations of norepinephrine (NE), troponin T (TnT), tumor necrosis factor-alpha (TNF-α), interleukin-18 (IL-18) and IL-1β by enzyme-linked immunosorbent assay. Echocardiography was performed before ischemia and at 14 days of reperfusion, and left ventricular short axis shortening rate (FS), ejection fraction (EF), and cardiac output (CO) were measured. The rats were sacrificed at 14 days of reperfusion and the hearts were taken for determination of the contents of norepinephrine (NE) in myocardial tissues in the infarction area (by enzyme-linked immunosorbent assay), percentage of myocardial fibrosis area (by Masson staining), M1 macrophage marker CD68 + cell count in the infarction area (by immunohistochemical method), and expression of NLRP3 and gasdermin D (GSDMD) in myocardial tissues (by Western blot). Results:Compared with Sham group, the serum concentrations of TnT, TNF-α, IL-18 and IL-1β, percentage of myocardial fibrosis area, and NE levels in serum and myocardial tissues were significantly increased, the expression of NLRP3 and GSDMD in myocardial tissues was up-regulated, CD68 + cell count was increased, and EF, CO and FS were decreased in IR group ( P<0.05). Compared with IR group, the serum concentrations of TnT, TNF-α, IL-18 and IL-1β, percentage of myocardial fibrosis area, and NE levels in serum and myocardial tissues were significantly decreased, the expression of NLRP3 and GSDMD in myocardial tissues was down-regulated, CD68 + cell count was decreased, and EF, CO and FS were increased in IR+ SCGB group ( P<0.05), and no statistically significant changes were found in the parameters mentioned above in IR+ NS group ( P>0.05). Conclusions:SCGB can improve the cardiac function in a rat model of myocardial I/R, and the mechanism may be related to the inhibition of NLRP3 signaling pathway.
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Objective:To conduct a meta-analysis for the effects of ultra-early postoperative rehabilitation on hospital stay, complications and vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods:PubMed, Embase, Cochrane Library, WOS, CNKI, CBM and Wanfang databases were searched by computers to collect control studies on ultra-early rehabilitation of aSAH. The retrieval time limit was from the establishment of the databases to August 2021. The methodological quality of the included literature was evaluated according to Cochrane Handbook Systematic Reviews Interventions, and the Revman 5.2 software was used for meta-analysis.Results:A total of 5 articles were obtained, with a total of 413 patients. The methodological quality of the 5 studies was lower (grade C). The results of the meta-analysis showed that the average length of stay in the intervention group (mean difference –4.14, 95% confidence interval [ CI] –10.69-2.42; P=0.22] and the incidence of complications (odds ratio 0.86, 95% CI 0.40-1.83; P=0.70) were lower than those in the control group, but there was no significant difference. The incidence of cerebral vasospasm in the intervention group was lower than that in the control group, and there was significant difference (odds ratio 0.31, 95% CI 0.18-0.53; P<0.001). Conclusions:Postoperative ultra-early rehabilitation in patients with aSAH can reduce the incidence of cerebral vasospasm without increasing the incidence of complications. Therefore, the ultra-early rehabilitation can be considered. The methodological quality of the literature included in this study is lower, and high-quality randomized controlled trials are needed to further verify the effects of ultra-early rehabilitation on hospital stay, complications, and cerebral vasospasm.
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OBJECTIVE To study the effects of self-assembled nanoparticles from Shaoy ao gancao decoction （SGD-SAN）on the in vitro release and intestinal absorption of the main components of Glycyrrhiza uralensis . METHODS Gancao single decoction （GSD），Shaoyao single decoction （SSD），mixed suspension of Shaoyao and Gancao single decoction （MSSGD）and SGD （i.e. Shaoyao-Gancao decoction ）were prepared ，and SAN was characterized. HPLC method was adopted to determine the contents of 7 main components （liquiritin apioside ， liquiritin， isoliquiritin apioside ， isoliquiritin， liquiritigenin， glycyrrhizic acid ， isoliquiritigenin）in G. uralensis . The dialysis bag method was used to investigate the effects of the formation of SGD-SAN on in vitro release of 7 main components in G. uralensis with pH 1.2 HCl solution and pH 6.8 phosphate buffered solution （PBS）as release media. Single-pass intestinal perfusion study was performed to investigate the effects of the formation of SGD-SAN on the intestinal absorption of 7 main components from G. uralensis . RESULTS SAN with particle size of 200-300 nm and polydispersity index of 0.3-0.5 was found in GSD ，MSSGD and SGD. GSD-SAN and MSSGD-SAN were in rod shape while SGD-SAN was irregularly spherical under transmission electron microscope. The results of in vitro release study showed that the formation of SGD-SAN could significantly increase in vitro release of liquiritigenin ，isoliquiritigenin and glycyrrhizic acid ，and had no effect on other components of G. uralensis in pH 1.2 HCl solution. The formation of SGD-SAN also had no effect on the release of each component from G. uralensis in pH 6.8 PBS. The results of intestinal perfusion experiments showed that the formation of SGD-SAN could significantly promote the absorption of each component from G. uralensis in the ileum. CONCLUSIONS- The formation of SGD-SAN significantly improves the in vitro release of poorly soluble components from G. uralensis and promotes the intestinal absorption of main components from G. uralensis ，which is the physical structure basis for the compatibility and synergy of Paeonia lactiflora and G. uralensis .
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Objective:To evaluate the cognitive function of elderly inpatients in Qinghai and analyze the influencing factors in this prospective study.Methods:A total of 1077 elderly inpatients were enrolled for general information investigation, including the Mini Nutritional Assessment-Short form(MNA-SF), Geriatric Depression Scale 15(GDS-15), FRAIL Scale, activities of daily living(ADL), instrumental ability of daily living(IADL)and the Mini-Mental State Examination(MMSE).Results:The 1077 elderly inpatients being subjected in this study, included 470 in the cognitive impairment(CI)group and 607 in the normal group.The prevalence of CI in hospitalized elderly patients was 43.64%(470/1077). The results of univariate analysis showed that as compared with the normal group, the proportion of cognitive impairment was higher in female, elder patients, and boiling tea-drinker, otherwise the proportion of CI was lower in patients living with the spouse, normal sleep, often eating beef and mutton( P<0.01 or P<0.05); FRAIL Scale, ADL total score, and IADL total score were higher in the normal group than in the CI group( P<0.01); the elderly depression score and frailty score were higher in the CI group than in the normal group( P<0.01). The results of logistic regression analysis showed that the risk of CI was higher in female and people frequently drinking boiling tea than in male and people not frequently drinking boiling tea( OR=0.740, 1.211, both P<0.05), and that frequent consumption of beef and mutton, and reasonable levels of nutrition, ADL, and IADL were protective factors for CI in elderly hospitalized patients( OR=0.780, 0.938, 0.956, 0.895, all P<0.05). Conclusions:The incidence of cognitive impairment in hospitalized elderly patients in Qinghai is relatively high.Female and often drinking boiling tea may increase the risk of cognitive impairment.Regularly eating beef and mutton, reasonable levels of nutrition, maintaining good daily life ability can delay cognitive impairment.
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Objective:To investigate the prevalence of mild cognitive impairment(MCI)in elderly inpatients in high altitude areas, analyze the influencing factors, and then construct a risk factor model.Methods:A cross-sectional random sampling method was used to conduct a questionnaire survey among elderly patients over 65 years old hospitalized at Qinghai Provincial People's Hospital from October 2018 to February 2019.The survey contents included demographic data, lifestyles, physical activities and cognitive function.The occurrence of MCI was analyzed with descriptive epidemiological measures, a predictive model of influencing factors was established using Logistic regression analysis, and influencing factors were ranked.Results:There were a total of 1412 elderly people aged 65 and above, with 760 males, accounting for 53.8%.The ages of respondents ranged between 65-82 years, with an average age of(72.8±5.8)years.Of the subjects, 600 had MCI, with a prevalence of 42.4%.Male( OR=1.318, P=0.02), junior high school education or above( OR=0.521, P<0.001), bedriddenness( OR=2.658, P=0.002), lifestyle( OR=0.702, P=0.011), abnormal defecation( OR=1.625, P=0.005)and frailty( OR=1.536, P=0.002)were included into the predictive model of influencing factors.The area under the ROC curve in this study was 0.676(95% CI: 0.648-0.704), with sensitivity=0.553, specificity=0.741, and Youden index=0.274.When ordered by importance, the independent risk factors were frailty, male, abnormal defecation, bedriddenness, lifestyle, and education level. Conclusions:Male, frailty, abnormal defecation and long-term bedriddenness are risk factors for cognitive impairment in elderly people, whereas living with a partner and education above junior high school are protective factors.
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Candida auris ( C. auris) is a recently emerged multidrug-resistant fungal pathogen, featured by difficulty in identification, high mortality and easy spread in hospital environments. Furthermore, C. auris is resistant to various frontline antifungals. However, the mechanisms governing drug resistance remain unclear. This review summarized the mechanisms of triazole resistance in C. auris, including ERG11 missense mutations or overexpression, the activity of efflux pumps, missense mutations in TAC1 B, the gain of an extra copy of chromosomeⅤ, the role of Hsp90 and biofilm formation. In addition, the factors associated with the resistance to other drugs including echinocandins, polyenes, nucleoside analogues and acrylamide were also reviewed.
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Objective@#To analyze the status of serum 25 hydroxyvitamin D[25 (OH)D] in children aged 0-6 years in Gansu Province, and to analyze the relationships between 25 (OH)D and age, seasonal characteristics and physical development, so as to provide a scientific reference for supplementing vitamin D for children in due time.@*Methods@#Stratified random cluster sampling method was used to select a total of 9 790 children aged 0-6 years from 6 cities and prefectures maternity and child health institutions in Gansu Province for health examination from January 2019 to December 2020. Serum 25 (OH)D concentration from 1 mL peripheral blood was tested by enzyme linked immunoassay. Subjects were classified into overweight and normal figure groups based on weight for height.@*Results@#the serum 25 (OH)D level M(P 25 ,P 75 ) of the children aged 0-6 was 81.31(63.14, 95.86)nmol/L. The detection rate of 25 (OH)D deficiency and insufficiency was 45.11%. The serum 25 (OH)D level of children 4- 6 years old was significantly lower than that of infants <1 year old and children 1-<4 years old, and the detection rate of 25 (OH)D deficiency and insufficiency was highest among 4-6 years old( χ 2=83.67, P <0.05). In winter the proportion of 25 (OH)D insufficiency and deficiency was highest (55.82%) ( χ 2=194.12, P <0.01). For overweight children, the abnormal rate of 25 (OH)D (19.83%) was significantly higher in autumn ( P <0.01).@*Conclusion@#Children s vitamin D levels were associated with age, season and physical development. Vitamin D surveillance should be focused on ages less than 1 year old and above 4 years old, winter should be an important season. For overweight children, autumn should be the focus period for vitamin D deficiency prevention.
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@#Alzheimer''s disease (AD) is the most common cause of senile dementia, accounting for an estimated 60% to 80% of cases, but there are no approved drugs to slow or stop the progressive clinical decline in the past years.Amyloid cascade hypothesis is recognized as the major etiologic basis for AD, however, the failures of several amyloid plaque-targeted programs have led many to dismiss the amyloid beta (Aβ) hypothesis of AD. Several reports show that soluble oligomers of Aβ (AβOs), which appear in brains more than 10 years before the clinical syndrome, are more toxic than Aβ plaque, causing synaptic dysfunction and neuronal apoptosis. Some agents that can effectively inhibit Aβ oligomer formation or block their toxicity made significant efficacy in clinical 2 and 3 trials, with the potential to be approved for the treatment of AD. This article reviews the recent development of AD drugs targeting Aβ oligomers, analyzes their structural characteristics, mechanism of action, preclinical and clinical data, and discusses the future direction of AD treatment, thus providing new strategies for AD drug research.
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Five patients with mediastinal bronchogenic cyst (MBC) were treated with endoscopic submucosal tunnel dissection (ESTD) between January 2018 and October 2019 at the Department of Gastroenterology in Henan Provincial People′s Hospital. Lesions were located in the middle or lower esophageal level, with diameters≤3.5 cm. The tunnel establishment time was 13-18 min, and the tumor stripping time was 30-51 min. The number of titanium clips used for tunnel closure was 5-8. The tumors were completely resected. No major bleeding or hypoxemia occurred during the operation and no serious adverse reactions occurred after the operation. Postoperative pain scores were all ≤3. The hospital stay was 4-7 days. There was no tumor residue and recurrence during 4-23 months of follow-up.It is suggested that ESTD for MBC which derived from post mediastinum and located at the lower or middle level esophagus is safe and effective.
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Objective:To analyze the changes in biological characteristics including infectivity, growth and pathogenicity of Chlamydia muridarum ( Cm) after serial passage in vitro in special conditions in order to provide reference for screening attenuated live vaccines and virulence-related genes. Methods:Wild-type Cm strain (G0) was cultured for several passages using conventional cell culture method under alternate unassisted and assisted culture conditions. Then, the 28th generation (G28) of Cm was selected and compared with the parental G0 strain in terms of centrifugation dependence, attaching ability, intracellular growth curve, plaque size and fallopian tube lesions after genital tract infection in a mouse model. Results:Compared with the parental G0 strain, the G28 strain showed significantly decreased dependence on centrifugation during cell infection ( P<0.05) and increased attachment capacity to cells ( P<0.05). No significant differences were observed in the growth curves 32 h after cell infection or in the plaque sizes between the parental G0 and G28 strains. In the in vivo virulence test, fallopian tube lesions were observed in 87.5% of G0-infected mice and 37.5% of G28-infected mice ( P<0.05). Conclusions:Compared with the parental G0 strain, the G28 strain showed significantly enhanced in vitro infection ability, but decreased in vivo pathogenicity, which brought hope for further identification of virulence genes, isolation of attenuated strains with single genotype and development of live attenuated Chlamydia vaccines.
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Objective:To evaluate the effects of stellate ganglion block (SGB) on the activation of M1 microglia during cerebral ischemia-reperfusion (I/R) in rats.Methods:Fifty-four SPF healthy male Sprague-Dawley rats, aged 8-10 weeks, weighing 240-270 g, were divided into 3 groups ( n=18 each) using a random number table method: sham operation group (group Sham), cerebral I/R group (group IR) and SGB group.Blood vessels were only exposed, without occlusion in group Sham.Cerebral I/R was induced by occlusion of the middle cerebral artery for 90 min followed by reperfusion in group IR.Cervical sympathetic trunk transaction was performed to induce left SGB immediately after onset of reperfusion in group SGB.Blood samples were collected from the apex of the heart at 6, 12 and 24 h of reperfusion for determination of the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β in the serum (using enzyme-linked immunosorbent assay). The animals were sacrificed after the neurological function was evaluated at 24 of reperfusion, and brain tissues were removed for microscopic examination of the pathological changes in cortex, for determination of percentage of cerebral infarct size (by TTC staining), for assessment of cell apoptosis and apoptosis rate in cortex (by TUNEL), and for determination of the expression of microglial biomarker Iba-1 and activated M1 microglia biomarker CD68 (by Western blot). Results:Compared with group Sham, the neurological function score, percentage cerebral infarct size, apoptosis rate in cortex, concentrations of TNF-α, IL-6 and IL-1β in the serum, and the expression of Iba-1 and CD68 were significantly increased in IR and SGB groups ( P<0.05). Compared with group IR, the neurological function score, percentage cerebral infarct size, apoptosis rate in cortex, concentrations of TNF-α, IL-6 and IL-1β in the serum, and the expression of Iba-1 and CD68 were significantly decreased in group SGB ( P<0.05), and the pathological changes of brain tissues were significantly attenuated in group SGB. Conclusion:The mechanism by which SGB reduces cerebral I/R injury is related to inhibiting activation of M1 microglia in rats.
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Objective:To investigate the effect of the timing of intra-aortic balloon counterpulsation (IABP) treatment on the clinical efficacy of patients after severe cardiac surgery.Methods:A prospective study was conducted on 64 patients with IABP after cardiac surgery in Gaozhou People′s Hospital of Guangdong Province from March 2018 to March 2020.According to the time of IABP treatment, 33 patients were divided into early treatment group (severe cardiac surgery<6 h) and late 31 cases in treatment group (≥6 h after severe cardiac surgery): two groups of mean arterial pressure(MAP), left ventricular ejection fraction (LVEF), mechanical ventilation time, IABP indwelling time, ICU stay time, central venous oxygen saturation(ScvO2), N terminal pro B type natriuretic peptide(NT-proBNP), lactate clearance rate, complications and follow-up.Results:After 48 hours of IABP, MAP and LVEF in the early treatment group were (79.47±7.07) mmHg and (45.20±3.86)%, respectively, and those in the late treatment group were (71.38±6.26) mmHg and (41.66±4.49)%.There were significant differences between the two groups ( t value was 34.604, 29.375 respectively all P<0.01). The mechanical ventilation time (71.56±5.98) h, IABP indwelling time (68.31±10.10) h, ICU stay time (5.84±1.04) d in the early treatment group, and those in the late treatment group (82.79±4.96) h, (89.49±9.97) h, (6.82±1.07) d. There were significant differences between the two groups ( t value was 70.093, 72.855, 31.859 respectively, all P<0.01). The ScvO 2, NT-pro BNP and lactate clearance rate in the early treatment group were (71.66±5.45)%, (1 698.36±1 032.98) ng/L and (30.12±2.29)%, respectively at 48 hours after IABP, and those in the late treatment group (66.03±4.61)%, (2 898.43±1 383.29) ng/L and (20.47±1.92)%.There were significant differences between the two groups ( t value was 38.279, 34.379 respectively, all P<0.01). The incidence of complications were 18% (6/33) and 41.94%(13/31) in the early treatment group and the late treatment group.There was significant difference between the two groups( P=0.038). Conclusion:Early use of IABP treatment can improve the patients′ hemodynamic and serological indicators, reduce the patient′s mechanical ventilation time, IABP time, ICU monitoring time and complications.
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Chronic obstructive pulmonary disease (COPD) is well known as a chronic lung disease. In recent years, with the deepening of its understanding, various complications of COPD, especially pulmonary hypertension(PH) have received more and more attention. COPD patients with PH have an increased fatality rate and a poor prognosis, which seriously affects the quality of life of the patients, and the treatment of the disease lacks effective drugs. In order to fully understand the current status of the treatment of the disease, the research progress of the drug treatment of COPD combined with PH was reviewed. The results show that for patients with COPD and PH, the best treatment should be given to their underlying diseases. The use of statins and fasudil may be beneficial, but the effect of targeted drugs is still controversial. In the future, more large randomized controlled trials need to be carried out to further clarify the efficacy of various drugs on COPD.
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Objective To study the relationship between the quality of Astragalus membranaceus and soil in Gansu Minle. Methods we sampled the medicinal materials and soils of Astragalus membranaceus in Minle County, and determined the medicinal quality, soil factors and heavy metal elements by high performance liquid chromatography, ultraviolet spectrophotometry, atomic absorption spectrophotometry, and etc. Results The quality of Minle Astragalus meets the requirements of the Pharmacopoeia standards and is low on the risk of heavy metal pollution. There was a significant negative correlation between the extract and the available potassium. There was a significant positive correlation between the astragaloside IV and the available potassium. There was a highly significant positive correlation between calycosin-7-glucoside and soluble salt. There was a significant positive correlation with available potassium, and a significant negative correlation with pH. Among them, soil pH value is the most important factor affecting the content of astragalus extract, astragaloside IV and verrucous glucoside, followed by total phosphorus, organic matter and total nitrogen. Conclusion The results revealed that the soil factors is the main influencing factor of the quality of Astragalus membranaceus in Minle County, which can provide a theoretical basis for the standardized cultivation of Astragalus membranaceus in Minle County.
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Objective@#To investigate the clinical effect of diced cartilage in correcting nasal alar base depression after cleft lip surgery.@*Methods@#A retrospective study was conducted in 15 patients of nasal deformity after lip surgery from January 2018 to January 2019. All the patients were taken from autologous costal cartilage to reconstruct the outline of nasal malformation, and the remaining autologous costal cartilage was cut into 0.5-1.0 mm pieces and filled into the basilar lacunar space of the nasal alar by the 1 ml syringe whose anterior needle nipples was removed. The effects of visual images before and after operation were compared and analyzed by Adobe Photoshop CS6 software. The patients were followed up for 6-15 months (mean 10months). The satisfaction and complications of the patients were investigated.@*Results@#The nasal alar base was significantly elevated and the outline of the nasal deformity was improved in 15 patients after operation. The overall effect was satisfactory and no obvious complications were found. No obvious absorption was found in the follow-up.@*Conclusions@#The application of diced cartilage to correct the nasal alar base depression after cleft lip surgery was a feasible method with important clinical value. It advanced in taking good use of the remaining cartilage and reducing the damage to both the donor and recipient area.
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Objective:To culture and identify dermal mesenchymal stem cells (DMSCs) in skin lesions of patients with psoriasis, and to determine the expression of hairy and enhancer of split-1 (HES1) and chemokine ligand 6 (CXCL6) in DMSCs.Methods:DMSCs were isolated from skin lesions of 15 patients with psoriasis and normal skin tissues of 18 healthy controls, and then subjected to culture. Cell phenotypes were identified by flow cytometry, and mRNA and protein expression of HES1 and CXCL6 was determined by real-time fluorescence-based quantitative PCR (RT-PCR) and Western blot analysis respectively. Comparisons were performed between 2 groups by using t test. Results:There was no difference in the morphology of DMSCs between the psoriasis group and control group. The mRNA expression of HES1 and CXCL6 in the psoriasis group was 3.56 and 3.44 times that in the control group respectively, and there was a significant difference between the two groups (both P < 0.05) . The protein expression of HES1 and CXCL6 in DMSCs was significantly higher in the psoriasis group than in the control group (both P < 0.05) . Conclusion:The high expression of HES1 and CXCL6 in DMSCs from lesions may be involved in the occurrence of psoriasis.
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Objective@#To study the tissue size, calcification characteristics and the correlation between calcification and age and lateral side of 6, 7 and 8 costal cartilage in women, so as to provide reference for clinical application.@*Methods@#From the radiology storage center of Second Xiangya Hospital, 70 cases of female costal cartilage were treated with dual-source CT three-dimensional reconstruction. The reconstructed images were treated with maximum intensity projection (MIP) and volume reconstruction (VR). The length, width and thickness of bilateral 6, 7 and 8 costal cartilage were measured by VR images, and the correlation between calcification rate, calcification degree, calcification type, calcification location, calcification with age and side was observed and analyzed on VR and MIP images. The data were analyzed by SPSS 20.0 and compared by corresponding statistical method, including independent sample t test, chi-square test, logistic regression analysis and variance analysis.@*Results@#(1) The length of costal cartilage on the left was (98.7 ±12.7) mm, (132.8 ±13.8) mm, (81.5 ±11.6) mm, width (12.6 ±1.5) mm, (11.0 ±1.4) mm, (7.4 ±1.1) mm, thickness (8.1 ±0.5) mm, (7.7 ±0.6) mm, (6.6 ±0.6) mm. On the right side, the length of costal cartilage was (95.8 ±11.3) mm, (133.1 ±12.0) mm, (81.7 ±12.3) mm, width (12.2 ±1.4) mm, (11.11 ±1.5) mm, (7.4 ±1.1) mm, thickness (8.2 ±0.6) mm, (7.7 ±0.5) mm, (6.5 ±0.6) mm. There was no significant difference in the length, width and thickness of the left and right sides of the costal cartilage in the same sequence (P>0.05). There were significant differences in length, width and thickness between unilateral costal cartilage with different ordinal numbers (P<0.01). (2) The total calcification rates of left and right costal cartilage were 61.9% (130/210) and 60.0% (126/210), respectively, and there was no significant difference between the two groups (The chi-square was equal to 0.160. The P value was equal to 0.689), but there was no significant difference in left and right total calcification types, total calcification location and total calcification count (P>0.05). There was no significant difference in the total calcification type between left and right, the total calcification location and the total calcification degree count (P>0.05). There was also no significant difference between the two groups (P>0.05). There was no significant difference in the calcification rate between the left and right sides of the 6th, 7th and 8th costal cartilage, but there was significant difference in the total calcification types of the 6th, 7th and 8th costal cartilage (The chi-square was equal to 61.541, P value was less than 0.001). (3)The relationship between calcification rate and age was analyzed by univariate analysis and logistic regression equation. The higher the age, the higher the calcification rate. The relationship between the calcification degree and age of the 6th, 7th and 8th costal cartilage was tested by variance test, and the regression equation showed that the calcification degree of the 6th, 7th and 8th costal cartilage was higher with the age.@*Conclusions@#Preoperative three-dimensional reconstruction and image post-processing of costal cartilage with dual-source CT can accurately measure the amount of cartilage tissue and define the characteristics of calcification, so as to guide the clinical selection of costal cartilage that meets the requirements of operative method. In female patients of different ages undergoing rhinoplasty and external ear reconstruction, the calcification rate of costal cartilage increased with age, but there was no positive correlation. With the increase of calcification with age, artificial materials can be used for cases with severe calcification to avoid the blindness of surgery.