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Objective: To analyze the clinical characteristics of patients with Mucopolysaccharidosis ⅣA (MPS ⅣA). Methods: A retrospective study was conducted on 111 patients with MPS ⅣA in Xinhua Hospital of Shanghai Jiao Tong University School of Medcine from December 2008 to August 2020, confirmed by enzyme activity and genetic testing. General situation, clinical manifestations and enzyme activity test results were analyzed. According to the clinical manifestations, it can be divided into severe, intermediate and mild group. The independent sample t test was used to compare the birth body length and weight of children with that of normal boys and girls, and group comparisons of enzyme activities were evaluated by median test. Results: One hundred and eleven unrelated patients, 69 males and 42 females, were classified into 3 subtypes: severe (n=85), intermediate (n=14), and mild (n=12). The age at symptom onset were 1.6 (1.0, 3.0) years, and at diagnosis were 4.3 (2.8, 7.8) years. Skeletal manifestations were observed in all patients and consisted mainly of pectus carinatum (96/111, 86.5%), motor dysfunction (78/111, 70.3%), spinal deformity (71/111, 64.0%), growth retardation (64/111, 57.7%), joint laxity (63/111, 56.8%) and genu valgum (62/111, 55.9%). Eighty-eight patients (88/111, 79.3%) with MPS ⅣA were also along with non-skeletal manifestations, mainly including snoring (38/111, 34.2%), coarse faces (34/111, 30.6%), and visual impairment (26/111, 23.4%). The most common skeletal manifestation was pectus carinatum (79 cases), and non-skeletal manifestation was snoring (30 cases) and coarse faces (30 cases) in severe patients, pectus carinatum (13 cases) and snoring (5 cases) in intermediate type, motor dysfunction (11 cases) and snoring (3 cases) and visual impairment (3 cases) in mild patients. The height and weight of severe patients began to fall below -2 s at 2-<5 years and 5-<7 years, respectively. At the age of 10-<15 years, the standard deviation score of the height of severe patients reached (-6.2±1.6) s in males and (-6.4±1.2) s in females, and the score of weight got (-3.0±1.1) s in males and (-3.5±0.5) s in females. The height of intermediate patients began to fall below -2 s at the age of 7-<10 years, and the standard deviation score of height were -4.6 s and -3.6 s in 2 males, and -4.6 s and -3.8 s in 2 females at the age of 10-<15 years. The weight remained within -2 s in 72.0% (18/25) of intermediate patients compared to age-matched healthy children. In the mild patients with MPS ⅣA, the mean standard deviation score of height and weight was within -2 s. The enzyme activities of mild patients (2.02 (1.05, 8.20) nmol/(17 h·mg)) were both significantly higher than that of intermediate (0.57 (0.47, 0.94) nmol/(17 h·mg)) and severe (0.22 (0, 0.59) nmol/(17 h·mg)) patients (Z=9.91, 13.98, P=0.005, 0.001), and the enzyme activity of intermediate patients was significantly higher than that of severe patients (Z=8.56, P=0.010). Conclusions: The clinical manifestations of MPS ⅣA are charactered by pectus carinatum, motor function impairment, spinal deformity and growth retardation. The clinical characteristics, growth rate and enzyme activity differ among the 3 subtypes of MPS ⅣA.
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Male , Child , Female , Humans , Adolescent , Mucopolysaccharidosis IV , Pectus Carinatum , Retrospective Studies , Snoring , China , Mucopolysaccharidoses , Growth Disorders , Vision DisordersABSTRACT
Objective:To evaluate the efficacy and safety of enteral extended biliary stenting for biliary stricture.Methods:A multicenter retrospective cohort study was conducted on data of 550 patients with obstructive jaundice due to extrahepatic bile duct stricture between February 2006 and April 2020. Patients were assigned to conventional group (undergoing conventional biliary stent placement) and extended group (undergoing enteral extended biliary stent placement). Propensity score was used to match the basic data of patients of the two groups. Then the stent patency time, bilirubin difference before and after 1 week operation, incidence of complications and hospital stay were compared between the two groups.Results:Among the 550 patients, clinical data of 20 cases were missing and 35 failed to be followed up. Finally, 326 patients were enrolled to the study after propensity score matching with 163 cases in each group. The patency time of extended group was 111.0 (82.0, 192.0) days, which was longer than that of conventional group with patency time of 93.0 (70.0, 141.8) days ( Z=3.260, P=0.001). Total bilirubin difference value of pre-operation and post-operation was less in extended group [51.2 (26.0, 114.7) μmol/L VS 46.0 (13.9, 81.1) μmol/L, Z=2.095, P=0.036]. The rate of early adverse events [4.3% (7/163) VS 3.7% (6/163), P=0.079] and median in-patient days (10.0 days VS 10.0 days, P=0.379) were similar in the two groups. Conclusion:Enteral extended biliary stent is effective and safe for treatment of biliary stricture, which can prolong the patency time without increasing postoperative complications and hospital stay.
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Objective:To investigate the diagnostic value of Japan NBI Expert Team (JNET) classification with blue-laser imaging magnifying endoscopy (BLI-ME) for colorectal neoplastic lesions.Methods:Data of 40 colorectal neoplastic lesions in 34 patients that received BLI-ME from September 2016 to December 2018 in Peking University International Hospital were reviewed and endoscopic images from those lesions were selected. Four senior endoscopists analyzed and classified these images according to the JNET criteria and determined the possible pathologic type. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of JNET classification under BLI-ME system were calculated with final pathologic results as the golden standard.Results:Of all the 40 lesions, there were 3 non-cancerous lesions, 20 adenoma, 10 high grade intraepithelial neoplasia/submucosal-superficial lesions and 7 submucosal-deep lesions. The accuracy of 4 endoscopists was 75.00%-87.50%, and 65.38%-95.89% for different JNET types. For each JNET type, the sensitivity was 60.71%-91.67%, specificity was 84.17%-97.73%, PPV was 63.46%-95.89%, and NPV was 88.51%-99.31%. For the 4 endoscopists, the assurance rate of surface pattern was 73.08%-100.00%, 80.77%-100.00% for deciding vascular pattern, and 67.31%-100.00% for deciding final JNET type. The Kappa value between any two endoscopists was 0.630-0.887, and the interclass correlation coefficient for all results was 0.880. Conclusion:JNET classification shows significant diagnostic value under BLI-ME system for colorectal neoplastic lesions.
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BACKGROUND@#Determining the Helicobacter pylori (H. pylori) infection state during the gastroscopic process is important but still challenging. The linked color imaging (LCI) technique might emphasize the mucosal color change after H. pylori infection, which might help the diagnosis. In the present study, we aimed to compare the LCI technique with traditional white light imaging (WLI) endoscopy for diagnosing active H. pylori infection.@*METHODS@#We collected and analyzed gastroscopic images from 103 patients in our hospital from November 2017 to March 2018, including both LCI and WLI modes. All images were randomly disordered and independently evaluated by four endoscopists who were blinded to the H. pylori status of patients. In addition, the H. pylori state was determined by both rapid urease test and pathology staining. The sensitivity, specificity, positive prediction value (PPV), and negative prediction value (NPV) were calculated for the detection of H. pylori infection. Moreover, the kappa value and interclass correlation coefficient (ICC) were used to evaluate the inter-observer variety by SPSS 24.0 software.@*RESULTS@#Of the 103 enrolled patients, 27 of them were positive for H. pylori infection, while the 76 patients were negative. In total, 388 endoscopic images were selected, including 197 WLI and 191 LCI. The accuracy rate for H. pylori evaluation in the corpus LCI group was significantly higher than other groups (81.2% vs. 64.3%-76.5%, χ = 34.852, P < 0.001). Moreover, the corpus LCI group had the optimal diagnostic power with the sensitivity of 85.41% (95% confidence interval [CI]: 76.40%-91.51%), the specificity of 79.71% (95% CI: 74.38%-84.19%), the PPV of 59.42% (95% CI: 50.72%-67.59%), and the NPV of 94.02% (95% CI: 89.95%-96.56%), respectively. The kappa values between different endoscopists were higher with LCI than with WLI (0.433-0.554 vs. 0.331-0.554). Consistently, the ICC value was also higher with LCI than with WLI (0.501 [95% CI: 0.429-0.574] vs. 0.397 [95% CI: 0.323-0.474]). We further analyzed the factors that might lead to misjudgment, revealing that active inflammation might disturb WLI judgment (accuracy rate: 58.70% vs. 76.16%, χ = 21.373, P < 0.001). Atrophy and intestinal metaplasia might affect the accuracy of the LCI results (accuracy rate: 66.96% vs. 73.47%, χ = 2.027; 68.42% vs. 73.53%, χ = 1.594, respectively); however, without statistical significance (P = 0.154 and 0.207, respectively).@*CONCLUSIONS@#The application of LCI at the corpus to identify H. pylori infection is reliable and superior to WLI. The inter-observer variability is lower with LCI than with WLI.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry: ChiCTR1800016730; http://www.chictr.org.cn/showproj.aspx?proj=28400.
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Background@#Determining the Helicobacter pylori (H. pylori) infection state during the gastroscopic process is important but still challenging. The linked color imaging (LCI) technique might emphasize the mucosal color change after H. pylori infection, which might help the diagnosis. In the present study, we aimed to compare the LCI technique with traditional white light imaging (WLI) endoscopy for diagnosing active H. pylori infection.@*Methods@#We collected and analyzed gastroscopic images from 103 patients in our hospital from November 2017 to March 2018, including both LCI and WLI modes. All images were randomly disordered and independently evaluated by four endoscopists who were blinded to the H. pylori status of patients. In addition, the H. pylori state was determined by both rapid urease test and pathology staining. The sensitivity, specificity, positive prediction value (PPV), and negative prediction value (NPV) were calculated for the detection of H. pylori infection. Moreover, the kappa value and interclass correlation coefficient (ICC) were used to evaluate the inter-observer variety by SPSS 24.0 software.@*Results@#Of the 103 enrolled patients, 27 of them were positive for H. pylori infection, while the 76 patients were negative. In total, 388 endoscopic images were selected, including 197 WLI and 191 LCI. The accuracy rate for H. pylori evaluation in the corpus LCI group was significantly higher than other groups (81.2% vs. 64.3%-76.5%, χ2 = 34.852, P < 0.001). Moreover, the corpus LCI group had the optimal diagnostic power with the sensitivity of 85.41% (95% confidence interval [CI]: 76.40%-91.51%), the specificity of 79.71% (95% CI: 74.38%-84.19%), the PPV of 59.42% (95% CI: 50.72%-67.59%), and the NPV of 94.02% (95% CI: 89.95%-96.56%), respectively. The kappa values between different endoscopists were higher with LCI than with WLI (0.433-0.554 vs. 0.331-0.554). Consistently, the ICC value was also higher with LCI than with WLI (0.501 [95% CI: 0.429-0.574] vs. 0.397 [95% CI: 0.323-0.474]). We further analyzed the factors that might lead to misjudgment, revealing that active inflammation might disturb WLI judgment (accuracy rate: 58.70% vs. 76.16%, χ2 = 21.373, P < 0.001). Atrophy and intestinal metaplasia might affect the accuracy of the LCI results (accuracy rate: 66.96% vs. 73.47%, χ2 = 2.027; 68.42% vs. 73.53 %, χ2 = 1.594, respectively); however, without statistical significance (P = 0.154 and 0.207, respectively).@*Conclusions@#The application of LCI at the corpus to identify H. pylori infection is reliable and superior to WLI. The inter-observer variability is lower with LCI than with WLI.@*Trial registration@#Chinese Clinical Trial Registry: ChiCTR1800016730; http://www.chictr.org.cn/showproj.aspx?proj=28400
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OBJECTIVE@#To observe the gait changes of Alzheimer's disease PS1M146V/APPswe/tauP301L triple-transgenic (3xTg-AD) mice and to investigate the improvement effect of single chain variable domain antibody fragment 17 (scFv17) on the gait.@*METHODS@#In the present study, a selection of 6-month-old 3xTg-AD mice (=18) and C57BL/6 wild-type mice (=24) was performed. First, we observed their gait changes and found that the gait of 12-month-old 3xTg-AD mice was severely damaged. Then, the two groups of mice were randomly divided into four groups:WT+PBS(=12), WT+scFv17(=12), 3xTg-AD+PBS(=9) and 3xTg-AD+scFv17(=9). The gait behavior test and pathological test were performed after 12 weeks'continuous administration of scFv17 (1.5 mg/kg) or an equal volume of PBS (0.01 mol/L) by nasal gavage twice a week.@*RESULTS@#Compared with the same month old wild type mice, the rear track width of 12 month old 3xTg-AD mice was increased(<0.01), swing time percent was decreased (<0.01), stance time percent was increased(<0.01), so the ability of movement coordination and balance was seriously damaged. ScFv17 could improve the coordination and balance ability of 12 month old 3xTg-AD mice(<0.01). The morphological structure of 3xTg-AD mice cerebellar Purkinje cells was improved. The treatment of scFv17 increased the Nissl body number of the cerebellar Purkinje cells of 3xTg-AD mice (<0.01). scFv17 reduced the amyloid β protein (Aβ) plaques in the cerebellar cortex of 3xTg-AD mice (<0.01), and scFv17 reduced the intracellular neurofibrillary tangles (NFT) of the cerebellar Purkinje cells of the 3xTg-AD mice (<0.01).@*CONCLUSIONS@#The coordination and balance ability of 3xTg-AD mice was significantly impaired. ScFv17 can improve gait behaviour in the 3xTg-AD significantly.The mechanism may be related to the improvement of the structure and protein function of cerebellar Purkinje cells, and the eliminating of the Aβ plaques and the neurofibrillary tangles.
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Animals , Mice , Alzheimer Disease , Amyloid beta-Peptides , Amyloid beta-Protein Precursor , Disease Models, Animal , Gait , Mice, Inbred C57BL , Mice, Transgenic , tau ProteinsABSTRACT
Objective To verify the feasibility of using small intestine submucosa for graft stents.Methods A Z-type Nitinol wire stent was used as the metal stent material,and porcine small intestine submucosa was used as the biofilm material to prepare the bio-coated stent.In vitro implantation,extracorporeal pulsation and extracorporeal flexion of the stents were designed based on the requirements for the small intestine submucosa graft stent implantation during the endovascular aneurysm repair and of the mechanical properties of the graft stent during human body activity.The feasibility of using small intestine submucosa for the graft stents was evaluated according to the patency of the stent lumen after the experiment,the presence or absence of cracks in the membrane,and the presence or absence of fracture of the metal stent.Results In the in vitro experiments,all the samples were able to maintain complete tunica and luminal patency except the 8th sample that showed suture rupture.Besides,all the samples showed good rebounding and adhering properties in both in vitro implantations and extracorporeal pulsation pressure experiments,and no dangerous problems were found such as film rupture,suture loss and stent fracture.Conclusion Small intestine submucosa can meet the durability requirements of graft stents,adapt to the conditions of graft stents such as implantation,bending and blood pulsation,and can be used as the covering material of graft stents.
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OBJECTIVE To evaluate the decontamination capability of hydrogel polymer coated ZnO nanoparticles (ZnO NP-gel) against soman. METHODS ZnO NP was synthetized using chemical precipitation method and modified with 4-pentenoic acid,and then polymerized with comonomers to obtain ZnO NP-gel. The transmission electron microscope (TEM), scanning electron microscope (SEM) and particle size instrument were used to observe the internal structure,micromorphology,particle size and zeta potential of these materials. An infrared spectroscope (IR) was used to analyze their chemical bond structure,while X-ray diffraction (XRD) was used to analyze the diffraction pattern.The content of soman was determined by benzidine chromogenic reaction. ZnO NP(1 g·L-1), ZnO NP-gel (1 g·L-1) and distilled water were mixed with soman(52.2 mg·L-1),stood for 30 min,and then filtered before filtrate was subcutaneously injected into mice (40 μL·g-1) to observe the symptoms of poisoning and death. RESULTS SEM and TEM showed that ZnO NP-gel had a block structure, the zeta potential of which was (-7.89 ± 0.04) mV. The results of IR indlicated that ZnO NP-gel had stronger absorption peaks at 754 and 618 cm-1, and XRD revealed that these materials had a sharp peak at 2θ=8.06738°. The decontamination efficiency of ZnO NP-gel was higher than that of ZnO NP group at the same concen?tration (n=3, P<0.05), and the time for decontamination of 50% soman was shortened by four times. The mice were injected subcutaneously with the soman solution treated with ZnO NP-gel, which caused no convulsion or death. CONCLUSION ZnO NP-gel can perform the double function of fast adsorption and catalysis of soman,and the decontamination ability of which could be improved through polymer modification.
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OBJECTIVE To improve the poor water solubility and evaluating poor acitivity of etoposide (VP-16) by preparing VP-16 nanoparticle suspension (VP-16 NP) and its penetration through the blood-brain barrier (BBB).METHODS VP-16 NP was prepared with the anti-solution exchange method.The shape structure and diameter were observed with transmission electron microscopy (TEM) and scanning electron microscopy (SEM) and dynamic light scattering (DLS), respectively. The drug release profiles of the VP-16 powder and VP-16 NP were measured.The effect of VP-16 NP on the growth of KB cells was observed via MTT assay. In addition, primary brain microvascular endothelial cells from 1stto 2nd generation of SD rats at two weeks of age were used to construct an in vitro BBB model.The classic 4 h leak test,trans-epithelial electrical resistance (TEER) test and fluorescein disodium salt(FLU)perme?ability test were conducted to verify whether the in vitro BBB model was successfully established.RESULTS VP-16 NP was a solid sphere with a size of 140 nm detected by TEM,SEM and DLS.The cumulative release rate of VP-16 NP was 3 times that of VP-16 powder. The results of MTT colorimetric assay showed that VP-16 powder had no inhibitory effect on KB cells,while VP-16 NP could effectively inhibit KB cells. In the 4 h leakage experiment, the top and bottom chambers of the Transwell cell model could maintain a liquid surface distance of >0.5 cm,indicating that the in vitro BBB model was initially formed.The effective resistance value of the TEER experiment was 223 Ω·cm2,indicating that the in vitro BBB model was basically established. In FLU permeability experiments, the permeability coefficients were respectively (0.33±0.04)×10-3,(0.42±0.07)×10-3,and (0.52±0.06)×10-3cm·min-1at 15,30 and 60 min, indicating that the model had low permeability.The above three experiments suggested that the BBB in vitro model was successfully constructed. On this basis, the in vitro BBB model was used to evaluate the penetration of VP-16 NP at a permeability coefficient of (1.87±0.03)×10-3cm·min-1at 30 min,showing high permeability.VP-16 NP showed better penetration of BBB.CONCLUSION VP-16 NP is success?fully prepared,which increases the release rate of the drug,enhances the killing effect of the cells,and shows good penetration through the in vitro BBB model evaluation.
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Objective To explore the effect of age,walking speed and the morphological growth of lower limbs on 4～6 years old children's gait,so as to provide theoretical references for children's gait assessment and the design of a walker robot.Methods Totally one hundred and fifty-seven children ranging in age from 4 to 6 were selected as subjects in this research.Gait parameters were acquired by the 3D shooting technique,while the morphological indexes of the lower extremity,including the length A of the lower extremity,calf length,thigh circumference,pelvic width,width between two greater trochanters,foot length,foot girth and foot width,were measured.The differences of gait parameters among children of different ages and sexes were compared using the variance analysis.The step regression analysis was carried out to study the relationship between the walking speed and other gait parameters.The relationship between children's gait and morphology was analyzed using the canonical correlation analysis.Results The six-year-old children's gait cycle,step length and walking speed were significantly higher than those of four-and five-year-old children(P＜0.05).The swing phase percentage of six-year-old children was significantly higher than that of four-year-old ones(P＜0.05).The support percentage of six-year-old children was significantly lower than that of the four-year-old(P＜0.05).With the increase of the walking speed,young children's step length,cadence and percentage of the swing phase increased linearly.And the gait cycle,percentage of double support phase and percentage of the support phase decreased linearly with the increase of the walking speed.There was significant correlation between the lower extremity length A,calf length,width between two greater trochanters and step length for the children aged from four to six.Conclusion For children aged 4 to 6 years,the step length,walking speed and gait cycle increase continuously with the increment of age,whereas the cadence and percentage of the support phase decrease with the increment of age.The step speed is significantly correlated with other gait parameters such as the step length,cadence and gait cycle.The length of lower extremities,calf length and width between two greater trochanters are the main factors which affect the step length.
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Objectives: To observe the prevalence of bleeding and to explore the independent predictors of bleeding in ST-segment elevation acute myocardial infarction patients with fibrinolysis therapy in China. Methods: From January 2013 to June 2014, 1 568 patients undergoing fibrinolysis in the Chinese Acute Myocardial Infarction Registry (CAMI) were prospectively included. Patients were divided into bleeding group (bleeding after fibrinolysis, n=55) and no bleeding group (without bleeding after fibrinolysis, n=1 513). Logistic regression analysis was performed to define the independent predictors of bleeding. Results: The prevalence of bleeding with fibrinolysis in these patients was 3.5% (55/1 568). The fibrinolysis success rate is 86%. Among them, the rate of intracranial bleeding was 0.6%, and the rate of gastrointestinal bleeding was 1.9%. The fibrinolysis success tended to be higher in patients with bleeding (94.1% vs 85.7%, P=0.0589) ,and the mortality rate was significantly higher in patients with bleeding (20.0% vs 7.1%, P=0.0019) . Logistic regression analysis showed that age≥75 years (OR=2.45, 95%CI:1.10-5.46, P=0.0290) and use of rtPA (HR=3.41, 95%CI:1.48~7.86, P=0.0040) were independent predictors of bleeding after fibrinolysis in this patient cohort. Conclusions: The prevalence of bleeding after fibrinolysis in Chinese STEMI patients is low. Older age and rtPA use are independent predictors of bleeding after fibrinolysis in this patient cohort.
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Objective: To evaluate the predictive value of PARIS bleeding score on in-hospital bleeding of acute myocardial infarction (AMI) patients after drug-eluting stent (DES) implantation with dual-antiplatelet therapy (DAPT). Methods: There were 27 594 AMI patients enrolled in China acute myocardial infarction (CAMI) registry between 2013-01-01 to 2014-09-30 from 107 hospitals, and 14 625 of them had successful in-hospital DES implantation with DAPT were studied. Based on BARC (bleeding academic research consortium definition) criteria, the end point major bleeding (MB) events were defined by both BARC type 3, 5 and BARC type 2, 3, 5; the incidence of in-hospital bleeding, clinical features and predictive value of PARIS bleeding score according to different BARC type were evaluated. Results: Compared with non-MB patients, MB patients had the higher PARIS bleeding score, P<0.001. Based on PARIS score risk stratification, taking BARC type 3, 5 as endpoint, 77/14 625 (0.53%) patients had bleeding events, PARIS scores were different among high risk, mid risk and low risk patients, P<0.001; bleeding risk in mid risk patients was 2.38 times higher than low risk patients, P=0.006 and bleeding risk in high risk patients was 4.78 times higher than low risk patients, P<0.001.Taking BARC type 2,3,5 as endpoint,223(1.52%)patients had bleeding events,bleeding risk in mid risk patients was 1.64 times higher than low risk patients, P=0.002 and bleeding risk in high risk patients was 2.23 times higher than low risk patients, P=0.001. ROC analysis showed that PARIS score had predictive value on both BARC type 3, 5 and BARC type 2, 3, 5 bleeding, area under curve (AUC) of BARC type 3, 5 (AUC: 0.672) was higher than AUC of BARC type 2, 3, 5 (AUC:0.596) (z=2.079, P=0.038), which implied that PARIS score had better predictive value in severe bleeding events. Conclusion: PARIS bleeding score had predictive value on in-hospital bleeding in AMI patients after DES implantation with DAPT, it can also be used in bleeding risk stratification. PARIS bleeding score had better predictive value on severe bleeding.
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Objective To reduce the occurrence of recurrent choledocholithiasis caused by biliary sphincter dysfunction after extensive endoscopic sphincterotomy ( EST ) for large stone extraction, and to investigate the sphincter-preserving effects of duodenal papilla occlusion by SureClip from MicroTech. Methods Three patients with large biliary stones ( 1. 0-2. 5 cm in stone size, 1. 2-3. 0 cm in common bile duct diameter) and without ERCP history underwent EST ( larger than 1. 0 cm) in Peking University Third Hospital from March 2018 to May 2018. Biliary and pancreatic stents were placed after stone extraction, followed by duodenal papilla occlusion with SureClip from MicroTech. Pressures of biliary duct and Oddi sphincter were measured at pre-EST, immediately after EST, and when stents were removed 3 weeks after EST, respectively. Healing conditions of papilla and complications were documented. Five pigs underwent similar experiments without stone extraction. Results The pressure of Oddi sphincter was significantly reduced after EST, and recovered after papilla occlusion 3 weeks after operation both in pigs and human. All stones were completely removed in the 3 patients without any post-ERCP complications. The papilla was healed under endoscopic observation when stents were removed 3 weeks after papilla occlusion. In animal experiments, histology revealed completely muscularis propria disruption of post-EST papilla without occlusion. In contrast, the muscle layer of post-EST papilla with occlusion by SureClip from MicroTech appeared scar healing. Conclusion The duodenal papilla occlusion by SureClip from MicroTech after EST works as "papilla remolding", which accelerates healing of papilla, and retains the sphincter pressure and anti-reflux barrier function.
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Objective To investigate the correlation between the gene polymorphism of osteoprotegerin genes rs3134069,rs2073617 and rs2073618 and the onset risk of large artery atherosclerotic stroke (LAA) in the Han population in Liaoning,China.Methods Using the case-control study design,213 patients with LAA were selected as case group according to the TOAST etiology classification,and 197 health subjects in the same period were selected as control group.Rs3134069,rs2073617,and rs2073618 were genotyped using the modified multiplex ligase reaction technique.Multivariate logistic regression analysis was used to determine the independent correlation between gene polymorphism and LAA.Results There were no significant differences in the genotypes and alsle distribution frequencies of OPG genes rs3134069,rs2073617 and rs2073618 between the case group and the control group (all P ＞0.05).The dominant and recessive models also showed that there were no significant differences (all P＞0.05).Conclusion The polymorphisms of OPG genes rs3134069,rs2073617 and rs2073618 were not significantly associated with LAA susceptibility in Han population of Liaoning,China.The presence of each allele could not constitute a risk factor for the onset of LAA.
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Objective@#To observe the killing and clearance effect of an Er:YAG laser combined with sodium hypochlorite on Enterococcus faecalis at different depths of the root canal in vitro to provide a reference for clinical application.@*Methods @#A total of 75 models of Enterococcus faecalis infection were successfully established and randomly divided into three groups (25 per group). Ten random samples per group underwent no processing. The remaining models in group A were treated with an Er:YAG laser combined with sodium hypochlorite 52.5 g/L. Group B was treated with 52.5 g/L sodium hypochlorite (positive control), and group C was treated with normal saline (negative control). The bacterial reduction rate was calculated for each group. The bactericidal effect on the surface of the root canal wall was observed in 5 samples by scanning electron microscopy.@*Results@#There was no statistically significant difference (P > 0.05) between group A (100.00 ± 0.00) and group B (98.62 ± 2.01) but was a statistically significant difference between group A (100.00 ± 0.00) and group C (64.37 ± 2.45) (P < 0.05). The percentage reduction in bacteria was higher in group A (99.46 ± 2.31) than in groups B (92.89 ± 3.07) and C (56.72 ± 4.96) (P < 0.05). The decrease in bacteria was greater in group A (97.62 ± 3.73) than in groups B (72.49 ± 2.35) and C (44.42 ± 4.78) (P < 0.05). The bacterial reduction rate in group A (95.89 ± 2.46) was higher than that in groups B (63.88 ± 1.08) and C (33.31 ± 5.21) (P < 0.05). There were significant differences at different dentin depths in the bacterial reduction rates among groups A, B and C (P < 0.05). Electron microscopy analysis showed that the Er:YAG laser combined with 52.5 g/L sodium hypochlorite was better than either treatment alone at removing bacteria from the surface of the root canal wall.@*Conclusion@# An Er:YAG laser can effectively enhance the bactericidal effect of sodium hypochlorite on the inner wall of the root canal.
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In this study, we developed a qualitative analytical method based on liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UHPLC-Q-TOF-MS/MS) for identification of multi-constituents of raw Fructus Arctii (RFA) and processed Fructus Arctii (PFA). We established a UHPLC-UV analytical method for simultaneously determining 6 major compounds in Fructus Arctii. UHPLC- Q-TOF-MS/MS qualitative analysis was performed under negative and positive ion modes and a total of 23 chemical compounds were identified. The analysis data were subjected to a principle component analysis with a t-test. Ten peaks were found to be the main difference (P<0.05) between RFA and PFA. HPLC-UV quantitative method result showed the contents of 6 constituents were different between RFA and PFA. The results indicated that there was less arctiin, chlorogenic acid, isochlorogenic acid A in PFA than in RFA. However, there were higher levels of arctigenin, isochlorogenic acid B, isochlorogenic acid C in the PFA than RFA, which may be the main reason for different clinical efficacy of RFA and PFA.
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Alzheimer's disease (AD) is a progressively neurodegenerative disorder, which seriously affects human health but is still irreversible up to now. Recent studies indicate that type 2 diabetes mellitus (T2DM) is an important risk factor for AD, and the drugs used for treatment of T2DM have shown some neuroprotective effects in the treatment of AD. Glucagon-like peptide-1 (GLP-1)/ glucose-dependent insulinotropic polypeptide (GIP)/glucagon (Gcg) receptor Triagonist is a new monomeric polypeptide equally activating the GLP-1/GIP/Gcg receptors, which is built on the basis of GLP-1/Gcg receptor coagonist core sequence, and incorporated with partial amino acids of GIP. Recently, the Triagonist has been reported to be effective in alleviating diabetic complications in rodent models of obesity. The present study observed for the first time the cognitive improvement effects of the Triagonist in the triple-transgenic AD mice (3xTg-AD) by using multiple behavioral techniques, and explored its probable molecular mechanisms using ELISA and Western blot. The results showed that the chronic treatment with the Triagonist (i.p.) significantly reversed the impairments in working memory of 3xTg-AD mice, with an obvious increase in the percentage of correct spontaneous alternation in the Y maze; the Triagonist treatment also improved long-term spatial memory and re-learning ability of 3xTg-AD mice in classical Morris water maze and reverse water maze tests, with decreased escape latency in under water platform tests and increased swimming time in probe tests. ELISA and Western blot experiments showed that the Triagonist up-regulated the levels of cAMP, PKA and p-CREB in the hippocampus of 3xTg-AD mice. These results indicate that GLP-1/GIP/Gcg receptor Triagonist can improve the cognitive behaviors in 3xTg-AD mice, and the up-regulation of hippocampal cAMP/PKA/CREB signal pathway may mediate the neuroprotection of the Triagonist, suggesting that the GLP-1/GIP/Gcg receptor Triagonist may be a novel therapeutic strategy for the treatment of AD.
ABSTRACT
Objective To understand the status of mobile phone use and bacterial carriage on surface of mobile phones used by health care workers(HCWs) in municipal hospitals in a city,explore the influencing factors of mobile phone use behavior and bacterial carriage status.Methods In April-June,2016,111 HCWs in 24 hospitals in a city were performed questionnaire survey,on-site observation,and sampling of mobile phone surface.Results A total of 111 (100.00％) available questionnaires were distributed and returned.The average age of the respondents were (32.00 ± 9.03)years old,female and nurses were predominant.95.50％ of respondents used touch screen mobile phones,24.32％ used mobile phones during diagnosis and treatment,65.77％ used mobile phone ＞2 hours every day,93.69％ cleaned and disinfected mobile phones,98.20％ thought that pathogenic microorganisms exited on the surface of mobile phones.A total of 111 mobile phone surface specimens were collected,the qualified rate was 80.18％,contamination rate was 95.50％,average colony number was 2.90 CFU/cm2,the maximum bacterial content was 111.60 CFU/cm2.Among 44 specimens of mobile phone surface,55 strains of 18 species of pathogenic bacteria or opportunistic pathogenic bacteria were detected.Age,gender,and occupation were the influencing factors of mobile phone use behavior and attitude;qualified rates were all significantly different among mobile phones used by HCWs of different gender,occupation,and duration of mobile phone use (all P＜0.05);bacterial contamination on the surface of mobile phones used by HCWs of different age,gender,occupation,duration of mobile phone use,and whether to use the phone shell/set were significantly different respectively(all P＜0.05).Conclusion Potential pathogens on the surface of mobile phones may cause healthcare-associated infection through the use of mobile phones by HCWs during the process of medical diagnosis and treatment.
ABSTRACT
Objective To evaluate clinical significance of direct antiglobulin testing(DAT)in anemia in patients with severe chronic hepatitis B(CHB).Methods Red blood cell(RBC)-related parameters detection and DAT were performed among 30 healthy persons,30 CHB patients,and 50 severe CHB patients,clinical factors related to posi-tive DAT were analyzed.Results RBC count,hemoglobin (Hb)concentration,and hematocrit(HCT)level in severe CHB patients were all lower than CHB patients and healthy group(P <0.05),RBC distribution width(RDW)in severe CHB patients were all higher than CHB patients and healthy group(P<0.05);the positive rate of DAT in patients with se-vere CHB,CHB,and healthy group were 62.82%,13.33% and 0 respectively.RBC count,Hb concentration,and HCT level in severe CHB patients with positive DAT were all lower than severe CHB patients with negative DAT (all P <0.05),while RDW was higher than the latter (P=0.001);after RBC was separated through capillary,positive intensity of DAT of aged RBCs was higher than young RBCs in severe CHB patients (P <0.001);among severe CHB patients, DAT-positive and-negative patients differed in gender,age,alanine aminotransferase,total bilirubin,complement C3, C-reactive protein,and complication of diabetes(all P≤0.05).Conclusion Anemia in severe CHB patients may be re-lated to immune hemolysis of aged RBCs induced by antibody adsorption.
ABSTRACT
Objective To evaluate clinical significance of direct antiglobulin testing(DAT)in anemia in patients with severe chronic hepatitis B(CHB).Methods Red blood cell(RBC)-related parameters detection and DAT were performed among 30 healthy persons,30 CHB patients,and 50 severe CHB patients,clinical factors related to posi-tive DAT were analyzed.Results RBC count,hemoglobin (Hb)concentration,and hematocrit(HCT)level in severe CHB patients were all lower than CHB patients and healthy group(P <0.05),RBC distribution width(RDW)in severe CHB patients were all higher than CHB patients and healthy group(P<0.05);the positive rate of DAT in patients with se-vere CHB,CHB,and healthy group were 62.82%,13.33% and 0 respectively.RBC count,Hb concentration,and HCT level in severe CHB patients with positive DAT were all lower than severe CHB patients with negative DAT (all P <0.05),while RDW was higher than the latter (P=0.001);after RBC was separated through capillary,positive intensity of DAT of aged RBCs was higher than young RBCs in severe CHB patients (P <0.001);among severe CHB patients, DAT-positive and-negative patients differed in gender,age,alanine aminotransferase,total bilirubin,complement C3, C-reactive protein,and complication of diabetes(all P≤0.05).Conclusion Anemia in severe CHB patients may be re-lated to immune hemolysis of aged RBCs induced by antibody adsorption.