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Objective:To explore the effect of minimally invasive hematoma puncture and drainage in the treatment of elderly patients with cerebral hemorrhage by using 3D slicer and Sina software to conduct 3D reconstruction and preoperative localization of intracerebral hematoma.Methods:A total of 74 elderly patients with a first-onset intracerebral hematoma aged ≥75 years, having surgical indications and stable vital signs were grouped into 3D slicer plus Sina software localization group(as group A, n=40)or CT localization group(as group B, n=34). Based on the localization, hematoma puncture and drainage were performed after local anesthesia.Preoperative preparation time, hematoma location, puncture success rate, postoperative hematoma clearance rate, postoperative re-bleeding rate and GCS score were statistically analyzed.Glasgow coma scale(GCS)scores were used in predicting the mortality.Results:The preoperative preparation time was significantly shorter in group A than in group B[(5.5±3.4)min vs.(8.5±2.7)min, t=3.337, P=0.001]. The success rate of hematoma puncture and drainage(90.0% and 70.6%, χ2=4.51, P=0.034)and postoperative hematoma clearance rate[(87.5±3.4)% and(80.3±2.7)%, t=10.10, P=0.000]were higher in group A than in group B. There were no significant differences in operative time, the accuracy of hematoma localization, re-bleeding rate and GCS score between the two groups( P>0.05). Conclusions:3D slicer plus Sina software can precisely locate the intracerebral hematoma, and minimally invasive hematoma puncture and drainage of intracerebral hematoma under local anesthesia were safe and effective in the treatment of elderly patients with intracerebral hemorrhage.
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OBJECTIVE：To optimize the processing technology of Paeonia lactiflora stir-baked with wine ，and to investigate its in vitro anticoagulant effect. METHODS ：The weight coefficient of each index was determined and the comprehensive score was calculated with analytic hierarchy process （AHP），Criteria Importance Though Intercrieria Correlation （CRITIC）and AHP-CRITIC weighting method ，using the contents of oxypaeoniflorin ，albiflorin，paeoniflorin，benzoic acid and water-soluble extract as index. Box-Behnken response surface methodology was used to optimize the parameters of P. lactiflora stir-baked with wine ，such as moistening time ，frying time and frying temperature. Then in vitro anticoagulant experiment was used to investigate the pharmacodynamics of P. lactiflora stir-baked with wine prepared according to the optimal processing technology. RESULTS ：The weight coefficients of albiflorin ，oxypaeoniflorin，paeoniflorin，benzoic acid and water-soluble extract determined by AHP-CRITIC weighting method were 0.233 9，0.131 7，0.183 3，0.078 9，0.372 3，respectively；the optimal processing technology of P. lactiflora stir-baked with wine included moistening time of 35 min，frying time of 20 min and frying temperature of 120 ℃. The results of in vitro anticoagulant test showed that P. lactiflora and P. lactiflora stir-baked with wine could significantly prolong the time of thrombin time ，prothrombin time ，activated partial thrombin time of plasma ；the effects of P. lactiflora stir-baked with wine were significantly better than those of P. lactiflora （P＜0.05）. CONCLUSIONS ：The optimized processing technology of P. lactiflora stir-baked with wine is stable and feasible. The in vitro anticoagulant effect of P. lactiflora stir-baked with wine prepared by this tehcnology is better than that of raw products.
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Objective:To explore the relationship between different types of helicobacter pylori (Hp) infection and metabolic Syndrome (MS) in healthy population.Methods:The data of 4 602 adults who underwent physical examination in the Space Center Hospital from January to December 2019 were collected for research, the serum Hp antibody typing was detected by immunoblotting, and the results of liver ultrasound and blood biochemical examination were collected for statistical analysis.Results:Among the physical examination population,there were 2 018 cases with positive serum Hp antibody and 2 584 cases with negative serum Hp antibody.According to the expression of cytotoxin-associated gene A protein (CagA) and vacuolar toxin, 2 018 patients with positive serum Hp antibody were divided into 1 088 cases in type Ⅰ group (53.9%(1 088/2 018)) and 930 cases in type Ⅱ Group (46.1%(930/2 018)). There were significant differences in age, systolic blood pressure and prevalence of nonalcoholic fatty liver disease (NAFLD) between type Ⅰ group and type Ⅱ Group ( P<0.05). There was no significant difference in gender, fasting blood glucose, triglyceride,high-density lipoprotein cholesterol (HDL-C), diastolic blood pressure, body mass index (BMI) and waist circumference between the two groups ( P>0.05). There was no significant difference in the prevalence of ms between the two groups (18.3% (199/1 088)) and 19.0%(177/930), P=0.670). Multivariate logistic regression analysis showed that there was no correlation. between different serum Hp antibody typing and MS ( OR=1.194,95% CI 0.842-1.693, P=0.319). Conclusion:Different subtypes of type Ⅰ and type Ⅱ Hp infection are not distinctly associated with metabolic syndrome.
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Background@#Enteritis is one of the most frequently reported symptoms in piglets infected with porcine circovirus type 2 (PCV2), but the immunopathogenesis has not been reported. @*Objectives@#This study examined the effect of a PCV2 infection on the intestinal mucosal immune function through morphological observations and immune-related molecular detection. @*Methods@#Morphological changes within the ileum of piglets during a PCV2 infection were observed. The expression of the related-molecules was analyzed using a gene chip. The immunocyte subsets were analyzed by flow cytometry. The secretory immunoglobulin A (SIgA) content was analyzed by enzyme-linked immunosorbent assay. @*Results@#The PCV2 infection caused ileal villus damage, intestinal epithelial cells exfoliation, and an increase in lymphocytes in the lamina propria at 21 days post-infection.Differentially expressed genes occurred in the defense response, inflammatory response, and the complement and coagulation cascade reactions. Most of them were downregulated significantly at the induction site and upregulated at the effector site. The genes associated with SIgA production were downregulated significantly at the induction site. In contrast, the expression of the Toll-like receptor-related genes was upregulated significantly at the effector site. The frequencies of dendritic cells, B cells, and CD8 + T cells were upregulated at the 2 sites. The SIgA content decreased significantly in the ileal mucosa. @*Conclusions@#PCV2 infections can cause damage to the ileum that is associated with changes in immune-related gene expression, immune-related cell subsets, and SIgA production.These findings elucidated the molecular changes in the ileum after a PCV2 infection from the perspective of intestinal mucosal immunity, which provides insights into a further study for PCV2-induced enteritis.
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BACKGROUND: Mesenchymal stem cell transplantation has been proved to be effective for ulcerative colitis, while the effect of endothelial progenitor cells in ulcerative colitis treatment is still unknown. They are both promising cells for tissue engineering, which can be used for cell transplantation. OBJECTIVE: To explore whether co-transplantation of endothelial progenitor cells and adipose mesenchymal stem cells can relieve ulcerative colitis in a mouse model. METHODS: C57BL/6J mice were randomly divided into six groups (n=24 per group): co-transplantation group, mesenchymal stem cell transplantation group, endothelial progenitor cell transplantation group, glucocorticoid treatment group, transplantation control group and normal control group. Murine ulcerative colitis model was established in all groups except for the normal control group. At 7 and 10 days after modeling, transplantation groups were respectively injected via tail vein with adipose mesenchymal stem cells and/or endothelial progenitor cells, glucocorticoid or PBS. Mice were sacrificed at 12 days after modeling. Colon length, disease activity index, histological score and the serum level of tumor necrosis factor-α were compared between groups. RESULTS AND CONCLUSION: Treatment with glucocorticoid was significantly effective for ulcerative colitis relative to the transplantation control group (P 0.05). Co-transplantation of adipose mesenchymal stem cells and endothelial progenitor cells was better than the other treatments, which significantly improved the shortening of the colon, disease activity index, histological score, and serum level of tumor necrosis factor-α.
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OBJECTIVE@#To explore the effect of mild hypothermia on inflammatory response and angiogenesis in brain tissues of rats with intracerebral hemorrhage (ICH) and its possible mechanism for improving behavioral deficits of the rats After ICH.@*METHODS@#A total of 120 healthy male SD rats were randomly divided into sham operation group, ICH group and mild hypothermia group. Rat models of ICH were established in the latter two groups by stereotactic injection of autogenous blood in the brain, and the rats in the sham operation group received injection of normal saline in the same manner. At 15 min after modeling, the rats in hypothermia group were subjected to mild hypothermia (30-32 ℃) for 8 h followed by rewarming (37-38 ℃); the body temperature was maintained at 37-38 ℃ in the other two groups. At 2, 4, 7, 14 and 21 days after the treatment, Longa scoring, balance beam scoring and Berderson scoring were used to evaluate the behavioral deficits of the rats. Immunohistochemical staining was used to detect the protein expressions of tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) in the brain tissue of the rats, and the mRNA expressions of α subunit of hypoxia-inducible factor 1 (HIF1-α) and vascular endothelial growth factor (VEGF) were detected using RT- PCR.@*RESULTS@#At 2, 4, 7, 14 and 21 days after the treatment, the behavioral scores of the rats were significantly higher in ICH group and mild induced hypothermia group than in the sham operation group ( < 0.05 or 0.01). The protein expressions of TNF-α and NF-κB and mRNA expressions of HIF1-α and VEGF were significantly higher in ICH group and mild hypothermia group than in the sham operation group ( < 0.01). The behavioral scores were significantly lower in mild hypothermia group than in ICH group ( < 0.05), and the protein expressions of TNF-α and NF-κB were lower and the mRNA expressions of HIF1- α and VEGF were higher in mild hypothermia group than in ICH group ( < 0.05 or 0.01).@*CONCLUSIONS@#Mild hypothermia can improve behavioral deficits in rats with ICH possibly by antagonizing brain inflammation and promoting angiogenesis.
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OBJECTIVE： To establish the method for the content determination of gentiopicrin and loganic acid in Gentiana scabra， and to investigate the correlation of their contents with appearance traits and quality gradation criterion. METHODS： HPLC method was adopted. The determination was performed on Ascentis Express C18 column with mobile phase consisted of 0.1％ phosphoric acid-acetonitrile （gradient elution） at the flow rate of 0.4 mL/min. The column temperature was 30 ℃， and detection wavelength was set at 240 nm. The sample size was 1 μL. Taking the length， number and diameter of fibrous roots as indexes， the appearance and morphological characteristics of G. scabra were studied. The relationship of gentiopicrin and loganic acid content with the appearance property of medicinal material was analyzed by SPSS 21.0 software. k-mean clustering analysis was carried out by using SPSS 21.0 software， and gradation standard for G. scabra was established preliminarily. RESULTS： The linear range of gentiopicrin and loganic acid were 0.5-3.0 μg/mL （r＝0.999 9） and 0.05-0.50 μg/mL （r＝0.999 9）. The limit of quantification of gentiopicrin and loganic acid were 0.295， 0.289 μg/mL； the detection limit were 0.082， 0.081 μg/mL； RSDs of precision， stability， repeatability tests were all lower than 2％； the recovery rates were 97.56％- 102.23％ （RSD＝1.56％， n＝6） and 97.58％-102.67％ （RSD＝1.86％， n＝6）. Correlation results showed that there was a significant positive correlation of the length of G. scabra， the number of roots， root diameter， with the contents of gentiopicrin and loganic acid. The order of affecting content was the number of roots ＞length ＞root diameter. k-means clustering analysis showed that 54 batches of G. scabra was divided into two categories； S4-S6，S13，S17-S23，S25，S28，S31-S34 were clustered into a category； S1-S3， S7-S12， S14-S16， S24， S26，S27，S29， S30，S35-S54 were clustered into the other category. The results of gradation showed that 54 batches of G. scabra could be divided into two grades， and the results were consistent with the cluster analysis. CONCLUSIONS： Established method is simple and stable， and can be used for simultaneous determination of gentiopicrin and loganic acid in G. scabra. The more fibrous roots， the longer the length， the thicker the root， the higher the content of gentiopicroside and loganic acid， the better the quality of G. scabra.
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Objective We attempted to investigate optic radiation (OR) injury and visual field mean defect (MD) in patients with hypertensive putaminal hemorrhage by using diffusion tensor imaging (DTI). Methods Thirty-three first onset of patients with hypertensive putaminal hemorrhage and 30 normal healthy control subjects were recruited. DTI data were acquired between 3 and 5 days as well as 3 months after onset. DTI-Studio software was used to reconstruct the OR and examine the degree of OR injury (typeⅠ, Ⅱ, and type Ⅲ). Fractional anisotropies (FA) and apparent diffusion coefficient (ADC)values of the ORs were measured. Statistical analysis was performed to calculate hematoma volume, MD,OR-FA and ADC values by using SPSS 17.0 software. Results FA and ADC values of ORs were not significantly different between the two hemispheres in normal control groups (student t-test, P>0.05). Compared with MD values in control group, the visual field was significantly impaired in patients group (P<0.01). FA and ADC values of ORs were significantly different between two hemispheres in patient group (student t-test, P<0.01). There was no correlation of hematoma volume with OR-FA nor with ADC values nor with MD values (P>0.05). The MD values were correlated with OR-FA and ADC values after onset(P<0.05). MD, FA and ADC values of ORs in the affected hemisphere of the patient group were significantly different for the three OR types between 3 and 5 days as well as 3 months after onset (P<0.01). Conclusion DTI can examine the three-dimensional relationship between hematoma and OR, reflect the changes of OR morphology and predict the degree of visual-field defects.
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Objectives To conduct grading comparison for the damage degree of pyramidal tracts after procedure in patients with unilateral hypertensive putamen hemorrhage via transsylvian-transinsular (TS-TI) approach and transcortical transtemporal (TC-TF) approach using magnetic resonance diffusion tensor imaging (DTI) and to evaluate the postoperative recovery of the patients according to the quality criteria of the activities of daily living (ADL),and to identify the advantages and disadvantages of both surgical approaches.Methods Sixty-three consecutive patients with first onset of unilateral hypertensive basal ganglia putamen hemorrhage admitted to Department of Neumlsurgery in Affiliated Hospital of Southwest Medical University of Traditional Chinese Medicine were enrolled prospectively.The volume of hematoma at admission was 26-45 ml.They were randomly divided into group A and group B by random number table.The patients in group A (n =31) were treated via the TS-TI approach,and those of group B (n =32) were treated via the TC-TT approach.The operator was the same surgeon.The patients of rebleeding were excluded (4 in group A,7 in group B),and 52 patients were actually included,including 27 in group A and 25 in group B.The DTI examinations were perforrned 5 to 8 d after procedure.The image data were processed by PHILIPS Extended MR Workspace 2.6.3.4 (EMW 2.6.3.4) software.The bilateral pyramidal tracts were reconstructed,the damage degree of pyramidal tract and its relationship with hematoma and surgical approach were observe respectively.The ADL quality criteria were used to evaluate the recovery at 3 months after procedure.The SPSS 17.0 software was used to conduct rank sum test for the pyramidal tract injury grade after procedure in both groups.The number of rebleeding in the operation areas and the ADL quality criteria evaluation were tested by Chi-squared test.Results There was no significant difference in the postoperative rebleeding rate between group A (12.9％,4/31) and group B (21.9％,7/32) (x2 =0.367,P =0.545).The postoperative pyramidal tract damage degree of group A was better than that of group B.There was significant difference (U =180.00,P =0.004).The comparison of ADL quality evaluation in both groups after procedure showed that the good prognosis rate (81.5％,22/27) of group A after procedure was better than that of group B (56.0％,14/25).There was significant difference (x2 =3.957,P =0.047).Conclusions The three-dimensional relationship between the hematoma lesions and the pyramidal tracts was observed by DTI,the damage degree of the pyramidal tracts were identified.The TS-TI approach was superior to the TC-TF approach in the postoperative damage degree of pyramidal tract and the quality of ADL for the treatment of hypertensive putamen hemorrhage.
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Objective To systematically evaluate the association between frailty and risk of postoperative delirium.Methods Systematic review of literature was conducted using eight electronic databases:PubMed,Embase,CENTRAL,Web of Science,CNKI,CBM,VIP and Wanfang Data,and prospective cohort studies about association between frailty and postoperative delirium published before March 2017 were included.Two authors independently screened the literature,extracted the data,and assessed the quality using NOS Scale,and meta-analysis was conducted by RevMan 5.3 software.Results A total of eight studies involving 846 patients were included in this review.Meta-analysis showed that:frailty was associated with higher risk of postoperative delirium [OR=3.63,95％CI (2.06,6.40),P＜0.001].Subgroup analysis showed that:①Frailty assessment tool:Fried frailty criteria and other frailty assessment were associated with increased risk of postoperative delirium[OR=5.81,95％CI(3.54,9.77),P＜0.001],[OR=1.76,95％CI(1.06,2.92),P=0.03].②Age:frailty patients aged 60～74 had increased risk of postoperative delirium [OR=5.05,95％CI (3.14,8.12),P＜0.001],but for patients aged ≥ 75,frailty wasn't associated with postoperative delirium [0R=1.73,95％CI (0.99,3.00),P=0.05].③Type of surgery:for cardiovascular and non-cardiovascular surgery patients,frailty was associated with increased risk of postoperative delirium [OR=3.40,95％CI (1.64,7.05),P＜0.001],[OR=4.95,95％CI (2.41,10.16),P＜0.001].Conclusion Frailty can increase the risk of postoperative delirium.In consideration of quantity and quality of included studies,the conclusion needs to be validated by multi-centered prospective cohort studies with large sample size.
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Objective To investigate the prevalence and influencing factors associated with frailty among institutional older adults and to provide evidence for intervention study.Methods A total of 237 older adults living in four welfare homes from Chengdu in Sichuan Province were recruited by convenience sampling.A cross-sectional survey was conducted,and frailty was assessed by the frailty phenotype;general information was collected by selfmade general information questionnaire;functional capacity was assessed by Barthel questionnaire;depressive status was assessed by GDS-15;cognitive function was assessed by clock drawing test and nutritional status was assessed by short form mini nutritional scale questionnaire (MNA-SF).Results The reported rate of frailty was 55.69％ among institutional older adults,and 44.31％ reported no frailty;grip weakness (207,87.3％),slow walking speed (172,72.6％) and low physical activity(131,55.3％) were the main frailty problems.Univariate analysis showed that the elderly'frailty conditions were different in the pre-retirement occupations,smoking,alcohol consumption,physical exercise,chronic diseases,medication,acute events (last year),self-reported health,using assisted walking devices,ability of daily life,depression,cognitive ability and nutritional status,and the differences were statistically significant(P＜0.05).Conclusion The status of frailty is not optimistic among institutional older adults and many factors are associated with frailty.Healthcare providers should pay more attention to the frailty issue and take timely intervention strategies to prevent or delay the frailty.
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<p><b>OBJECTIVE</b>To compare the clinical efficacy differences between acupoint plaster therapy with midnight-noon ebb-flow hour-prescription method and traditional acupoint plaster therapy for senile osteoporosis (SOP).</p><p><b>METHODS</b>With randomized controlled blind design, 76 SOP patients with deficiency of liver and kidney syndrome were randomly divided into an observation group and a control group, 38 cases in each one. Based on oral administration of caltrate D, the patients in the observation group were treated with acupoint plaster therapy with midnight-noon ebb-flow hour-prescription method at Yingu (KI 10), Taixi (KI 3), Dazhong (KI 4), Fuliu (KI 7) and Zhiyin (BL 67), while the patients in the control group were treated with traditional acupoint plaster therapy. Each plaster therapy lasted for 6 h, once a day; there was an interval of 2 d after consecutive 5-day treatment; 4 weeks were taken as one course, and totally 2 courses were given. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the pain and dysfunction before intervention, after 4 weeks and 8 weeks intervention. Osteoporosis symptom rating sale and quality of life questionnaire of the European foundation for Osteoporosis (QUALEFFO-41) were adopted to evaluate the TCM syndrome and quality of life before and after 8-week intervention.</p><p><b>RESULTS</b>All the outcomes were significantly improved after treatment in the two groups (<0.01,<0.05); after 4 weeks and 8 weeks of treatment, the VAS and ODI in the observation group were lower than those in the control group (all<0.05). Repeated ANOVA indicated the VAS and ODI were significant in group effect, time effect and interaction effect (all<0.01). Further comparison showed that VAS and ODI at later time points were lower than those in the early time points (all<0.01). After the treatment, the scores of TCM syndrome and QUALEFFO-41 in the observation group were lower than those in the control group (all<0.05). The effective rate was 85.7% (30/35) in the observation group, which was superior to the effective rate in the control group[74.3%(26/35),<0.05].</p><p><b>CONCLUSIONS</b>The acupoint plaster therapy with midnight-noon ebb-flow hour-prescription method is superior to traditional acupoint plaster therapy in improving pain, dysfunction, TCM syndrome and quality of life in SOP patients; in addition, its clinical efficacy is significant.</p>
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BACKGROUND:Adipose-derived mesenchymal stem cels have gained more and more attention due to their high safety, less invasiveness, easy purification and rapid proliferation. OBJECTIVE:To isolate and culture adipose-derived mesenchymal stem cels efficiently and rapidly with high purity and then to explore the cel homing to the intestinal tract after fluorescence labeling. METHODS: Mouse adipose tissue obtained from the groin and epididymis was asepticaly isolated and digested with 0.1% colagenase I. Then the digested cels and undigested adipose tissue were cultured together in the dish to harvest adipose-derived mesenchymal stem cels. The cels were identified by morphology, surface markers, growth kinetics, osteogenic and adipogenic differentiation potential, and then labeled by PKH67 before injected into ulcerative colitis mouse models through the tail vein to observe their homing to the intestinal tract. RESULTS AND CONCLUSION:In vitro, adipose-derived mesenchymal stem cels isolated by this method exhibited spindle-like appearance, grew intensively and arranged in a swirling shape. Adipose-derived mesenchymal stem cels expressed CD29, CD44 and CD90, but not expressed CD45. After osteogenic induction, alkaline phosphatase staining showed black particles and alizarin red S staining showed red mineralized nodules. After adipogenic induction, oil red O staining showed many lipid droplets were dyed red. Cel growth curve showed cels at 3-5 days were in logarithmic growth phase and they were active. Under fluorescence microscopy, frozen sections of the colon were found green fluorescence points that were increased with time. Results suggest that adipose-derived mesenchymal stem cels isolated and culturedin vitro can proliferate rapidly, purify easily and can be induced to osteoblasts and adipocytes; in vivo, PKH67-labeled cels can home to and proliferate in the colon.
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Objective To investigate the association between morning blood pressure surge(MBPS)and the ambulatory blood pressure monitoring parameters on carotid artery intima-media thickness(IMT)in hypertensive patients.Methods Based on the occurrence of MBPS two hundred twenty six hypertensive patients were allocated as MBPS(n=51)or non-MBPS(n=175).However,based on the IMT,226 patients were stratified as IMT increased(n=94)or group normal IMT(n=132).Plasma lipids,24 h ambulatory blood pressure monitoring(ABPM)and ultrasound examinations of the IMT of carotid arteries were determined.Results 1)The value of MBPS,mean arterial pressure(MAP),morning pulse pressure(MPP),carotid artery IMT,carotid artery crouse score in MBPS group were significantly higher than that in no MBPS groups(P