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The concept of "Microbe-gut-eye axis" holds that metabolites of the gut microbiota are involved in the pathogenesis of various eye diseases. The composition and diversity of gut microbiota in diabetic retinopathy (DR) patients are significantly different from those in non-DR patients. Metabolites of the gut microbiota such as lipopolysaccharide, short-chain fatty acid, bile acids and branched-chain amino acid aggravate or attenuate the progression of DR by regulating the release of inflammatory cytokines, mitochondrial function, insulin sensitivity, immune response, and autophagy of retinal cells. Therefore, gut microbiota and their metabolites play a role in the occurrence and development of DR through multiple pathways. The participation of gut microbiota may open up a new way to prevent and treat DR in the future.
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Objective:To investigate the regional homogeneity (ReHo) among the major depressive disorder patients without mixed features (MDD noMF), major depressive disorder with mixed features (MMF), bipolar disorder with mixed features (BMF) and bipolar disorder patients without mixed features (BD noMF) patients, and to explore the brain activity and functional connectivity patterns of the MMF and BMF patients. Methods:This was a cross-sectional study. The MDD noMF patients (MDD noMF group), MMF patients (MMF group), BMF patients (BMF group), BD noMF patients (BD noMF group), and age-and gender-matched healthy controls (HC group) were recruited from Beijing Anding Hospital, Capital Medical University between April, 2021 and June, 2022. All the participants underwent resting-state functional MRI scanning. The ReHo values was computed with the DPABI software based on the MATLAB. Firstly, the difference in ReHo among the patients with MDD noMF, MMF, BMF, BD noMF and HC group were estimated by the analysis of covariance and the post-hoc method (LSD or Games-Howell). And then, the brain regions with significant different ReHo values were selected as the seeds to calculate the functional connectivity with the whole brain. Results:A total of 29 cases in the MDD noMF group, 24 cases in the MMF group, 26 cases in the BMF group, 29 cases in the BD noMF group, and 42 in the HC group were included. The differences in ReHo values in the left fusiform and the left precuneus of the 5 groups were statistically significant ( P<0.05). Among of them, the ReHo values of the left fusiform were lower in the MMF, BMF and BD noMF groups compared with the HC group ( P<0.05), while the ReHo values of the left precuneus in MDD noMF, MMF, BMF and BD noMF groups were higher than that in the HC group ( P<0.05). The ReHo value of the left fusiform was lower in the MMF group compared with the MDD noMF group ( P=0.001); the ReHo value of the left fusiform was lower in the BMF group compared with the MDD noMF and BD noMF groups ( P<0.05). The functional connectivity between the left fusiform and vermis, left insula, right putamen, and left medial superior frontal gyrus, and functional connectivity between the left precuneus and right superior frontal gyrus (dorsolateral) showed significant difference among the MDD noMF, MMF, BMF, BD noMF and HC groups ( P<0.05). Compared with HC group, MDD noMF, MMF, BD noMF groups showed higher functional connectivity between the left fusiform and the vermis, and MDD noMF, MMF, BMF, BD noMF group showed higher functional connectivityy between the the left fusiform and the left insula, left medial superior frontal gyrus and right putamen ( P<0.05). Compared with the MDD noMF group, the MMF, BMF and BD noMF groups showed higher functional connectivity between the left fusiform and the left insula ( P<0.05). Compared with the MDD noMF group, the BMF and BD noMF groups had higher functional connectivity between the left fusiform and the left medial superior frontal gyrus ( P<0.05). The BMF group showed higher functional connectivity of the left fusiform with the right putamen than the MDD noMF and BD noMF groups. Additonally, the BMF and BD noMF groups showed higher functional connectivity between the left precuneus and the right superior frontal gyrus (dorsolateral) than HC, MDD noMF and MMF groups ( P<0.05). Conclusions:MMF and BMF patients have local abnormalities of functional activity synchronization in the left fusiform and precuneus and abnormal functional connectivity patterns with multiple brain regions. MMF and BMF patients have specific neuroimaging features compared to MDD noMF or BD noMF patients and also share similar neuroimaging pathogenesis.
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Objective:To investigate and analyze the status quo of death cognition and hospice care attitude of clinical medical graduate students, to compare the differences between the two groups, and to explore the correlation between death cognition and hospice care attitude, so as to provide the reference for the reform and construction of death cognition and hospice care education in medical colleges and universities in China.Methods:A survey was carried out on 496 doctoral and postgraduate students majoring in clinical medicine by using the "Questionnaire of General Sociology Survey", the Chinese version of the "Death Attitude Profile Revised Scale", and the Chinese version of the "Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B)" to investigate the death cognition and hospice care attitude of 496 doctoral and postgraduate students majoring in clinical medicine, and classified and compared the survey results of the two groups. The results of this study were statistically analyzed by t-test, Pearson correlation analysis and other statistical methods. Results:A total of 469 valid questionnaires were recovered after excluding 27 unqualified questionnaires. Statistical analysis showed that the scores of each dimension in the death attitude description scale of doctoral students were ranked as follows: approach acceptance (4.28±0.53), neutral acceptance (3.99±0.41), death avoidance (2.74±0.63), fear of death (2.65±0.57) and escape acceptance (2.47±0.69) the scores of postgraduates were ranked as neutral acceptance (3.96±0.52), approach acceptance (2.84±0.61), fear of death (2.78±0.65), death escape (2.62±0.73), escape acceptance (2.39±0.77). At the same time, the scores of hospice care attitude in the doctoral group were higher than those in the master group [(110.63±8.96) vs. (106.78±6.52)], and the difference was statistically significant ( P<0.001). In addition, the scores of "fear of death" and the scores of hospice care attitudes were negatively correlated with the scores of doctoral and master students ( r=-0.25, r=-0.21), while the scores of hospice care attitudes were positively correlated with the scores of "neutral acceptance" in death cognition ( r=0.50, r=0.32). However, the hospice care attitude scores of doctoral students were negatively correlated with the "death avoidance" scores in death cognition ( r=-0.27). Conclusion:Doctoral and postgraduate students have a certain awareness of hospice care, while their death cognition and hospice care attitude still need to be improved and strengthened from sociology, psychology, ethics and other perspectives. The above will promote the harmony between doctors and patients while meeting the needs of an aging society in China.
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Hemispherectomy (HS) is an effective surgical therapy to treat refractory epilepsy caused by diffuse hemispheric disorders.After HS surgery, the seizures are often well controlled in patients, and the bilateral limb motor function improves even recovers in some children.This result reveals the strong neuronal plasticity of the brain.The brain, especially of young children, can achieve functional reorganization and cortical remodeling after extensive damage.Multimodal magnetic resonance imaging techniques can jointly analyze the structure and function of the brain and associated neuroimaging features to reveal the neurophysiological mechanisms underlying improved motor function.In this paper, the progress of multimodal magnetic resonance imaging research on motor function alterations in children after hemispherectomy was reviewed.
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Objective:To explore the significance of laboratory parameters in predicting the endoscopic manifestations of ulcerative colitis (UC) after treatment.Methods:From January 2015 to December 2020, the clinical data of 68 patients with UC hospitalized and treated in Peking University People′s Hospital were retrospectively and continuously collected. According to the degree of bleeding, vascular pattern, erosion and ulcer under endoscopy before and after treatment, they were divided into progressive group (post-treatment ulcerative colitis endoscopic index of severity (UCEIS) score higher than pre-treatment) and non-progressive group (post-treatment UCEIS score equal to or lower than pre-treatment). The baseline platelet count, platelet volume, platelet hematocrit, platelet distribution width, serum albumin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and related laboratory parameters were compared between the two groups. And analyzed the significance of related laboratory indexes in predicting the endoscopic manifestations of UC after treatment. Independent sample t test and receiver operating characteristic curve (ROC) analysis were used for statistical analysis. Results:According to the degree of bleeding under endoscopy before and after treatment, the patients were divided into progressive group (12 cases) and non-progressive group (56 cases). The baseline platelet count and platelet volume of the progressive group were higher than those of the non-progressive group ((375.58±154.30) ×10 9/L vs. (288.22±103.76) ×10 9/L, (9.29±1.13) fL vs.(8.52±1.29) fL), and the differences were statistically significant ( t=2.40 and 2.08, P=0.019 and 0.049). According to the degree of vascular texture under endoscopy before and after treatment, the baseline platelet volume and serum albumin level of the progressive group (9 cases) were higher than those of the non-progressive group (59 cases) ((9.58±1.18) fL vs. (8.54±1.26) fL, (41.49±5.08) g/L vs. (36.63±6.14) g/L), and the baseline CRP of the progressive group was lower than that of the non-progressive group (2.26 mg/L(0.95 mg/L) vs.8.64 mg/L (26.08 mg/L) ), and the differences were statistically significant ( t=2.32, 2.32, and z=-2.27, P=0.022, 0.047 and 0.045). According to the degree of erosion and ulcer under endoscopy before and after treatment, CRP and ESR of the progressive group (16 cases) were lower than those of the non-progressive group (52 cases) ((2.21 mg/L(5.26 mg/L) vs. 10.63 mg/L(29.97 mg/L), 14.50 mm/1 h (15.25 mm/1 h) vs.17.00 mm/1 h (11.00 mm/1 h)), and the differences were statisticaly significant ( z=-3.64 and -2.42, P=0.001 and 0.020). The cutoff value of baseline platelet count to assess the progression of bleeding under endoscopy after treatment was 336×10 9/L (sensitivity=0.636, specificity=0.852, area under the curve=0.698). The cutoff value of baseline CRP to assess the progression of erosion and ulcer under endoscopy after treatment was 3.44 mg/L (sensitivity=0.750, specificity=0.727, area under the curve=0.727). Conclusions:The baseline platelet volume, serum albumin and ESR are suggestive of endoscopic mucosal changes in patients with UC after treatment. The baseline platelet count and CRP can predict the efficacy in patients with UC.
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Objective:To analyze the related factors of poor uterine scar healing after cesarean section, to establish and evaluate a nomogram model for predicting the risk of poor uterine scar healing after cesarean section.Methods:A total of 170 pregnant women who underwent cesarean section in Hunan Provincical Maternal and Child Care Hospital from April 2019 to May 2020 were prospectively selected as the research objects, and they were divided into poor healing group (48 cases) and good healing group (122 cases) according to the uterine scar healing situation after cesarean section. Logistic regression model was used to analyze the related factors of poor uterine scar healing after cesarean section. The nomograph model for predicting the risk of poor uterine scar healing after cesarean section was drawn by using rms package in R language (R3.6.3). The nomogram model was evaluated and verified by receiver operating characteristic curve (ROC), calibration curve and Hosmer-Lemeshow goodness of fit test.Results:Logistic regression model showed that prenatal body mass index (BMI), the number of cesarean section, premature rupture of membranes, incision position near the cervical orifice, operation time were the independent risk factors of poor uterine scar healing after cesarean section ( P<0.05). According to the above results of logistic regression analysis, a nomogram model was drawn to predict the risk of poor uterine scar healing after cesarean section. The ROC results showed that the area under curve (AUC) of this nomogram model to predict the risk of poor uterine scar healing after cesarean section was 0.902. The calibration curve was a straight line with a slope close to 1 and Hosmer-Lemeshow goodness of fit test (χ 2=5.912, P=0.657) showed that the nomogram model has good consistency and good calibration. Conclusions:The nomogram model for predicting the risks of poor uterine scar healing after cesarean section is established based on the five independent factors of maternal prenatal BMI, number of cesarean section, premature rupture of membranes, incision position near the cervical orifice and operation time, which has good accuracy and differentiation.
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Objective:To analyze the application effect of day checklist model combined with fault finding and error correction method in the teaching of new nurses in neurology department.Methods:A total of 42 new neurology nurses accepted in the department of neurology from January 2019 to June 2020 were selected in the study and they were divided into control group and study group. The conventional group was given the conventional teaching method, while the study group was given the day checklist model combined with fault finding and error correction method, both of which were taught for 3 months. Assessment performance of theoretical knowledge and operational skills before and after teaching, critical thinking ability before and after teaching and satisfaction with the teaching after teaching in neurology nursing were compared between the two groups. SPSS 25.0 was used for t test and rank sum test. Results:After teaching, assessment performance of theoretical knowledge and operational skills, the 7 dimensions of critical thinking ability scores and the total scores were higher than those before teaching, and the study group did better than the control group ( P < 0.05). There were significant differences between the 2 groups of new nurses in the distribution of satisfaction with teaching ( P < 0.05), and the total satisfaction rate of the study group (100.00%) was higher than that of the control group (80.96%) ( P < 0.05). Conclusion:Using the method of day checklist model combined with fault finding and error correction method in the teaching of new nurses in the neurology department can improve their assessment results, enhance their critical thinking ability and improve the teaching satisfaction.
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Objective:To survey the enablement level of elderly patients in the community and its influencing factors.Methods:A total of 460 patients aged ≥60 years visiting Changfeng and Fenglin Community Health Service Centers of Shanghai during September 3 to 15, 2018 were invited for a questionnaire survey. A self-made health status questionnaire, Patient Enablement Instrument (PEI), Chinese Health Questionnaire (CHQ-12), the Consultation and Relational Empathy Measure (CARE) were applied for survey.Results:All valid 460 questionnaires were retrieved. The positive rate of patient enablement was 73.91% (340/460). The median score for PEI was 3, Q1 was 0 and Q3 was 6. The univariate analysis showed that patient′s gender( Z=-2.32, P=0.02), age ( H=9.73, P<0.01), reason for visit ( H=42.06, P<0.01), health status in the past year ( H=8.28, P=0.02), consultation time ( H=22.92, P<0.01), sufficiency of communication with the doctor as patient thought ( H=41.83, P<0.01), detailed inquisition ( H=81.11, P<0.01), attending a contracted doctor ( Z=-3.42, P=0.04), the satisfaction of the visit ( H=38.64, P<0.01), total score of CHQ-12 ( Z=-2.01, P=0.04) and the score of CARE were significantly associated with the enablement level of the patient after the visit ( H=288.06, P<0.01). Multivariate linear regression showed that age 60-79( P=0.03), visit for acute disease( P<0.01), good or moderate health status in past year ( P<0.01), communication with the doctor<3 min or 3-<5 min ( P<0.01), sufficient or moderate time for communication with the doctor as patient thought ( P<0.01), detailed or moderate inquisition( P=0.03 or P=0.01), attending a contracted doctor ( P<0.01), CHQ-12 ≥4 ( P<0.01), middle or high CARE score ( P<0.01)were associated with the enablement of elderly patients after visit, with a cumulative contribution rate of 73.40%( F=50.08, P<0.01). Conclusion:The level of enablement of elderly patients after visiting the general outpatient clinic of the community health service center is relatively low. Patient′s age, types of disease, health status and the time of communication with the doctor, the sufficiency of communication time as patient thought, the detailed inquisition, attending a contracted doctor, the mental health status, and the empathy expression of the doctor are associated with the enablement of patients.
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Objective:To explore the clinical effects in repairing dorsal complex tissue defect of finger with the flap based on superficial palmar branch of radial artery (SPBRA) with palmaris longus tendon.Methods:From May, 2011 to October, 2017, dorsal complex tissue defects of 15 fingers and thumbs in 15 patients were treated by the flaps which were based on SPBRA with palmaris longus tendon. There were 10 males and 5 females, in an average of 35.8 (19-51) years. All the defects (3 thumbs, 5 index, 2 middle and 5 ring fingers) were dorsal complex tissue defects and all had extensor tendon defects. The areas of soft tissue defect measured 2.0 cm×1.5 cm to 4.0 cm×2.0 cm. The lengths of tendon defect measured 2.0-4.0 cm. All patients received emergency surgery. The time before the surgery was 1.5-3.0 hours. The surgery time was 3.0-4.5 hours, 3.6 hours in an average. Postoperative regular follow-up.Results:All of the wounds healed in stage I and all flaps survived. Texture of the flaps was soft with rosy color. No obvious swelling occurred. All the donor sites healed in stage I. The patients were followed-up for 4-18 months, 8 months in an average. The appearance and function of the repaired fingers and thumbs were satisfactory. The pain, temperature and touch sensations were good. The color of flaps was similar to the normal finger without swelling. The wear resistance of the flaps was good. Thin-line scars were in the wrist donor sites without contracture. The range of motion of active palmar flexion of the wrist was from 0° to 80° and active hyperextension was from 0° to 70°. No obvious limitation was found.Conclusion:It is able to achieve a satisfactory clinical effects by using the flap that is based on SPBRA with palmaris longus tendon in repairing the dorsal complex tissue defect of hand. The advantages of the technique are that the donor site is concealed. The wound is small, and the flap is easy to be harvested and anastomosed.
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OBJECTIVE： To evaluate the effects of Pharmacy Benefit Management （PBM） model on drug compliance， health outcomes， economic burden and satisfaction of patients in Wuhu city of Anhui province. METHODS： In cross-sectional study， the questionnaires were designed according to the National Health Service Survey. Through cluster sampling and convenient sampling， the questionnaire survey （including subjective evaluation） was conducted among hypertensive patients who participated in or did not participate in the PBM program in pilot area of Wuhu city. Descriptive analysis was used to analyze the general characteristics of the two groups. The Propensity Score Matching （PSM） was used to approximately randomize the included data to balance the baseline characteristics. Univariate linear regression or Logistic regression analysis were used to evaluate the relationship of whether to join PBM or not with drug compliance，QALY， hospitalization probability，monthly average drug cost for chronic diseases and monthly self-paid drug cost for chronic diseases， etc. RESULTS： A total of 755 valid questionnaires were collected， including 405 in the PBM group and 350 in the non-participating group. There was statistical significance in patient’s gender， age， education degree， nature of household registration， type of medical insurance or usual visited medical institutions （P＜0.05）. About 95％ patients （405 cases） satisfied with PBM program. 281 cases of PBM group and 193 cases of non-participating group were included through PSM. Results of regression analysis showed that lower one level at least of medication compliance in PBM group was 0.49 times as that in the non-participating group； the hospitalization probability in PBM group was 0.56 times as that in the non-participating group （P＜0.05）. There was no statistical significance of difference in control of blood pressure QALY， monthly average drug cost for chronic diseases and monthly self-paid drug cost for chronic diseases between two groups （P＞0.05）. CONCLUSIONS： The implementation of PBM model in pilot areas can improve drug compliance and reduce hospitalization rate of patients. The most patients are highly satisfied. However， the effects of PBM on patients’ control of blood pressure， QALY and medical expense are not obvious， and its long-term effect needs more follow-up studies to verify.
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Objective@#To report the operation methods and clinical effects of repairing finger tip defect with the free tibial dorsal nerve flap of the second toe.@*Methods@#13 patients with finger tip defects were repaired by the tibial dorsal nerve flap of the second toe. The area of finger tip defect was 2.5 cm×1.5 cm-1.3 cm×1.0 cm, and the area of cutting flap was 2.7 cm×1.7 cm-1.5 cm×1.1 cm. All donor site defects on the second toe were covered with full-thickness skin graft.@*Results@#There were 13 cases in this group, and all the flaps and skin grafts were survived. Postoperative follow-up ranged from 6 to 18 months, with an average of 13 months. The appearance of the fingers was satisfied and the sensory recovery was good. Two-point discrimination of the flaps returned to 7-13 mm, with an average of 9 mm. According to the total active move(TAM)scale, results were excellent in 11 fingers, good in 1 finger, and fair in 1 finger. The donor site skin graft was well healed, the second toe pulp was full, and the two-point discrimination of the toe pulps were 6-10 mm, with an average of 8 mm.@*Conclusions@#Compared to the traditional method of repairing finger tip defect with the tibial inherent nerve flap of the second toe, our new method can reduce the damage to the donor site, and we can repair finger tip defect as well as the traditional one at the same time. So it was a better operative method to repair finger tip defect with the tibial dorsal nerve flap of the second toe.
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Objective@#To discuss the effect of psychological nursing based on relaxation training for the psychological state in patients with impatced third molar removal surgery.@*Methods@#A total of one hundred patients with impacted third molar removal surgery were selected from June 2015 to June 2017 in People's Liberation Army No. 105 hospital. According to the nursing method, all patients were divided into psychological intervention group and the control group, 50 cases in each group, the control group was given routine nursing intervention and the psychological intervention group was given psychological nursing intervention based on relaxation training.@*Results@#The after intervention Corah's modified dental anxiety scale (6.3±1.2), Stouthard dental fear scale (62.9±6.5) scores and heart rate [(76.4±5.2) bpm], systolic blood pressure [(102.5±6.3) mmHg], diastolic blood pressure [(75.3±3.1) mmHg] levels of psychological group were significantly lower than those of the control group. The once removal success rate, intraoperative relaxation sense rate of psychological group were significantly higher than those of the control group, the teeth extraction time of psychological group was significantly lower than that of the control group, the difference was statistically significant (P=0.013, P=0.003).@*Conclusions@#Psychological nursing intervention based on relaxation training can effectively improve the mental state and stress state of patients with impacted third molar removal surgery, which is beneficial to the process of the surgery.
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Objective To investigate the clinical effect of super large venous flap with palmaris longus tendon for repairing the complex tissue defect of the palm of finger.Methods From May,2011 to October,2017,complex tissue defect of the palm of 15 fingers in 15 cases was treated by a super large vein flap with palmaris longus tendon.There were 10 males with 10 fingers and 5 females with 5 fingers.The age was from 19 years to 51 years (average,35.8years).Among these cases,machine injury was in 12 cases and crush injury was in 3 cases.Complex tissue defect of the palm of the finger with tendon defect occurred in all the cases.There were 3 thumbs,5 index fingers,3 middle fingers and 5 ring fingers.The area of skin defect was from 3.5 cm×2.0 cm to 7.5 cm×3.5 cm.The length of tendon defect was 2.0-4.0 cm.Phalangeal fractures occurred in 4 cases (2 cases of proximal phalanx,1 of middle phalanx,and 1 of distal phalanx).All the patients received the operation in one stage.The time between the injury and the operation was 1.5-3.0h(average,2.0 h).The time of the operation was 3.0-4.5 h(average,3.6 h).Regular followed-up was performed after operation.Results All flaps survived.Fourteen cases were followed-up for 6 to 12 months(average,7 months),and 1 case lost.The skin flap has soft texture,good elasticity,and no bloat.The color of skin flap was close to the normal skin.Sensory recovery reached S2 to S3,and the function and appearance of the finger were well restored.Conclusion The super large vein flap with palmaris longus tendon can be used to repair the complex tissue defect of the palm of fingers.The flap can get a satisfactory effect after surviving.It is an ideal method of repairing this kind of damage.
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Objective To analyze the clinical characteristics and endoscopic findings in patients with cirrhosis and upper gastrointestinal variceal bleeding (UGIB) and to evaluate the risk factors of rebleeding after endoscopic therapy.Method Between May 2010 and May 2017,383 patients who diagnosed with cirrhosis and UGIB were enrolled.Results The incidence of rebleeding was 8.88％ (n =34).In the univariate analysis,advanced age (P =0.362,OR =0.662),male (P =0.036,OR =2.975),cause of cirrhosis (P =0.047,OR =2.512),Child-Pugh scores (P =0.026,OR =1.852),prothrombin time (P =0.017,OR =3.746),thrombocytopenia (P =0.445,OR =0.577),severe varices (P =0.314,OR =0.745),red color sign (P =0.016,OR =4.013),portal vein diameter (P =0.365,OR =1.026),portal thrombosis (P =0.027,OR =1.954) were risk factors for rebleeding following endoscopic therapy.In the non-condition multivariate logistic regression analysis,male (P =0.036,OR =2.975),autoimmune liver disease (P =0.047,OR =2.512),Child-Pugh scores (P =0.026,OR =1.852),prothrombin time (P =0.017 OR =3.746),red color sign (P =0.016,OR =4.013),portal thrombosis (P =0.027,OR =1.954) were independent risk factors for rebleeding following endoscopic therapy.Conclusions Esophagogastric variceal rebleeding is common after a successful initial endoscopic therapy.Independent risk factors for rebleeding are male,autoimmune liver disease,elevated Child-Pugh scores,prolonged thrombin time,portal vein thrombosis and red color sign.
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Objective To analyze the clinical characteristics and endoscopic findings in the elderly cirrhotic patients with variceal bleeding.Method In this study,181 cirrhotic patients with variceal bleeding cltnically and endoscopically diagnosed from May 2011 to May 2016 were divided into ≥60 years of age group (58 cases) and control group (＜ 60 years of age,123 cases).Clinical data and endoscopic findings were compared retrospectively.Results The cirrhosis caused by virus and alcohol (15/58,62/123) was less in elderly group,but autoimmune disease and non-alcoholic fatty liver disease was more common (14/58,12/58)(x2 =7.452,P =0.004).The incidence rate of hypertension and coronary artery disease was higher in elderly group (20/58,7/58,x2 =6.124,12.764,P =0.012,0.001).However,there was no difference in the incidence rate of diabetes between the two groups (P ＜ 0.05).Gastric varices bleeding was higher in the elderly group (x2 =3.965,P =0.049).The gastric varices located in cardia were more in the elderly group (37.93％,22/58) than control (34.96％,43/123),(x2 =4.124,P =0.044).The rate of EIS was higher in the elderly group and cyanoacrylate injection was less than control (x2 =3.621,P =0.046).Conclusions Compared with those of ＜ 60 years of age,the causes and endoscopic findings and treatment are different cirrhotic variceal bleeding in patients ≥60 years of age.
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Objective To study the clinical, laboratorial, histopathological, imaging features of two cases of hypothyroid myopathy. Method Clinical manifestations, thyroid function, electromyography, muscle MRI, muscle biopsy and follow-up results were collected, and analyzed with the literature. Result These two patients were middle-age to old age and the onset of disease was insidious. Their common clinical manifestations included subacute progressive weakness in the proximal muscles,myalgia after sports and reduction in tendon reflex.The blood test showed an increase in serum concentration of CK and TSH, and a decrease in FT3 and FT4. The electromyography showed suspicious myogenic damage.Muscle histopathological findings were largely nonspecific,such as type I fiber predominance and type 2 atrophy. The MRI revealed extensive muscular dystrophy and fatty filtration in the posterior group of thighs. Treatment of replacement therapy with L-T4 relieved the myopathic symptoms quickly. Conclusion When a patient presents with a subacute progressive weakness in the proximal muscles, the hypothyroidism should be consideration. Muscle histopathological findings may be nonspecific. The muscle MRI have a value of differential diagnosis and lesion assessment.
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Objective To observe the clinical characteristics of non-viral liver diseases which were examined by ultrasound guided liver biopsy in order to explore the significance of liver biopsy.Methods From January 2006 to December 2015,patients with non-viral liver diseases who received liver biopsy were retrospectively enrolled.Etiology,pathological diagnosis and clinical diagnosis of the patients were analyzed;the differences in disease types between male and female,among different age (less than 60 years and over 60 years)were compared;and the consistency of two pathologists in the pathological diagnosis was analyzed.Chi-square test was performed for statistical analysis.Results Among 182 patients,there were 73 (40.1％) males and 109 (59.9％) females.The most common etiology were autoimmune liver disease (68 cases,37.4％),non-alcoholic fatty liver disease (NAFLD) (40 cases,22.0％) and drug-induced liver injury (DILI) (29 cases,15.9％).The differences in etiology between male and female,between age less than 60 years and over 60 years were statistically significant (X2 =7.31 and 5.87,both P ＜ 0.05).The consistency of two pathologists in the diagnosis of NAFLD,alcoholic liver disease,hereditary metabolic disease and neoplastic disease was good (Kappa=0.85,0.88,0.75 and 1.00).The consistency rates of two pathologists in the diagnosis of autoimmune disease,NAFLD and DILI were 52.9％ (36/68),75.0％ (30/40) and 48.3％ (14/29),respectively.The consistency rate was highest in NAFLD,and the difference was statistically significant (X2 =7.68,P=0.023).However,there was no significant difference in consistency rates of two pathologists in the diagnosis of autoimmune liver disease and DILI (X2 =0.12,P=0.859).The consistency rates between pathological diagnosis and clinical diagnosis in autoimmune liver disease,NAFLD and DILI were 60.3％ (41/68),85.0％ (34/40) and 55.2％ (16/29),respectively,and the difference was statistically significant (X2 =8.98,P=0.011).The consistency rate in NAFLD was highest.However,there was no significant difference in consistency rates between pathological diagnosis and clinical diagnosis in autoimmune liver disease and DILI (X2 =0.22,P=0.639).Conclusions The liver biopsy may guide the clinical diagnosis of NAFLD.However,to improve the diagnostic rates of autoimmune liver disease and DILI,biopsy results,history and laboratory results should be combined.
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Objective:To investigate effects of over-expression and suppression of HMGB1 on proliferation and invasion of endometrial carcinoma HEC-1A cell and underlying mechanisms.Methods:Over-expression or silence of HMGB 1 in HEC-1A cell lines were established by lentiviral vector containing HMGB 1 recombinant plasmid or by HMGB 1 shRNA,respectively.Cell counting kit-8,Transwell,and wound healing assay were used to analyze proliferation,invasion,and migration of HEC-1A cells,respectively.Western blot and reverse transcription-PCR (RT-PCR) were used to detect the expression of NF-κB,VEGF,and matrix metalloproteinase 2 (MMP2) in the cells.Results:Over-expression of HMGB1 promoted the proliferation,invasion,and migration of HEC1A cell,and up-regulated NF-κB,VEGF,and MMP2 expressions,while suppression of HMGB1 inhibited the proliferation,invasion,and migration of HEC-1A cells and down-regulated NF-κB,VEGF,and MMP2 expressions.Conclusion:HMGB1 plays an important role in proliferation,invasion,and migration of HEC1A cell via NF-κB/VEGF/MMP2 pathway.HMGB 1 might be a potential target for endometrial carcinoma therapy.
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To investigate the effect of jianpi-jiedu (JPJD) prescription-contained serum on colorectal cancer SW48 cell proliferation and the underlying mechanisms. Methods: Crude extract from JPJD was made by water extract method and the main components of crude extract from JPJD were analyzed by ultra-performance liquid phase high resolution time of flight mass spectrometry (UPLC-Q-TOF/MS). The low, medium, and high-concentration of JPJD-contained serum were prepared by the serum pharmacological method. The effect of serum containing JPJD on SW48 cell proliferation was determined by MTT assay. The cell cycle was detected by flow cytometric method. The protein levels of mammalian target of rapamycin (mTOR), phospho-mTOR, P-P53, and -P21, and the mRNA level of mTOR were examined by Western blot and RT-PCR, respectively. Results: Seven compounds including calycosin-7-glucoside, astragaloside, ginsenoside-Re, ginsenoside-Rb1, glycyrrhizinic acid, apigenin, atractylenolide-II were identified. MTT assays demonstrated that the SW48 cell proliferation was inhibited by medium and high concentration of JPJD-contained serum and the percentages of cells at G1 phase in SW48 cell cultured in the medium and high concentration of JPJD serum group were significantly higher than those in the control group (P<0.05). Meanwhile, the levels of mTOR mRNA and phospho-mTOR protein in the medium and high concentration of JPJD serum groups were substantially lower than those in the control group (P<0.05). Conversely, the expressions of phospho-P53 and P21 protein were significantly increased in the medium and high concentration of JPJD serum group compared with those in the control group. Conclusion: JPJD prescription-contained serum can inhibit SW48 cell proliferation, which may be related to mTOR-P53-P21 signaling pathways.
Subject(s)
Animals , Humans , Apigenin , Blotting, Western , Cell Cycle , Cell Division , Cell Proliferation , Genetics , Colorectal Neoplasms , Cyclin-Dependent Kinase Inhibitor p21 , Drugs, Chinese Herbal , Pharmacology , Flow Cytometry , Ginsenosides , Glycyrrhizic Acid , Lactones , Phosphorylation , Genetics , RNA, Messenger , Saponins , Sesquiterpenes , Signal Transduction , TOR Serine-Threonine Kinases , Triterpenes , Tumor Suppressor Protein p53ABSTRACT
To investigate the effect of the jianpi-jiedu formula (JPJD) on the expression of angiogenesis-relevant genes in colon cancer. Methods: Crude extract was obtained from JPJD by water extract method. The effect of JPJD crude extract on colon cancer cell proliferation capacity was determined by MTT assays. The IC50 value was calculated by GraphPad Prism5 software. Affymetrix gene expression profiling chip was used to detect significant differences in expressions of genes after JPJD intervention, and pathway enrichment analysis was performed to analyze the differentially expressed genes. Ingenuity Pathway Analysis software was applied to analyze differentially expressed genes relevant to tumor angiogenesis based on mammalian target of rapamycin (mTOR) signaling pathway and then the network diagram was built. Western blot was used to verify the protein levels of key genes related to tumor angiogenesis. Results: JPJD crud extract inhibited the proliferation capacity in colon cancer cells. The IC50 values in 24, 48, and 72 hours after treatment were 13.060, 9.646 and 8.448 mg/mL, respectively. The results of chip showed that 218 genes significantly upgraded, and 252 genes significantly downgraded after JPJD treatment. Most of the genes were related to the function of biosynthesis, metabolism, cell apoptosis, antigen extraction, angiogenesis and so on. There were 12 differentially expressed angiogenesis genes. IPA software analysis showed that the JPJD downregulated expression of sphingomyelin phosphodiesterase 3 (SMPD3), VEGF, vascular endothelial growth factor A (VEGFA), integrin subunit alpha 1 (ITGA1), cathepsin B (CTSB), and cathepsin S (CTSS) genes, while upregulated expressions of GAB2 and plasminogen activator, urokinase receptor (PLAUR) genes in the colorectal cancer cell. Western blot results demonstrated that JPJD obviously downregulated expressions of phospho-mTOR (P-mTOR), signal transducer and activator of transcription 3 (STAT3), hypoxia inducible factor-1α (HIF-1α), and VEGF proteins, while obviously upregulated the level of phospho-P53 (P-P53) protein. Conclusion: JPJD may inhibit colorectal tumor angiogenesis through regulation of the mTOR-HIF-1α-VEGF signal pathway.