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@#Objective The resting-state functional magnetic resonance imaging (rs-fMRI) method was used to observe brain activity and its functional connection upon electroacupuncture stimulation at bilateral uterine acupoints (EX-CA1), as well as to investigate the mechanism of acupuncture in the treatment of gynecological diseases. Methods Twenty-two healthy female subjects were stimulated by electroacupuncture at bilateral uterine acupoints; rs-fMRI data of the brain were acquired and standardized. Degree centrality (DC), amplitude of low-frequency fluctuation (ALFF), and regional homogeneity (ReHo) were used to analyze local spontaneous brain activity via acupuncture. An independent component analysis was used to evaluate the functional connectivity of the resting brain networks after acupuncture. Results Analytical results showed that the neural activity intensity of the precuneus lobe, orbitofrontal cortex, lingual gyrus, amygdala, and posterior central gyrus decreased after acupuncture (voxel P < 0.001, cluster P < 0.05). Functional connectivity analysis revealed weakened auditory and right frontal-parietal networks (voxel P < 0.001, cluster P < 0.05), enhanced visual network (voxel P < 0.001, cluster P < 0.05), and synergistic auditory network and hypothalamic-pituitary system. Conclusion Significant differences in neural activity and functional connectivity in specific brain regions were observed after acupuncture intervention at uterine acupoints; the hypothalamic-pituitary system also showed various active states in different brain regions. It is speculated that the effective mechanism of acupuncture at uterine acupoints is related to the regulation of reproductive hormones, emotional changes, and somatic sensations. Therefore, the methods used in this study could clarify the neural mechanism of uterine-point acupuncture in the treatment of gynecological diseases and may serve as a reference for other studies pertaining to acupuncture.
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Objective: To evaluate the efficacy within the first 24 h post extracorporeal membrane pulmonary oxygenation (ECMO) and the impact of early efficacy on the prognosis of adult patients with fulminant myocarditis (FM). Methods: This retrospective case analysis study included hospitalized patients (age≥18 years) who were diagnosed with fulminant myocarditis from November 2016 to May 2021 in the First Affiliated Hospital of Zhengzhou University. Patients were divided into survival or non-survival groups according to treatment outcomes. The age, sex, treatments, drug use, ECMO use, clinical and laboratory data (before and 24 h after the use of ECMO) were analyzed. The change rate of clinical and laboratory data after 24 h use of ECMO was calculated to find differences between two groups. Multivariate logistic regression was used to analyze the related factors with in-hospital death and complication between the two groups. Results: A total of 38 FM patients treated with ECMO were included. There were 23 cases (60.5%) in the survival group, aged (39.6±13.7) years, and 17 (73.9%) cases were female. The total ECMO time was (134.4±71.3)h. There were 15 cases (39.5%) in non-survival group, aged (40.0±15.8) years, and there were 12(80.0%) female, the ECMO time was (120.1±72.4) h in this group. The proportion of tracheal intubation and continuous renal replacement therapy in the survivor group and dosage of norepinephrine within 24 h after ECMO implantation were significantly less than in non-survival group (all P<0.05). There was no significant difference in all efficacy related biochemical indexes between two groups before ECMO use. The levels of lactic acid, procalcitonin, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase-MB, cardiac troponin I and N-terminal B-type natriuretic peptide prosoma were significantly less in survival group than in non-survival group at 24 h after the use of ECMO (all P<0.05). Results of multivariate logistic regression analysis showed that the higher 24 h change rate of creatinine (OR=0.587, 95%CI 0.349-0.986, P=0.044) and creatine kinase-MB (OR=0.177, 95%CI 0.037-0.841, P=0.029) were positively correlated with reduced risk of in-hospital mortality. The central hemorrhage and acute kidney injury in survival group were less than in non-survivor group (P<0.05). Conclusions: After 24 h early use of ECMO in FM patients, the improvement of various efficacy related biochemical test indexes in the survival group was better than that in the non-survival group. Faster reduction of creatine kinase-MB and creatinine values within 24 h ECMO use is positively correlated with reduced risk of in-hospital mortality in adult patients with FM.
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Extracorporeal Membrane Oxygenation/methods , Hospital Mortality , Myocarditis/therapy , Retrospective Studies , Treatment OutcomeABSTRACT
Purpose To observe the expressions of LC3, NY-ES0-2, MAGE-D4, CD4+, CD8+, CD68+ in colorectal cancer and normal tissues and analysis the correlation of autophagy related gene LC3 and tumor surface antigen NY-ES0-2, MAGE-D4, immune cells CD4+, CD8+, CD68 +. To investigate the effect of the change of autophagy on immune cells function and its clinical significance. Methods Immunohistochemistry and Western blot were used to detect the expressions of LC3, NY-ESO-2, MAGE-D4, CD4, CD8, CD68 in 128 cases of colorectal cancer and normal tissues. The correlation among each factors and the patients' clinicopathological features were analyzed. Results (1 ) The expression of LC3 in colorectal cancer tissue was higher than in normal tissues. The expression of NY-ESO-2 was low while the expression of MAGE-D4 was high in colorectal cancer and both almost not express in normal tissues(P＜0.05). The infiltration of CD4+, CD8 +, CD68+ immune cells in colorectal cancer were higher than in normal tissues(P＜0.05). (2)The expression of LC3 protein in colorectal cancer was correlated positively with the expressions of tumor surface antigen NY-ESO-2, MAGE-D4 protein and the infiltration of CD8 +, CD68 + immune cells (P＜ 0.05 ), but had no correlation with the infiltration of CD4 + immune cells (P＞0.05). (3 ) The expression of NY-ESO-2 was correlated positively with the infiltration of CD4+, CD8 +, CD68 + immune cells. The expression of MAGE-D4 was correlated positively with the infiltration of CD8 +, CD68+ immune cells. (4) The expressions of NY-ESO-2, MAGE-D4, the infiltration of CD4+, CD8 + immune cells and lymph node metastasis were negatively correlated (P＜0.05). The expressions of NY-ESO-2, MAGE-D4, the infiltration of CD4+, CD8+ immune cells and TNM stage were negatively correlated (P＜ 0.05). The infiltration of CD8 + immune cells and grade was positively correlated (P＜0.05). Conclusion The expression of autophagy-related gene LC3 was related to the expressions of tumor surface antigen NY-ESO-2, MAGE-D4 and the infiltration of immune cells CD8 + and CD68+ in colorectal cancer. Therefore the autophagy key factor LC3 may participate in the immune of colorectal cancer.
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An effective quality control system is the key to ensuring the quality, safety and efficacy of traditional Chinese medicines (TCMs). However, the current quality standard research lacks top-level design and systematic design, mostly based on specific technologies or evaluation methods. To resolve the challenges and questions of quality control of TCMs, a brand-new quality standard system, named "iVarious", was proposed. The system comprises eight elements in a modular format. Meaning of every element was specifically illustrated via corresponding research instances. Furthermore, frankincense study was taken as an example for demonstrating standards and research process, based on the "iVarious" system. This system highlighted a holistic strategy for effectiveness, security, integrity and systematization of quality and safety control standards of TCMs. The establishment of "iVarious" integrates multi-disciplinary technologies and progressive methods, basis elements and key points of standard construction. The system provides a novel idea and technological demonstration for regulation establishment of TCMs quality standards.
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An effective quality control system is the key to ensuring the quality, safety and efficacy of traditional Chinese medicines (TCMs). However, the current quality standard research lacks top-level design and systematic design, mostly based on specific technologies or evaluation methods. To resolve the challenges and questions of quality control of TCMs, a brand-new quality standard system, named "iVarious", was proposed. The system comprises eight elements in a modular format. Meaning of every element was specifically illustrated via corresponding research instances. Furthermore, frankincense study was taken as an example for demonstrating standards and research process, based on the "iVarious" system. This system highlighted a holistic strategy for effectiveness, security, integrity and systematization of quality and safety control standards of TCMs. The establishment of "iVarious" integrates multi-disciplinary technologies and progressive methods, basis elements and key points of standard construction. The system provides a novel idea and technological demonstration for regulation establishment of TCMs quality standards.
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<p><b>OBJECTIVE</b>To find an approach for trans-oral endoscopic thyroidectomy (TOET) and cervical lymphadenectomy using conventional endoscopic surgical instruments on frozen fresh cadavers.</p><p><b>METHODS</b>Six frozen fresh cadavers were used in three groups of trans-oral trocar installation experiments: oral vestibule installation, sublingual region installation, and combined bi-vestibular and sublingual installation. TOET (with pretrachealis method to thyroid fixation removal) and cervical lymphadenectomy were performed experiments on another 6 frozen fresh cadavers using the best access approach found in the aforementioned experiments.</p><p><b>RESULTS</b>In oral vestibule trocar installations, the trocars caused large lacerated wound and damaged air tightness. In sublingual installations, only one trocar could be installed in the sublingual area because the space in sublingual area was limited. In combined bi-vestibular and sublingual installations, no gland, vessel or nerve was damaged. Combined bi-vestibular and sublingual access were selected as the surgical approach on the basic of analysis the merits of each approach. TOET and cervical lymphadenectomy in area III, IV, VI, VII were performed without making any accessory damage through combined bi-vestibular and sublingual access approach.</p><p><b>CONCLUSIONS</b>TOET is feasible. Combined bi-vestibular and sublingual approach is available for TOET. Part of the cervical lymph nodes could be resected. Pretrachealis approach to thyroid fixation removal can still be used.</p>
Subject(s)
Adult , Humans , Cadaver , Endoscopy , Lymph Node Excision , Methods , Neck , Thyroidectomy , MethodsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effects of sequential colon dialysis (SCD), hemodialysis (HD) and peritoneal dialysis (PD) on the serum level of uric acid (UA) in patients with hyperuricemia.</p><p><b>METHODS</b>A total of 293 patients with mild, moderate and severe degree of hyperuricemia were randomly assigned to three groups according to digital randomized method, and treated with SCD, HD and PD respectively. The serum level of UA was determined with unicase-peroxidase conjugate method, the blood levels of K+, Na+, Cl-, Ca2+ were determined by automatic biochemical analysor, and changes of body weight were measured before and after dialysis.</p><p><b>RESULTS</b>In the 293 cases, the three modes of dialysis showed no difference in lowering uric acid in patients of mild degree (P > 0.05). But the HD did show a better efficacy than that of the other two in severe degree patients (P<0.01), while in patients of moderate degree, significant difference (P<0.01) showed between HD and SCD, PD and SCD, but not between HD and PD (P > 0.05). No obvious effect of the various modes of dialysis on the level of K+, Na+, Cl-, Ca2+, body weight.</p><p><b>CONCLUSION</b>SCD can decrease the serum level of UA effectively and reduce the incidence of complication of hyperuricemia to some extent, as hemodialysis and peritoneal dialysis can.</p>