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Objective:To investigate the correlation between serum cystatin C (Cys C) and left ventricular geometry in patients with obstructive sleep apnea syndrome (OSAS) complicated with prehypertension(PH).Methods:A total of 408 patients with PH and OSAS diagnosed by polysonogram monitoring in the sleep monitoring room of Respiratory Department, the First Hospital of Shanxi Medical University from July 2018 to June 2021 were collected. Serum Cys C concentration and echocardiography were performed in all patients. According to the classification of left ventricular geometry, all patients were divided into four groups: normal configuration (NG) group( n=297), concentric remodeling (CR) group( n=49), eccentric hypertrophy (EH) group( n=33), and concentric hypertrophy (CH) group( n=29). General clinical data, sleep parameters, blood biochemical parameters, Cys C concentration and echocardiographic parameters were compared among the four groups, and the correlation between serum Cys C and left ventricular geometry was analyzed. Results:①The serum Cys C concentration increased successively from NG group, CR group, EH group to CH group, and the increase in CH group was the most obvious ( P<0.05). In addition, there were statistically significant differences in body mass index (BMI), waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), severity of OSAS, the percentage of the time that the blood oxygen saturation was less than 90% of the total sleep time (T90), lowest oxygen saturation (Lowest-SaO 2), mean oxygen saturation (Mean-SaO 2), left ventricular end diastolic diameter (LVEDD), inter-ventricular septal diameter (IVST), left ventricular posterior wall thickness diameter (LVPWT), left ventricular mass index (LVMI), relative wall thickness (RWT), left ventricular ejection fraction (LVEF) and E/A among all groups (all P<0.05). ②Multivariate Logistic regression analysis showed that Cys C was independently correlated with CR (β=0.721, OR=2.057, P=0.047), EH(β=0.961, OR=2.614, P=0.017) and CH (β=1.180, OR=3.254, P=0.010). Conclusions:There is a correlation between serum Cys C and left ventricular geometry in OSAS patients with PH, suggesting that serum Cys C might be involved in the change of left ventricular geometry.
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Objective:To investigate the clinical application value of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area.Methods:Twenty-six patients who underwent laparoscopic cholecystectomy based on the concept of enhancing recovery after surgery using the LEER model in People's Hospital of Jinkouhe District of Leshan from January to October 2021 were included in the observation group. An additional 20 patients who concurrently underwent laparoscopic cholecystectomy and conventional intervention were included in the control group. Clinical efficacy, postoperative complications and postoperative pain were compared between the two groups.Results:Postoperative fasting time, length of hospital stay, and total hospital days in the observation group were 6 (6, 6) hours, 2 (2, 3) days and 4 (4, 6) days respectively, which were significantly shorter than 24 (24, 36) hours, 5 (5, 6) days, 7 (7, 9) days in the control group ( H = 351.00, 407.50, 458.00, all P < 0.05). Hospitalization cost in the observation group was 5 454.58 (5 014.11, 6 016.58) yuan, which was significantly lower than 6 611.91 (6 192.68, 7 841.73) yuan in the control group ( H = 420.00, P < 0.05). There were no significant differences in operative time and postoperative complications between the two groups (both P > 0.05). At postoperative 6 hours, Visual Analogue Scale score in the observation group was 3 (3, 4) points, and patients with mild pain accounted for 73.07% (19/26). At postoperative 24 hours, Visual Analogue Scale score in the observation group was 2 (2, 3) points, and patients with mild pain accounted for 92.31% (24/26). Overall pain was well controlled after surgery. Patient satisfaction rate in the observation was 96.15% (25/26). All patients recovered and were discharged. Conclusion:Application of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area can promote postoperative recovery, contribute to changing the theory of diagnosis and treatment, and improve overall medical quality. The enhanced recovery after surgery protocol using the LEER model has a good application value.
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Objective:To investigate the cognition and coping experience of fatigue in elderly patients with chronic obstructive pulmonary disease (COPD), so as to provide basis and research basis for the preparation of fatigue intervention measures for elderly patients with COPD.Methods:Qualitative research interview was used to conduct face-to-face and in-depth communication with 12 elderly patients with COPD under the guidance of pre-prepared interview outline. The 7-step Colaizzi analysis method was used to analyze the transcript of the interview and extract the theme and representative statements.Results:Fatigue cognition could be summarized into five themes:fatigue symptoms were often accompanied by drowsiness, fatigue, anxiety, poor sleep, memory loss and other symptoms; there was no definite time point for the appearance of fatigue symptoms; breathing difficulties, limited activities, mental and psychological disorders and deficient social support were the main causes of fatigue; family accidents, seasonal variation, the occurrence of complications and relapses of the malady were the aggravating factors of fatigue symptoms; fatigue affects the patient ′s ability to move, social circle and life motivation. Coping experiences could be summarized into three themes: strengthen self-management and ask for help; take the initiative to learn and improve the level of self-care; emotional disorder, negative response. Conclusions:There are obvious fatigue symptoms in elderly patients with COPD. Affected by many factors, such as disease factors, self-perceived burden level, family support and social support level, most patients have insufficient fatigue cognition and lack of coping ability. Medical staff should fully understand the fatigue cognition and coping experience of such patients and implement effective intervention programs to improve the coping ability of patients.
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Objective: To explore the clinicopathological characteristics and prognostic factors of gastric neuroendocrine neoplasm (NEN). Methods: Clinicopathological parameters and follow-up data collected from 117 patients with gastric NEN at Tianjin Medical University Cancer Institute and Hospital from March 2011 to December 2017 were reviewed, classified, and graded according to World Health Or-ganization (WHO) 2010 classification. Clinicopathological characteristics of different types and grades of gastric NEN were compared and survival analysis was performed. Results: Among the 117 cases confirmed as gastric NEN, this entire cohort comprised 13 cases (11.1%) of neuroendocrine tumor (NET) G1, 6 cases (5.1%) of NET G2, 57 cases (48.7%) of neuroendocrine carcinoma (NEC), and 41 cases (35.1%) of mixed adenoneuroendocrine carcinoma (MANEC). Gastric NET G1 and G2 typically consisted of multiple small tumors with shallow invasion and infrequent lymphatic and distant metastases at early stages at the time of diagnosis. The treatment of patients with gastric NET included endoscopic submucosal dissection and radical surgical resection. Precursor neuroendocrine lesions were detected in most cases. The patients with gastric NET G1 and G2 had a good prognosis. Gastric NEC and MANEC mostly consisted of single large tumors with deep infiltration, and common lymphatic and distant metastases at advanced stages when the diagnoses were confirmed. All the patients with gastric NEC and MANEC underwent surgical resection, and most received adjuvant therapy. Histopathological changes of gastric NEC were characterized by large cells and poorly differentiated tumors, while gastric MANEC had various forms of neuroendocrine and adenocarcinoma components. The prognosis of patients with gastric NEC and MANEC was poor for both; however, the predictors of progression-free survival and overall survival were different between gastric NEC and MANEC. Conclusions: Gastric NEN are a group of heterogeneous tumors with different clinicopathological features and prognosis. More multicenter studies with large sample sizes are still needed to improve the classification of gastric NEN and explore the prognostic factors.
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Lao-Xiang-Huang (LXH) of Chaozhou is the processed product of Fructus Citri sarcodactylis.LXH from different producing areas were used as research objects in the study for the establishment of HPLC fingerprints of LXH.Contents of hesperidin and 5,7-dimethoxycoumarin were also determined to provide scientific basis for the establishment of quality standard of LXH.Samples were separated by an Agilent Eclipse XDB C18 column (4.6 mm × 250 mm,5 μm) using acetonitrile-0.1％ phosphoric acid with water gradient system as a mobile phase.The flow rate was 1.0 mL· min-1.The injection volume was 20 μL.The detection wavelength was at 283 nm.The results showed that HPLC fingerprint of LXH was established with good separation and repeatability.The similarity evaluation on 27 batches samples of LXH showed that there was a certain similarity on the HPLC fingerprints of LXH.However,there was a certain difference as a whole.Contents of hesperidin and 5,7-dimethoxycoumarin in LXH were simultaneously determined.It was concluded that the established HPLC fingerprint of LXH and content determination of hesperidin and 5,7-dimethoxycoumarin method were accurate,sensitive and repeatable.It provided scientific evidence for the quality control standard of LXH of Chaozhou.
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An offline silver-impregnated silica gel solid-phase extraction (Ag-SPE) approach combined with a programmed temperature vaporization-gas chromatography-flame ionization detector (PTV-GC-FID) was proposed for routine analysis of mineral oil saturated hydrocarbons (MOSH) in chocolates. The MOSH in chocolates were extracted by n-hexane and 1 mL of extract was purified by offline Ag-SPE column. The SPE columns packed with 0.3％ Ag-activated silica gel were used to separate MOSH from triglycerides and olefins in chocolates. The eluent of MOSH fraction was only 5 mL and then concentrated to 0.2 mL through nitrogen blowing with little evaporation loss. The PTV parameters were as follows: the initial temperature was set at 45℃ and held for 1 min (split ratio was 200∶1), then warmed up to 360℃ at linear gradient of 250℃ minSymbolm_1 and held for 27 min (split valve was closed for 2 min followed by split ratio of 100∶1). The GC injection volume was 40 μL. The GC column was heated from 35℃ (3 min) to 350℃ at 25℃/min, and then raised to 370℃ (10 min) at 5℃/min. The flow rate of the carrier gas was 1.3 mL/min (and pressure was 60 kPa), FID temperature was set at 380℃. The limit of quantification (LOQ) and the recoveries of the method were 0.5 mg/kg and 84.9％-108.6％, respectively, with the relative standard deviations (RSD) of 0.2％-1.5％. Twenty-five commercial chocolate samples were analyzed with the proposed method, and it was found that the MOSH in three samples were not detected, and the concentrations of MOSH in other 22 samples were 1.09-8.15 mg/kg (the concentrations of MOSH with C16-C35 component were 0.56-4.43 mg/kg). The results suggested that it was necessary to routinely detect mineral oil contamination in chocolates for food safety.
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Objective To assess whether asymmetric spin echo version of echo planar imaging (ASE EPI) sequence can reflect cerebral oxygen metabolism by means of the changes in oxygen extraction fraction values before and after surgical operations in the canine model of ischimia. Methods A total of 12 healthy crossbreed dogs were enrolled in this study. All canines underwent cerebral MR imaging including coronal T2WI, DWI, MRA, ASE EPI and 3D PCASL. The bilateral carotid arteries (CA) were separated by surgical operations. The bilateral CA were ligated in 6 dogs, and the other 6 dogs had embolization in ligated bilateral CA. The cerebral MR imaging with the above protocol was repeated at 1 hour after surgical operation for each dog. All dogs were executed when they finished the MR examinations. Then the whole brains of the dogs were taken out for cutting coronal sections and 2, 3, 5-triphenyltetrazolium chloride (TTC) staining. The ASE EPI data were processed by the Functool software in the workstation to generate OEF maps. For measuring the OEF values before and 1 hour after surgical operations, one and the same region of interest (ROI) was respectively placed in the left and right hemispheres on the OEF maps for each dog. 3D PCASL data were processed by the Functool software in the workstation to yield CBF maps. The method for measuring the CBF values before and 1 hour after surgical operations on CBF maps was same as that for measuring on OEF maps. The changes of measurements before and after surgical operations were compared between the dogs with ligated bilateral CA and the dogs with embolization in ligated bilateral CA by using an independent samples t test. The measurements before and after surgical operations were respectively compared in the dogs with ligated bilateral CA and the dogs with embolization in ligated bilateral CA by using a paired t-test. The cutting slices with TTC staining were analysed for determining ischimia. Results The CBF values of the dogs with ligated bilateral CA were (59.81±23.59) and (38.56± 12.98) ml/(min · 100 g) before and after surgical operations, respectively. The CBF values of the dogs with embolization in ligated bilateral CA were (58.94±18.35) and (28.01±11.41) ml/(min·100 g) before and after surgical operations, respectively. The CBF values were significantly lower before surgical operations than after surgical operations in the dogs with ligated bilateral CA and the dogs with embolization in ligated bilateral CA, respectively (t=8.92 and 13.42, respectively; P=0.00, respectively). The CBF values were decreased more significantly in the dogs with embolization in ligated bilateral CA than in the dogs with ligated bilateral CA (t=2.92, P=0.00). The OEF values of the dogs with ligated bilateral CA were 0.29±0.02 and 0.32 ± 0.06 before and after surgical operations, respectively. The OEF values of the dogs with embolization in ligated bilateral CA were 0.29 ± 0.02 and 0.35 ± 0.06 before and after surgical operations, respectively. The OEF values were significantly higher before surgical operations than after surgical operations in the dogs with ligated bilateral CA and the dogs with embolization in ligated bilateral CA, respectively (t=-7.21 and-4.43, respectively;P=0.00, respectively). The OEF values were increased more significantly in the dogs with embolization in ligated bilateral CA than in the dogs with ligated bilateral CA (t=2.18, P=0.03). The pathological results showed that the dogs with embolization in ligated bilateral CA had swollen cortex with focal infarction which was matched with the hyperintensity areas on the OEF and DWI images. However, the dogs with ligated bilateral CA only had swollen cortex whereas didn't have focal infarction. Conclusions ASE EPI sequence can reliably reflect cerebral oxygen metabolism in ischemia. This sequence has an important role for assessing hemodynamic state in patients with cerebral vascular diseases.
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Objective:To study the effect and underlying mechanism of sulfur-fumigation and water-soaking on total ash of Di-oscoreae Rhizoma, find the key factor( s) affecting the total ash of Dioscoreae Rhizoma, and explore the rationality of ash limits of Di-oscoreae Rhizoma described in Chinese Pharmacopoeia. Methods:Dioscoreae Rhizoma was respectively dealt with sulfur-fumigation and water-soaking. The changes in total ash content of Dioscoreae Rhizoma was detected by the ash determination methods for total ash and SO2 described in the pharmacopoeia, and then the ash content change of inorganic salts was used to study the mechanism. Results:Sulfur-fumigation could slightly reduce the total ash content of Dioscoreae Rhizoma, while significantly reduce the ash content of calcium oxalate and calcium sulfate with the reduction degree of 7. 20% and 9. 90%, respectively. Calcium phosphate and calcium chloride were slightly affected by sulfur-fumigation, and the results indicated that the effect of sulfur-fumigation on ash content was mainly real-ized by increasing the decomposition rate of calcium oxalate and calcium sulfate. Water-soaking could decline the ash content of Di-oscoreae Rhizoma, and the phenomenon was common in the rhizome medicinal materials. The influence of water-soaking on total ash was more significant than that of sulfur fumigation. Conclusion:Sulfur-fumigation can reduce the total ash content of Dioscoreae Rhizo-ma by increasing the decomposition rate of calcium oxalate and calcium sulfate, however, the effect is mild and the process isn't the key influencing factor in the total ash content of Dioscoreae Rhizoma. During the preparation of Dioscoreae Rhizoma medicinal slices, water-soaking can cause the great loss of water-soluble mineral salts, such as Cl-, C2 O4 2-, NO3 - and SO4 2-, which leads to the reduction of total ash content, therefore, water-soaking is the key influencing factor in the total ash content of Dioscoreae Rhizoma.
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Sulfur , a major component of gunpowder , has been widely used in the engineering and military in-dustries since ancient times . In fact , the application of sulfur in traditional Chinese medicine ( TCM ) has a long history , which indicated the uniqueness of TCM theory and practice . Besides , sulfur has played an impor-tant role for the development of TCM in the history . In order to scientifically analyze the role of sulfur in TCM , this paper focused on the application and evolution of sulfur in the development process of TCM , which aimed to provide a reference for the study of the value and role of sulfur in TCM .
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Objective To evaluate therapeutic effect and opportunity of laser in situ keratomileusis(LASIK) for treatment of hypermetropia.Methods Three hundred and ninety hypermetropia eyes were treated with LASIK using solid excimer laser instrument(made in Novatec Corporation, USA),and were reexamined at 1,3,6 and 12 months after LASIK.Results Therapeutic effect of LASIK was more remarkable, stable and reliable, that of other methods in treating +2.00～+10.00D hypermetropia and astigmatism, and the rate and degree of refraction regression were small. The diopter has been stable in 6～12 months after LASIK. Diopter of 87 percentage of all eyes≤+2.00D, and 61 percentage≤+1.00D. LASIK had shorter recovery time, more gently operation reaction, more remarkable droping of diopter than other methods. Elevation of vision was remarkable after LASIK. Elevation of vision of amblyopia children who were treated with LASIK was quicker and more remarkable after treatment of amblyopia than that of other amblyopia children who were not treated with LASIK.Conclusion At present, LASIK is the best therapeutic method to treat hypermetropia.