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Based on the principle of molecular hybridization, fifteen compounds were designed and synthesized through the combination of aminothiazoloxime and phosphonate fragment. The results showed that these compounds had better inhibitory effects on the tested bacteria. In particular, the activities of compounds Ⅲf and Ⅲi against S. aureus, E. coli, methicillin-resistant S. aureus (MRSA) and fluoroquinolone-resistant E. coli (FREC) were the most significant, the minimal inhibitory concentration (MIC) of Ⅲf was 1, 8, 4, 16 μg·mL-1 respectively, and the MIC of Ⅲi was 4, 4, 16, 8 μg·mL-1 respectively, which were slightly lower than that of the control drug oxacillin, and their anti-E. coli, MRSA and FREC activities were superior to that of the control drug oxacillin. Their activities to S. aureus were close to that of oxacillin, and to E. coli, MRSA and FREC were superior to that of oxacillin, which is worthy of further study.
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Objective:To investigate the clinical efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula.Methods:Clinical data of 69 female infants with congenital anal atresia combined rectal vestibular fistula admitted to Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from July 2012 to July 2022 were retrospectively analyzed.They were divided into 2 groups according to the surgical methods: 34 cases of anal dimple anorectoplasty(group A) and 35 cases of anterior sagittal anorectoplasty(group B). The operation time, length of stay, short-term complications, long-term complications and bowel function (determined by the Rintala score at 6 months postoperatively) of the two groups were compared.The difference in the incidence of postoperative complications between groups was compared by Chi- square test, and the remaining differences between groups were compared by the paired t-test. Results:The operative time [(80.18±9.29) min vs.(103.85±8.26) min] and postoperative hospital stay[(6.10±1.52) d vs.(7.63±2.40) d] in group A were significantly shorter than those of group B ( t=11.40, 2.62; all P<0.05). The Rintala total score at 6 months postoperatively in group A was significantly higher than that of group B[(19.36±0.93) points vs.(18.76±0.44) points]( t=3.20, P<0.05). There were no significant differences in the incidences of short-term [(4/34, 11.8%) vs.(7/35, 20.0%)] and long-term complications [(2/34, 5.9%) vs.(4/35, 11.4%)]between group A and group B ( χ2=0.75, 0.75; all P>0.05). Conclusions:Anal dimple anorectoplasty for female infants with congenital anal atresia combined rectal vestibular fistula is safe and effective.
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During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.
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Objective:To compare the long-term efficacy of two-level cervical artificial disc replacement (CADR) and anterior cervical decompression and fusion (ACDF) in the treatment of cervical degenerative diseases.Methods:A retrospective analysis was performed on patients who had received two-level anterior cervical surgery for cervical degenerative diseases for more than 15 years from December 2003 to December 2007. The patients were divided into two groups: CADR and ACDF according to surgical methods. There were 15 patients in the CADR group, including 7 males and 8 females, with an average age of 49.73±10.26 (range, 32-70) years. Three cases of mixed cervical spondylosis, 5 cases of cervical spondylotic radiculopathy, 7 cases of cervical spondylotic myelopathy, including C 3, 4 and C 4, 5 level 1 case, C 3, 4 and C 5, 6 level 2 cases, C 4, 5 and C 5, 6 level 7 cases, C 5, 6 and C 6, 7 level 5 cases, operative segment range of motion (ROM) was 9.10°±4.00°. The follow-up time in the CADR group was 189.07±13.51 (range, 162-210) months. There were 20 patients in the ACDF group, including 12 males and 8 females, with an average age of 52.60±8.83 (range, 32-68) years. Two cases of mixed cervical spondylosis, 3 cases of cervical spondylotic radiculopathy, 15 cases of cervical spondylotic myelopathy, including C 3, 4 and C 4, 5 level 1 case, C 4, 5 and C 5, 6 level 15 cases, C 5, 6 and C 6, 7 level 4 cases, the ROM of the surgical segment was 8.31±5.23°. The mean follow-up time of ACDF group was 184.20±21.39 (range, 156-222) months. The Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) were evaluated preoperatively and at the last follow-up. The overall ROM of the cervical spine, ROM of the surgical segment, and Miyazaki grading of the adjacent intervertebral disc, Odom score and complications of the two groups were evaluated at the last follow-up. Results:In the CADR group, the JOA score improved from 13.20±2.64 preoperatively to 15.93±1.22 at last follow-up, and NDI improved from 27.60%±6.44% preoperatively to 15.07%±9.71% at last follow-up, JOA improvement rate was 59.44%±60.86%, and NDI decreased by 12.53%±9.64%. In the ACDF group, JOA score improved from 12.93±2.46 preoperatively to 15.65±1.25 at last follow-up, NDI improved from 30.80%±8.11% preoperatively to 12.80%±6.31% at last follow-up, JOA improvement rate was 60.51%±43.17%, NDI decreased by 18.00%±8.34%. There was no significant difference in JOA and NDI between the two groups before surgery and at the last follow-up. At the last follow-up, the overall ROM of the cervical spine in the CADR group was 38.33°±12.31°, the ROM of the surgical segment was 6.51°±4.61°, and the overall ROM of the cervical spine in the ACDF group was 31.11°±8.65°, the ROM of the surgical segment was 0°. There was a significant difference in the overall ROM of the cervical spine between the two groups at the last follow-up ( t=7.22, P=0.049). The incidence of increased Miyazaki grading of the upper and lower adjacent segment of the cervical intervertebral disc in the CADR group were 40% and 47%, and the rate of new intervertebral disc herniation were 20% and 13%. The incidence of increased Miyazaki grading of the upper and lower adjacent segment of the cervical intervertebral disc in the ACDF group were 45% and 50%, and the incidence of new herniated disc were 25% and 40%, there is a significant difference in the degeneration rate of the lower adjacent segments between the two groups (χ 2=4.38, P=0.036). At the last follow-up, the excellent and good rate of Odom in the CADR group was 80%, and 1 case was revised; the excellent and good rate of Odom in the ACDF group was 85%, and 1 case was revised. There was no significant difference in the overall efficacy between the two groups. Conclusion:The long-term clinical efficacy of two-level CADR is comparable to that of traditional ACDF, and it preserved the ROM of the surgical segment, and is superior to ACDF in terms of the overall cervical spine ROM, and the incidence of adjacent segment degeneration.
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Objective:To study the learning curve and inflection point of robot-assisted L 4 and L 5 pedicle screw insertion for lumbar spondylolisthesis. Methods:A retrospective study was conducted on the data of 43 patients with L 4 and L 5 pedicle screw insertion for lumbar spondylolisthesis from January 2016 to December 2020 using surgical robot, including 19 males and 24 females, aging 59 (48, 66) years old. According to Meyerding classification, there were 23 grade I slippage, 18 grade II slippage, and 2 grade III slippage. The screw deviation and screw accuracy grade were assessed. The operation time, intraoperative blood loss, the number of intraoperative fluoroscopies, postoperative complications, and postoperative hospital stay were recorded. Cumulative Sum (CUSUM) was used to analyze the learning curve, and the learning curve is divided into early and late learning stages according to morphology. T test and Wilcoxon rank-sum test were used for statistical analysis and comparison of indicators between early and late learning stages. Results:43 patients with lumbar spondylolisthesis successfully completed the operation, with 60 L 4 pedicle screws and 70 L 5 pedicle screws inserted. The accuracy of L 4 pedicle screw placement began to improve since the 23rd placement, and the accuracy of L 5 pedicle screw placement began to improve since the 20th placement. Using the 23rd pedicle screw (the 14th patient) to divide the learning curve as the early stage and the late stage. There was no statistically significant difference in the operation time (225.0±74.0 min vs. 207.0±81.2 min, t=0.65, P=0.521), intraoperative blood loss[200 (75, 500) ml vs. 100 (60, 200) ml, Z=1.30, P=0.195], the number of intraoperative fluoroscopies[10 (6, 10) vs. 10 (6, 10), Z=-0.37, P=0.712] and postoperative complications (8% vs. 0, P=0.302) between the early stage and late stage of learning curve. In the late stage of learning, the postoperative hospital stay was shorter[4.5 (3, 6) d vs. 6.0 (5, 9) d, Z=2.00, P=0.046]and the pedicle screw insertion accuracy was higher[L 4: 1.33 (1.06, 1.79) mm vs. 2.23 (1.12, 4.55) mm, Z=2.43, P=0.015; L 5: 1.47 (0.98, 1.87) mm vs. 3.21 (1.64, 4.87) mm, Z=3.90, P=0.001]. The accuracy of screw placement was similar between the early and late stages[L 4: 95%(21/22) vs. 97%(37/38), P=1.000; L 5: 91%(20/22) vs. 96%(46/48), P=0.585]. Conclusion:Robot-assisted L 4 and L 5 pedicle screw placement in the treatment of lumbar spondylolisthesis had a relatively obvious learning curve. Starting from the placement of the 23rd screws, the accuracy of screw placement gradually increased.
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Objective:To evaluate the correlation between endemic arsenic poisoning and abnormal electrocardiogram (ECG).Methods:PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang data, VIP and other databases were used for literature retrieval, and epidemiological literatures related to abnormal ECG of endemic arsenic poisoning published in domestic and abroad were included in the study. The time limit was from the establishment of the database to December 1, 2020. RevMan 5.3 was used for Meta-analysis of binary variables. Random effect model was selected according to the results of heterogeneity, and odds ratio ( OR) was used as the effect index. Characteristic changes were found by subgroup analysis. Bias was published by funnel plot. Results:Nine articles were included in this Meta-analysis, with 6 articles in Chinese and 3 articles in English, respectively. The abnormal ECG changes included QTc prolongation, ST-T segment change, left axis deviation and arrhythmia. Finally, 1 975 cases were included in the exposure group, including 575 cases of abnormal ECG; 750 cases of control group, including 145 cases of abnormal ECG. Meta-analysis showed that the combined OR value [95% confidence interval ( CI)] of abnormal ECG changes was 4.41 (2.83 - 6.87), with statistical significance between the two groups ( Z = 6.56, P < 0.05); the results of subgroup analysis showed that the combined OR values (95% CI) of QTc prolongation, ST-T segment change, left axis deviation and arrhythmia were 12.30 (5.91 - 25.59), 2.74 (1.39 - 5.41), 2.93 (0.89 - 9.62) and 4.13 (2.38 - 7.17), respectively. Conclusions:Endemic arsenic poisoning may cause abnormal ECG. Prolongation of QTc caused by arsenic exposure may be the characteristic change of abnormal ECG.
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Objective:To observe the role of nuclear factor erythroid 2-related factor 2 (Nrf2) in regulating apoptosis during malignant transformation of human bronchial epithelial cells (HBE cells) induced by sodium arsenite (NaAsO 2). Methods:HBE cells were treated with 0.0 and 1.0 μmol/L NaAsO 2, which were control group and arsenic exposed group respectively. HBE cells were treated with 1.0 μmol/L NaAsO 2 for 43 passages to establish a malignant transformation model. The dynamic changes of indexes in different passages (0, 1st, 8th, 15th, 22nd, 29th, 36th, and 43rd) after exposure to NaAsO 2 were monitored, including the apoptosis rate detected by flow cytometry and apoptosis-related proteins and Nrf2 protein detected by Western blotting. Nrf2 siRNA was transfected into malignant transformed HBE cells (T-HBE cells) to silence Nrf2. The silencing effect of Nrf2 protein was verified. And, the apoptosis rate and apoptosis-related proteins were detected. Results:With the increase of arsenic exposure, the apoptosis rates of HBE cells decreased (0, 1, 8, 15, 22, 29, 36 and 43 passages were 0.370 ± 0.029, 0.443 ± 0.069, 0.357 ± 0.046, 0.330 ± 0.016, 0.273 ± 0.050, 0.160 ± 0.024, 0.110 ± 0.022, 0.097 ± 0.012, respectively, Ftrend = 22.981, P < 0.05). Compared with the 0 passage cells, the apoptosis rates of the 22nd, 29th, 36th and 43rd passages in the arsenite group were lower. The differences between them were statistically significant ( P < 0.05). With the increase of arsenic exposure, the expressions of pro-apoptotic proteins caspase-3, cleaved-caspase-3, C/EBP-homologous protein (CHOP) and B-cell lymphoma-2 (Bcl-2) associated X protein (Bax) showed downward trends ( Ftrend = 22.356, 3.738, 6.130, 8.061, P < 0.05), while the anti-apoptotic proteins myeloid cell leukemia 1 protein (Mcl-1) and Bcl-2 showed upward trends ( Ftrend = 58.201, 7.691, P < 0.05). Compared with the 0 passage and the control group of the same passage, from the 22nd passage of caspase-3, cleaved-caspase-3, from the 15th passage of CHOP, Mcl-1, and Bcl-2, from the 29th passage of Bax in the arsenite group, the differences of protein were statistically significant ( P < 0.05). However, there were no significant differences in caspase-8, cleaved-caspase-8, caspase-12 and cleaved-caspase-12 protein expressions in the arsenic group ( P > 0.05). Compared with the 0 passage and the control group of the same passage, from the 8th passage of Nrf2 proteins in the arsenite group, the differences of expressions were statistically significant ( P < 0.05). Compared with T-HBE cells transfected with Con siRNA (control), the apoptosis rate of T-HBE cells transfected with Nrf2 siRNA was higher ( P < 0.05). Compared with T-HBE cells transfected with Con siRNA, the expression levels of Nrf2, Bcl-2 and Mcl-1 in T-HBE cells transfected with Nrf2 siRNA were lower ( P < 0.05), while the expression levels of cleaved-caspase-3/caspase-3, caspase-3, cleaved-caspase-3, CHOP, and Bax were higher ( P < 0.05). Conclusion:Nrf2 may regulate mitochondrial apoptotic pathway through Bcl-2, Mcl-1 and Bax, and endoplasmic reticulum apoptotic pathway through CHOP, so as to inhibit the apoptosis of HBE cells and participate in the process of malignant transformation of HBE cells induced by NaAsO 2.
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Objective:To explore the role of nuclear transcription factor erythrocyte line-2p45 (NF-E2) related factor-2 (NRF2) on autophagy during malignant transformation of immortalized human keratinocytes (HaCaT) induced by sodium arsenite (NaAsO 2). Methods:Using cell culture methods, long-term cultured HaCaT cells in DMEM high-glucose medium containing 0.0 (control group) and 1.0 μmol/L NaAsO 2 (arsenic-exposed group) to the 35th generation were used to construct a cell malignant transformation model, and 0, 1, 7, 14, 21, 28 and 35th generation cells of control group and arsenic-exposed group were collected during establishment of cell malignant transformation model. The NRF2 siRNA, phosphatidylinositol-3-hydroxykinase (PI3K) inhibitor LY294002 and mammalian target of rapamycin (mTOR) inhibitor Rapamycin were used to treat the 35th generation of malignant transformed HaCaT cells in arsenic-exposed group (T-HaCaT). The protein expressions of NRF2, PI3K-protein kinase B (Akt)-mTOR signaling pathway related indicators PI3K, Akt, mTOR, phosphorylated (p)-PI3K, p-Akt, p-mTOR, autophagy-related proteins p62, Beclin1, microtubule-associated protein-1 light chain (LC)3Ⅰ, and LC3Ⅱof different generations HaCaT cells in control group and arsenic-exposed group, and T-HaCaT cells of each treatment group were determined by Western blotting. Results:There were significant differences in the NRF2 protein and the ratios of p-PI3K/PI3K, p-Akt/Akt and p-mTOR/mTOR between different generations HaCaT cells in arsenic-exposed group ( F = 9.371, 16.035, 15.932, 27.739, P < 0.05), and they were higher than NRF2 protein and ratio of p-mTOR/ mTOR of the same generation in control group ( P < 0.05). Compared with HaCaT cells of the same generation, the expressions of NRF2, p-PI3K, p-Akt, p-mTOR and p62 proteins in T-HaCaT cells were significantly higher, Beclin1 protein expression and the ratio of LC3Ⅱ/LC3Ⅰ were significantly lower ( P < 0.05). The NRF2 silenced T-HaCaT cells had higher expression of Beclin1 and the ratio of LC3Ⅱ/LC3Ⅰ, and lower expressions of NRF2, p-mTOR and p62 than the corresponding control siRNA (Con siRNA) group ( P < 0.05). The T-HaCaT cells in LY294002 treatment group had higher expression of Beclin1 and the ratio of LC3Ⅱ/LC3Ⅰ, and lower expressions of NRF2, p-PI3K, p-Akt and p-mTOR proteins than the corresponding non-treatment group ( P < 0.05). The T-HaCaT cells in Rapamycin treatment group had higher expression of Beclin1 and the ratio of LC3Ⅱ/LC3Ⅰ, and lower expression of p-mTOR protein than the corresponding non-treatment group ( P < 0.05). Conclusions:During the arsenic-induced malignant transformation of HaCaT cells, NRF2 can act as a downstream factor of PI3K-Akt and an upstream factor of mTOR in PI3K-Akt-mTOR signaling pathway, an important regulatory mechanism of autophagy. This abnormal expression of autophagy may eventually lead to malignant transformation of cells.
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Objective:To explore the long-term clinical efficacy and complications of modified spinous process splitting laminoplasty using coralline hydroxyapatite (SLAC).Methods:The patients who underwent SLAC surgery in this hospital from 2005.5 to 2011.7 were included retrospectively. The perioperative data were collected and followed up. A total of 165 cases were included. Among them, there were 115 males and 50 females; the average age was 56.5±11.4 years (range: 26-84 years), and the average follow-up period was 136.5±23.2 months (range: 108-182 months). The modified Japanese Orthopedic Association (mJOA) score, the neck disability index (NDI) score were used to evaluate the clinical symptoms of patients, and follow-up imaging to observe the changes in cervical spine curvature and mobility.Results:In terms of functional score: mJOA score increased from 11.4±2.9 before surgery to 15.0±1.8 in the early postoperative period but dropped to 14.0±2.5 at the last follow-up ( F=77.096, P<0.001), and NDI score decreased from 19.2%±14.4% before surgery to 13.0%±15.0% in the early postoperative period, but it rose to 14.0%±14.9% at the last follow-up ( F=6.915, P<0.001). The improvement rate of mJOA was 63.5% (early postoperatively) and 50.8% (last follow-up). Regarding the curvature of the cervical spine, the C 2-C 7 Cobb angle decreased from 14.8°±9.1° before surgery to 11.1°±10.5°, and it was maintained at the last follow-up (11.0°±10.1°) ( F=1.083, P=0.342). The cervical spine range of motion decreased significantly, mainly because the Cobb angle in the flexion position decreased from -19.8°±13.6° before the operation to -3.7°±10.6° at the last follow-up ( P<0.001). Seventy-two patients (44.0%) had complications after operation. Six patients (3.6%) developed neurological symptoms aggravated during follow-up, and their mJOA decreased by more than 3 points. 62 patients (37.6%) developed axial symptoms, of which 7 cases were relieved early (within 6 months post-op), 55 patients had persisted symptom and 17 cases (10.3%) remained painful. C 5 nerve root palsy occurred in 10 cases (6.1%) after the operation, 9 cases resolved within two years and the last patient did not resolve. Conclusion:SLAC surgery can effectively alleviate the patient's neurological symptoms and maintain long-term efficacy and cervical lordosis. The occurrence of persistent axial symptoms and the loss of cervical flexion range are long-term complications after SLAC surgery.
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OBJECTIVE：To study the imp rovement effects of Polygonatum si biricum polysaccharides（PSP）on the myocardial injury of acute myocardial infarction （AMI）model rats. METHODS ：The rats were randomly divided into blank control group ， model group ，aspirin group （positive control ，25 mg/kg），PSP low-dose ，medium-dose and high-dose groups （0.5，1，2 g/kg）， with 10 rats in each group. Except for blank control group ，AMI model was established by ligation of the anterior descending branch of the left coronary artery of rats in other groups. After modeling ，blank control group and model group were given normal saline intragastrically ，and administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 28 days. After last medication ，left ventricular ejection fraction （LVEF）and left ventricular short axis shorting rate （LVFS）of rats were detected. The morphological changes of myocardial tissue were observed. The levels of oxidative stress indexes （SOD，MDA， ROS）in myocardial tissue of rats were detected by ELISA. The expression of apoptosis-related proteins （Bcl-2，Bax，caspase-3， caspase-8，caspase-9）and the Wnt/ β-catenin pathway-related proteins （Wnt1，β-catenin）in left ventricular anterior wall tissue of rats were detected by Western blot assay. RESULTS ：Compared with model group ，the levels of LVEF and LVFS ，the levels of SOD in myocardial tissue and protein expression of Bcl- 2 in left ventricular anterior wall tissue were increased significantly in PSP medium-dose，high-dose groups and aspirin group （P＜0.05）；the levels of MDA and ROS in myocardial tissue ，the protein expression of Bax ，caspase-3，caspase-8，caspase-9，Wnt1 and β-catenin in left ventricular anterior wall tissue were decreased significantly（P＜0.05）；myocardial tissue structure disorder and inflammatory cell infiltration were reduced. CONCLUSIONS ： PSP can relieve myocardial injury in AMI model rats ；its mechanism may be related to increasing SOD level in myocardial tissue ，decreasing MDA and ROS level ，regulating apoptosis-related proteins and Wnt/ β-catenin pathway-related proteins.
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With the deepening of the research on the "two sides" of arsenic from poison to medicine, arsenic has attracted extensive attention in affecting programmed cell death (PCD) and causing damage to a variety of organs. Recent studies have showed that reactive oxygen species (ROS) produced by intracellular arsenic metabolism is closely related to PCD induction. However, the specific mechanism is still unclear. In this paper, we have reviewed the main PCD forms, such as apoptosis, autophagy and necroptosis induced by arsenic via ROS and their possible mechanisms, in order to provide basic information for further research and prevention of arsenic toxicity, which is helpful for clinical development and utilization of arsenic in the treatment of tumors and related diseases.
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This study aimed to evaluate the effect of curcumin on brain hypoxicischemic(HI) damage in neonatal rats and whether the phosphoinositide 3-kinase(PI3K)/Akt/vascular endothelial growth factor (VEGF) signaling pathway is involved.Brain HI damage models were established in neonatal rats, which received the followingtreatments: curcumin by intraperitoneal injection before injury, insulin-likegrowth factor 1 (IGF-1) by subcutaneous injection after injury, and VEGF by intracerebroventricularinjection after injury. This was followed by neurological evaluation,hemodynamic measurements, histopathological assessment, TUNEL assay,flow cytometry, and western blotting to assess the expression of p-PI3K, PI3K, p-Akt,Akt, and VEGF. Compared with rats that underwent sham operation, rats with brainHI damage showed remarkably increased neurological deficits, reduced right bloodflow volume, elevated blood viscosity and haematocrit, and aggravated cell damageand apoptosis; these injuries were significantly improved by curcumin pretreatment.Meanwhile, brain HI damage induced the overexpression of p-PI3K, p-Akt, and VEGF,while curcumin pretreatment inhibited the expression of these proteins. In addition,IGF-1 treatment rescued the curcumin-induced down-regulated expression of p-PI3K, p-Akt, and VEGF, and VEGF overexpression counteracted the inhibitory effectof curcumin on brain HI damage. Overall, pretreatment with curcumin protectedagainst brain HI damage by targeting VEGF via the PI3K/Akt signaling pathway inneonatal rats.
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This study aimed to evaluate the effect of curcumin on brain hypoxicischemic(HI) damage in neonatal rats and whether the phosphoinositide 3-kinase(PI3K)/Akt/vascular endothelial growth factor (VEGF) signaling pathway is involved.Brain HI damage models were established in neonatal rats, which received the followingtreatments: curcumin by intraperitoneal injection before injury, insulin-likegrowth factor 1 (IGF-1) by subcutaneous injection after injury, and VEGF by intracerebroventricularinjection after injury. This was followed by neurological evaluation,hemodynamic measurements, histopathological assessment, TUNEL assay,flow cytometry, and western blotting to assess the expression of p-PI3K, PI3K, p-Akt,Akt, and VEGF. Compared with rats that underwent sham operation, rats with brainHI damage showed remarkably increased neurological deficits, reduced right bloodflow volume, elevated blood viscosity and haematocrit, and aggravated cell damageand apoptosis; these injuries were significantly improved by curcumin pretreatment.Meanwhile, brain HI damage induced the overexpression of p-PI3K, p-Akt, and VEGF,while curcumin pretreatment inhibited the expression of these proteins. In addition,IGF-1 treatment rescued the curcumin-induced down-regulated expression of p-PI3K, p-Akt, and VEGF, and VEGF overexpression counteracted the inhibitory effectof curcumin on brain HI damage. Overall, pretreatment with curcumin protectedagainst brain HI damage by targeting VEGF via the PI3K/Akt signaling pathway inneonatal rats.
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Objective:To evaluate the feasibility of surgery for upper cervical spine anomaly instability achieved by readjusting the clivus-axial angle (CAA) and evaluating available screw trajectories based on preoperative virtual simulation reduction using 3D CT reconstruction.Methods:From January 2014 to September 2019, 52 patients (28 males, 24 females; mean age 46.7 years; range 18-64 years) with upper cervical spine anomalies were enrolled in a retrospective study. DICOM data of preoperative CT scanning of cervical spine were imported into Mimics 15.0 to reconstruct the 3D model of atlantoaxial joint. The target range of CAA was set with the value measured in fusing images of extension view of cervical spine as the upper bound; and 140°, the lower limit of normal CAA range, was set as the lower bound. The trajectories of screws were sought within the target range of CAA. The exact CAA value of the available trajectories was set as the target angle of intraoperative reduction . The preoperative, postoperative and simulated target CAA values were compared. The accuracy of screw placement was evaluated according to the Gertzbein-Robbins scale. The pre- and postoperative neck disability index (NDI) and Nurick scale were also compared.Results:Among 52 patients, available screw trajectories existed in 35 patients. With the validation under computer-assisted navigation as the gold standard, 37 patients underwent Magerl screws fixation (Magerl group) while the other 15 patients underwent screw-rods fixation (screw-rods group). In Magerl group, no significant difference was found between simulated target CAA values (150.1°±6.6°) and postoperative CAA values (149.0°±6.5°)( t=1.194, P=0.240); postoperative CAA values were significantly larger than preoperative CAA values (124.0°±8.9°)( t=-13.499, P< 0.001). In screw-rods group, no significant difference was found between simulated target CAA values (150.4°±5.6°) and postoperative CAA values (150.2°±6.1°) ( t=0.319, P=0.754); postoperative CAA values were also significantly larger than preoperative CAA values (121.9°±8.3°)( t=-12.431, P< 0.001). Follow-up data were obtained in all 52 patients, with a mean follow-up time of 1.7±0.9 years (range, 0.5-4 years). A total of 106 screws were placed into 52 patients, including 74 in Magerl group and 32 in screw-rods group. According to the Gertzbein-Robbins scale, 88 and 15 were classified into grade A and B respectively; and 97.1% (103/106) of screws were acceptable. No severe complications such as vertebral artery injury and low cranial nerve palsy occurred. The postoperative NDI (9.7±6.4 vs. 27.4±8.7) and Nurick scale (1.1±1.4 vs. 2.6±1.3) decreased significantly compared to preoperative ones, respectively. Conclusion:Preoperative virtual simulation can evaluate available screw trajectories and provide the target CAA values for guidance of intraoperative reduction. Based on this, readjusting the CAA under computer-assisted navigation were safe and feasible, and warranted the possibility of a single posterior reduction and fusion approach for reducible upper cervical anomaly instability.
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@#AIM: To investigate the cause and treatment of abnormal blinking in 225 children. <p>METHODS: A retrospective analysis was performed on the causes, examination results, treatment methods and efficacy of abnormal blinking in 225 children. <p>RESULTS: Among 225 children, 156 cases(69.3%)had corneal or conjunctival diseases, of which 68 cases(30.2%)were diagnosed with allergic conjunctivitis and 88 cases(39.1%)with other corneal or conjunctival diseases, 38 cases(16.9%)were found with eyelid disease, 65 cases(28.9%)with ametropia, 56 cases(24.9%)with dry eye, and 108 cases(48%)with video terminal syndrome. After 1wk to 2mo of treatment for the underlying causes, 175 cases were cured and 35 cases were improved, with no improvement observed in 15 cases. <p>CONCLUSION: The cause of abnormal blinking in children is relatively complex, which is closely related to allergic conjunctivitis, video terminal syndrome, dry eye and ametropia. It should be considered comprehensively in clinical practice and treatment should be given targeting different causes.
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Objective To investigate the relationship between serum cystatin C(CysC)level and vascular complications in type 2 diabetes mellitus(T2DM)patients with normal renal function. Methods Totally 218 T2DM patients who were treated in the Department of Endocrinology,Affiliated Hospital of Chengde Medical College from January 2017 to May 2018 were enrolled.All subjects were divided into four groups based on the quartiles of serum CysC levels:G1 group:≤ 0.56 mg/L,58 cases;G2 group:0.57-0.73 mg/L,52 cases;G3 group:0.74-1.11 mg/L,56 cases;G4 group:≥ 1.12 mg/L,52 cases.The general data,biochemical indicators,glycated albumin,hemoglobin A
Subject(s)
Humans , Biomarkers/blood , Cardiovascular Diseases/complications , Cystatin C/blood , Diabetes Mellitus, Type 2/complications , Kidney , Risk FactorsABSTRACT
Objective@#To develop a calculation model for normal sagittal diameter (SD) of bulbo-medullary junction with the change of distance above the measurement baseline(the line connecting the anterior lower margin of the C2 vertebral body and the posterior upper margin of the C3 vertebral body), and to investigate its calculation error.@*Methods@#All of 164 patients with cervical disc herniation or cervical spinal stenosis who underwent cervical MRI between April 2018 and August 2018 in Beijing Jishuitan Hospital were included in this study. The normal bulbo-medullary junction was divided into two parts from top to bottom, and the dividing line was defined factitiously (the line parallel to the measurement baseline and through the lower margin of cancellous bone of the anterior arch of atlas). On the middle sagittal MRI images of 100 cases of normal bulbo-medullary junction, the change rate of the SD along the distance above the measurement baseline was counted on the upper and lower segments separately. The calculation model for SD of bulbo-medullary junction was established, with the SD of spinal cord at level of the lower margin of axis and the distance above the measurement baseline as independent variables. After setting-up of the calculation model, the actual SD at the lower margin of the C1 anterior arch and 10 mm above and below it was measured on other 64 cases of normal bulbo-medullary junction. The actual SD and calculation value were compared for calculating the error and error rate. The SD at the dividing line was estimated using the substituted estimation (the actual SD at level of the lower margin of axis) and mean-value estimation (the mean SD of the first 100 cases). Calculation value, substituted estimation and mean-value estimation were compared, and their calculation error and the occurrence rate of significant error (no less than 1 mm) were also compared.@*Results@#Calculation formula for SD of bulbo-medullary junction: (below the dividing line) SD=sagittal diameter at level of the lower margin of axis (SDA)+0.0472×height above the measurement baseline (HAB), (above the dividing line) SD=SDA+0.0472×height of dividing line above the measurement baseline (HDL)+0.298×(HAB-HDL). The error of calculation model increased with the distance above the measurement baseline. The error at the topmost level was 1.06±0.72 mm, and the error rate was 10.52%± 8.26%. Compared with the estimation method using the mean value, the calculation model was accompanied with a significantly lower ratio of significant error (Z=-3.527, P<0.001). Compared with the estimation method using a substitute, the error of the calculation model was significantly smaller (Z=-4.88, P<0.001) and the ratio of significant errors was significantly lower (Chi-Square= 6.015, P=0.024).@*Conclusion@#The SD calculation model could accurately estimate the SD of a normal bulbo-medullary junction, and has great significance for the quantitative imaging assessment and decompression strategy in patients with atlantoaxial instability.
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Objective@#To provide the normal value of atlas (C1) inner sagittal diameter in adults thus defining the diagnostic value of developmental canal stenosis at C1 and to establish the Jishuitan (JST) morphological classification for C1 developmental canal stenosis in craniovertebral junction (CVJ) anomalies.@*Methods@#From December 2010 to November 2018, 101 patients with various CVJ anomalies (50 males, 51 females; mean age 48.8±12.9 years, range 15-78 years; the anomaly group) and 857 patients with normal CVJ (461 males, 396 females; mean age 50.2±8.3 years, range 21-79 years; the normal group) were enrolled in a retrospective study. In the anomaly group, 92 cases of atlantoaxial dislocation were furtherly divided into three subgroups according to Wadia classification: atlantoaxial dislocation with os odontoideum (OO subgroup, n=33), atlantoaxial dislocation with occipitalization of the atlas (OA subgroup, n=24), atlantoaxial dislocation without both OO and OA (AAD subgroup, n=35); the rest of the anomaly group was combined with Chiari malformation (CM subgroup, n=9). The range of C1 inner sagittal diameter in each group was measured via CT scan images. The normality of C1 inner sagittal diameter of each group was tested via Shapiro-Wilk method. T test was performed on C1 inner sagittal diameter of each group. The diagnostic value of C1 developmental canal stenosis was defined as the lower bound of 95% confidence interval (CI) for the mean of the normal group. The C1 morphology of developmental canal stenosis cases in anomaly group were analyzed via CT scan images thus establishing the JST morphological classification for C1 developmental canal stenosis in CVJ anomalies.@*Results@#The mean C1 inner sagittal diameter was 29.05±1.60 mm (range, 24.05-33.50, 95%CI: 25.91-32.19). C1 developmental canal stenosis was defined as C1 inner diameter ≤ 25.91 mm. The mean C1 inner sagittal diameter of the whole anomaly group was 26.84±2.04 mm (95%CI: 22.84-30.84), which differed significantly from that in the the normal group (t=10.504, P< 0.01). A total of 33 cases meeting the criteria of C1 inner diameter ≤ 25.91 mm were diagnosed as C1 developmental canal stenosis, including 14 cases of the OO subgroup, 4 cases of the OA subgroup, 15 cases of the AAD subgroup and none of the CM subgroup. Based on the C1 morphological characteristics of 33 cases, the JST classification of C1 developmental canal stenosis in CVJ anomalies was established, which could be divided into type I-III. Type I: little atlas type, 84.9% (28/33), normal C1 posterior arch morphology without C1 occipitalization; Type II: atlas posterior arch incurving type, 3.0%(1/33), C1 posterior arch incurves towards spinal canal, without C1 occipitalization; Type III atlas occipitalization type, 12.1% (4/33), furtherly divided into: type IIIa with normal C1 posterior arch morphology; type IIIb with incurving C1 posterior arch.@*Conclusion@#The normal value of C1 inner sagittal diameter in adults was from 24.05 to 33.50 mm. The criteria of C1 inner sagittal diameter ≤ 25.91 mm can be used as the radiographic diagnostic value of C1 developmental canal stenosis. C1 developmental canal stenosis in CVJ anomalies can be classified according to the JST classification system.
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Objective@#To explore the Duhuo-Xuduan decoction combined with massage in the treatment of lumbar intervertebral disc herniation with yin deficiency of liver and kidney type.@*Methods@#According to the random number table method, 67 patients were divided into the control group (n=33) and the study group (n=34). The patients in the control group were treated with traditional massage, while the patients in the study group were treated with Duhuo-Xuduan decoction on the basis of the control group. The groups were treated continuously for 4 weeks. After treatment, the total clinical effective rate of the two groups was counted. The Visual analogue scale (VAS) and Oswestry dysfunction index were measured before and after treatment. At the same time, the level of serum Aggrecan, bone morphogenetic protein 7 (BMP-7), P substance (SP), 5-hydroxytryptamine (5-HT), dopamine (DA) were detected respectively before and after treatment. In addition, the adverse reaction of the two groups were observed.@*Results@#The total clinical effective rate of the study group was 97.06% (33/34), significantly higher than 81.82% (27/33) of the control group, and the difference was statistically significant (χ2=4.157, P=0.041). After treatment, the VAS score, Oswestry dysfunction index and serum SP, 5-HT, DA of study group was significantly lower than those of the control group (t=13.175, 12.524, 14.481, 15.729, 14.391, all Ps<0.01), while the level of serum Aggrecan, and BMP-7 of study group was significantly higher than that of the control group (t=18.697, 16.222, all Ps<0.01). There were no serious adverse reactions during treatment in both groups.@*Conclusions@#The Duhuo-Xuduan decoction combined with massage can alleviate pain, improve dysfunction of the patients with lumbar intervertebral disc herniation with yin deficiency of liver and kidney type. It is speculated that its mechanism may be related to analgesia and promoting cartilage regeneration of injured lumbar intervertebral disc.
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Objective To explore the Duhuo-Xuduan decoction combined with massage in the treatment of lumbar intervertebral disc herniation with yin deficiency of liver and kidney type. Methods According to the random number table method, 67 patients were divided into the control group (n=33) and the study group (n=34). The patients in the control group were treated with traditional massage, while the patients in the study group were treated with Duhuo-Xuduan decoction on the basis of the control group. The groups were treated continuously for 4 weeks. After treatment, the total clinical effective rate of the two groups was counted. The Visual analogue scale (VAS) and Oswestry dysfunction index were measured before and after treatment. At the same time, the level of serum Aggrecan, bone morphogenetic protein 7 (BMP-7), P substance (SP), 5-hydroxytryptamine (5-HT), dopamine (DA) were detected respectively before and after treatment. In addition, the adverse reaction of the two groups were observed. Results The total clinical effective rate of the study group was 97.06% (33/34), significantly higher than 81.82% (27/33) of the control group, and the difference was statistically significant (χ2=4.157, P=0.041). After treatment, the VAS score, Oswestry dysfunction index and serum SP, 5-HT, DA of study group was significantly lower than those of the control group (t=13.175, 12.524, 14.481, 15.729, 14.391, all Ps<0.01), while the level of serum Aggrecan, and BMP-7 of study group was significantly higher than that of the control group (t=18.697, 16.222, all Ps<0.01). There were no serious adverse reactions during treatment in both groups. Conclusions The Duhuo-Xuduan decoction combined with massage can alleviate pain, improve dysfunction of the patients with lumbar intervertebral disc herniation with yin deficiency of liver and kidney type. It is speculated that its mechanism may be related to analgesia and promoting cartilage regeneration of injured lumbar intervertebral disc.