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The co-existence of multiple chronic diseases has been increasing in the elderly population, it has become a major challenge globally, and identifying comorbidities patterns can help provide clues for disease prevention and treatment, as well as improving prognosis. This article reviews the identification methods, influencing factors and management strategies of chronic disease comorbidities, to provide a reference for the research and management of comorbidity.
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Objective:To report the clinical characteristics, diagnosis, and treatment of 2 cases of X-linked acrogigantism(X-LAG).Methods:The clinical information of two patients were retrospectively reported, and peripheral blood DNA was collected for copy number variations detection.Results:Both patients had onset at age of two, with common clinical characteristics including linear growth acceleration, mild facial coarsening, enlargement of hands and feet, increased appetite, and snoring, etc. The heights Z scores of the two patients before treatment were + 6.86 and + 6.53, respectively. Growth hormone(GH) glucose inhibition test showed that GH nadir values were over 1 ng/mL and insulin-like growth factor-Ⅰ(IGF-Ⅰ) were 586.0 ng/mL and 1 042.0 ng/mL, respectively. Patient 1 received three cycles of octreotide microspheres therapy followed by surgery, and achieved clinical and biochemical remission. Patient 2 had lanreotide for 5.5 years but failed biochemical remission. Microduplication of Xq26.3, which contained pathogenic gene G-protein coupled receptor 101(GPR101), was found in germline DNA of two patients through copy number variation detection, leading to the diagnosis of X-LAG.Conclusion:It should be cautious of X-LAG when children below 2 years old presents symptoms such as overgrowth and so on. Medication combined with surgery is effective.
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Objective: He-Wei Granule (HWKL) is a modern product derived from the modified formulation of traditional Chinese medicine Banxia Xiexin Decoction (BXD), which remarkedly enhanced the anti-proliferation activity of cyclophosphamide (CTX) on HepG2 and SGC-7901 cell lines in vitro in our previous research. The aim of the study was to investigate the synergistic effects of HWKL and CTX using a transplanted H22 hepatocellular carcinoma mouse model. Methods: The CTX-toxic-reducing efficacy of HWKL was evaluated by hematology indexes, organ indexes and marrow DNA detection. To investigate the underlying mechanisms, histopathology test, immunohistochemistry test and TUNEL staining were conducted. The efficacy of HWKL on the micro-vessel density (MVD) in tumor tissue was also evaluated by measuring CD34 level. Results: High dose HWKL (6.75 g/kg) markedly attenuated CTX-induced hepatotoxicity and myelosuppression while significantly enhanced CTX anticancer efficacy in vivo. Further mechanism investigation suggested that high dose HWKL significantly increased cleaved Caspase 3 level and promoted apoptosis in tumor tissue by up-regulating Bax expression and down-regulating Bcl-2 and FasL expressions. Compared with CTX alone group, the decrease in LC-3B and Beclin 1 levels suggested that the autophagy in H22 carcinoma was significantly inhibited with addition of high dose HWKL. ELISA assay results indicated that the autophagy inhibition was achieved by decreasing p53 expression, blocking PI3K/AKT/mTOR pathway and recovering Th1/Th2 cytokine balance. In addition, CD34 and EGFR immunohistochemistry assay suggest that high dose HWKL could significantly decrease micro-vessel density (MVD) and inhibit angiogenesis in H22 carcinoma. Conclusion: It can be concluded that high-dose HWKL enhanced CTX efficacy by promoting apoptosis, inhibiting autophagy and angiogenesis in tumor tissue while significantly alleviated CTX-induced toxicity, and could be applied along with CTX in clinical treatment as a supplement agent.
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Objective:To provide a promising and optimal laboratory susceptibility-testing method for the clinical usage of antibiotic (polymyxin), four susceptibility-testing methods were performed and the broth microdilution (BMD) was chosen as the gold standard.Methods:A total number of eighty-eight nonduplicate clinical Enterobacteriaceae specimes were collected from January to December of 2019 in the First Affiliated Hospital, Fujian Medical University. Among the clinical specimens, of which six strains were positive for mcr-1. The minimal inhibitory concentration (MIC) of polymyxin of the clinical specimens were examined by the following methods: (1) broth microdilution, (2) colistin broth disk elution, (3) Vitek-2?, (4)BD PhoenixTM,(5)commercial broth microdilution. With BMD as reference, essential agreement (EA), categorical agreement(CA), very major error(VME) and major error (ME) of polymyxins for different methods were analyzed. The Kappa-consistency testing, paired Chi-square testing and the Spearman-rank correlation testing were used to analyze the consistency between the four antimicrobial susceptibility testing methods and the gold standard.Results:Taking broth microdilution as reference, the EA of colistin broth disk elution, Vitek-2?, BD PhoenixTM, commercial broth microdilution were 94.32% (83/88), 92.05% (81/88), 90.90% (80/88), and 96.59%(85/88), respectively. The CA of all the four methods were 100% (88/88). No VME and ME were recorded for four methods. Moreover, the consistency between four susceptibility testing methods and the gold standard is acceptable (Kappa values=1, P<0.001, McNemar test P=1 and r>0.5, P<0.05). Conclusions:In the present work, four susceptibility testing methods all met the standards recommended jointly by the Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing, of which the performance of the commercial broth microdilution and CBDE fared relatively well. Thus, these four methods could be routinely used in clinical microbiology laboratory of our hospital for colistin and polymyxin B susceptibility testing.
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Late onset methylmalonic acidemia (MMA) is a rare genetic metabolic disease.This case is a 46 year old adult patient with MMA complicated with hyperhomocysteinemia.It starts with progressive limb weakness and mental abnormality, and has dysuria and respiratory failure.Neurological examination showed decreased muscle strength of limbs and pyramidal tract sign.The levels of blood homocysteine and urinary methylmalonic acid increased significantly.Head, neck, thoracolumbar magnetic resonance imaging showed abnormal signals in the spinal cord from the level of foramen magnum to the level of lumbar 1 vertebral body.Two heterozygous variants of mmachc were found by gene detection: c: 609G>A, c: 349G>A, consistent with cobalamin C deficiency.Treat with L-carnitine, vitamin B12 and betaine.The patients′ mental symptoms, limb muscle strength and respiratory failure were improved, and the level of blood homocysteine also decreased significantly.
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ObjectiveTo investigate the value of peripheral blood long non-coding RNA-LET (lncRNA-LET) in the diagnosis of chronic hepatitis B (CHB) cirrhosis, and to provide a basis for early clinical diagnosis and treatment of liver cirrhosis. MethodsA total of 175 CHB patients who attended The Affiliated Hospital of Chengde Medical University from March 2017 to May 2019 were enrolled, among whom 52 patients with hepatitis B cirrhosis were enrolled as cirrhosis group and 123 patients without the pathological changes of liver cirrhosis were enrolled as non-cirrhosis group. A total of 40 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as normal control group. Liver function parameters and the level of lncRNA-LET in peripheral blood were measured for all subjects. The t-test was used for comparison of continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of ranked data. A Pearson correlation analysis was performed to investigate correlation. The receiver operating characteristic (ROC) curve was used to investigate the value of peripheral blood lncRNA-LET in predicting liver cirrhosis. Results Compared with the normal control group, the cirrhosis group and the non-cirrhosis group had significantly higher serum levels of the liver function parameters total bilirubin (TBil), total bile acid (TBA), albumin (Alb), and alanine aminotransferase (ALT) (all P＜0.05) and a significantly lower serum level of cholinesterase (ChE) (P＜0.05); compared with the non-cirrhosis group, the cirrhosis group had significantly higher serum levels of TBil, TBA, Alb, and ALT (all P＜0.05) and a significantly lower serum level of ChE (P＜0.05). Compared with the normal control group, the cirrhosis group and the non-cirrhosis group had significantly lower relative expression of lncRNA-LET in peripheral blood (P＜0.05), and the cirrhosis group had significantly lower relative expression of lncRNA-LET in peripheral blood than the non-cirrhosis group (P＜0.05). The relative expression of lncRNA-LET decreased significantly with the increase in liver fibrosis stage (P＜0.05). In the patients with CHB, the relative expression of lncRNA-LET in peripheral blood was negatively correlated with liver fibrosis stage, TBil, TBA, Alb, and ALT (r=-0.352,-0.372,-0.364, and -0.410, all P＜0.001) and was positively correlated with ChE (r=0.340, P＜0.001). The ROC curve was used to analyze the value of peripheral blood lncRNA-LET in predicting liver cirrhosis, and the area under the ROC curve was 0934, with an optimal cut-off value of 0.833, a sensitivity of 84.57%, and a specificity of 80.57%. ConclusionThe expression level of lncRNA-LET in peripheral blood decreases with the progression of liver fibrosis and has a good value in the diagnosis of CHB cirrhosis, and therefore, it can be used as a potential biological indicator for the diagnosis of liver cirrhosis.
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OBJECTIVE@#To explore the value of interferon-inducible protein 10 (IP-10) in the auxiliary diagnosis of tuberculosis and the judgment of the severity of disease.@*METHODS@#From February, 2013 to February, 2017, a total of 193 patients with TB admitted in our hospital and 84 healthy control subjects were recruited consecutively. The peripheral blood plasma levels of interferon-γ (IFN-γ) and IP-10 were detected using liquid phase chip (Luminex) technique. According to the number of lung fields affected by TB, the patients were divided into group A (with lesions in 1-2 lung fields), group B (3-4 lung fields) and group C (5-6 lung fields), The expressions of IFN-γ and IP-10 in 3 groups were compared.@*RESULTS@#The plasma levels of IP-10 were significantly higher in TB patients than in the control subjects ( < 0.05), but IFN-γ levels were comparable between the two groups ( > 0.05). Among the TB patients, plasma IP-10 levels was the highest in group C ( < 0.05), and IFN-γ levels did not differ significantly among the 3 groups ( > 0.05).@*CONCLUSIONS@#Plasma IP-10 has a certain reference value in the auxiliary diagnosis of active tuberculosis and the judgment of the severity of the disease.
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Humans , Antigens, Bacterial , Biomarkers , Blood , Chemokine CXCL10 , Blood , Tuberculosis, Pulmonary , Blood , DiagnosisABSTRACT
Objective:To prepare the lithium-doped poly-glycerol sebacate (PGS-Li) scaffold using the specific effects of lithium ions and the excellent performance of PGS, and to provide the basis for its application prospects in cementation tissue engineering scaffold.Methods:The scaffolds were divided into two groups.The PGS-Li scaffolds prepared by adding lithium phosphate during the PGS cross-linking process were used as PGS-Li group, and the PGS scaffolds synthesized by the equal-purification of sebacic acid and glycerol were used as PGS group.The molecular weights of the scaffolds in two groups were determined by gel permeation chromatography.The structures of the scaffolds in two groups were analyzed by fourier transform infrared spectroscope.The surface morphology and the porosities and the pore sizes of the scaffolds in two groups were observed by scanning electron microscope.X-ray photoelectron (XPS) spectroscope and inductively coupled plasma optical emission spectrometer were used to determine the Li ion contents in the scaffolds in two groups.Thermogravimetric analyzer was used to analyze the thermal stabilities of the scaffolds in two groups.Contact angle measuring instrument was used to compare the hydrophilicities of the scaffolds in two groups.In vitro weight loss test was used to determine the degradation rates of the scaffolds in two groups.The OCCM-30cells were divided into experimental group (added with PGS-Li scaffold extract) , PGS group (added with PGS scaffold extract) and blank control group (added with DMEM culture medium) .MTT assay was used to detect the proliferation activities of cells in various groups at different time (24, 48and 72h) ;the cell morphology was observed by calcein-AM staining.Results:The gel permeation chromatography results showed that the molecular weight of the PGS-Li scaffold was slightly larger than that of the PGS scaffold.The specific absorption peak of phosphate was detected in the fourier infrared spectrum of the PGS-Li scaffold.The scaffolds in two groups had irregular three-dimensional network structures under scanning electron microscope, and the pore size was 20-160μm, the porosity of PGS scaffold was (53.92±2.18) ％, and the porosity of PGS-Li scaffold was (53.58±1.73) ％, there was no statistical difference between two groups (P＞0.05) .The XPS results showed that a peak appeared at 54.9eV in PGS-Li group, which coincided with the Li 1s binding energy, while the inductively coupled plasma emission spectrometer results showed that the Li ion content in the PGS-Li scaffold was 0.084％.The thermogravimetric analysis results showed that PGS-Li scaffolds began to degrade at a higher temperature and ceased at a lower temperature compared with PGS scaffolds.The contact angle measurement results indicated that both the materials were hydrophilic materials;the contact angle of PGS scaffold meterial was 78.26°±2.00°, and the contact angle of the PGS-Li scaffold material was 69.78°±1.15°;there was statistical difference between two groups (P＜0.05) .The in vitro degradation experiments showed that the degradation rate of PGS-Li scaffolds was faster than that of PGS scaffolds.The proliferation activity of OCCM-30cells in PGS-Li group had no significant difference compared with PGS group and blank control group (P＞0.05) .The calcein-AM staining results showed the green fluorescence in the OCCM-30cells in PGS and PGS-Li groups, and there were no significant changes in the morphology of cementoblasts.Conclusion:PGS-Li scaffolds have similar composition and structure to PGS scaffolds, and have better performance in hydrophilicity and thermal stability.PGS-Li scaffolds have no effect on the proliferation of cementoblasts and have broad application prospects in cementum tissue engineering.
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Objective To research the performance of direct settlement for allopatry medical insurance at a tertiary specialized children′s hospital in Beijing, and to analyze the basics of these inpatients and the structural characteristics of their diseases, for basis and suggestions for improving the policy of direct settlement of allopatry medical insurance. Methods A statistical description of direct settlement data was made for allopatry medical insurance at this hospital from August 2017 to July 2018, to study the age, hometown, attribute, distribution of inpatient departments and disease distribution of these children. Results The patients mainly came upon referrals, preschool children in most cases. The average daily hospitalization cost of the disease was high relatively, and the number of hospitalizations was high as well. Compared with children inpatients in Beijing, these patients tend to come for surgical treatment for malignant tumors and congenital diseases.Conclusions The allopatry direct settlement of children′s medical insurance settlement is found mostly with diseases those are complicated and severe. The management of such settlement can be improved by cooperating with their local institutions in advance, data checking in the course, simplifying the formalities for special diseases, and the differential reimbursement ratio for these patients.
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At the present day, curettage and periodontal surgery comprise the main strategy for the treatment of periodontitis, however, these methods are limited in regenerating cementum. It has been found that some biological factors such asenamel matrix derivative (EMD), transforming growth factor-β (TGF-β) and insulin-like growth factor (IGF) could promote cementum regeneration. In the cementum regenerationstudies, there has been a lack of criteria to distinguish cementum from alveolar bone and other types of cementum. Therefore, this article will briefly review the biological factors that affect the cementum regeneration and the molecular markers used to judge the regenerating cementum.
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OBJECTIVE:To study the effects of different processing methods and extraction solvents on the contents of major components in Polygonum multiflorum. METHODS:Decoction of black soybean and water were used to steam the raw P.multiflorum. Water,50％ ethanol,70％ ethanol and 90％ ethanol were used to extract the raw,black soybean steamed,water steamed and commercial processed P. multiflorum respectively. HPLC method was used to detect the contents of gallic acid,2,3,5, 4′-tetrahydroxystilbene-2-O-β-D-glucoside (THSG),emodin and physcion. RESULTS:The contents of 4 major components in 4 kinds of extracts from 3 kinds of processed P. multiflorum were higher than raw sample;the content of gallic acid extracted with water was the highest;the content of THSG extracted with 90％ ethanol was the lowest;the contents of emodin and physcione extracted with 50％ and 70％ ethanol were the higher. CONCLUSIONS:Different processing methods and different extraction solvents had effect on the contents of the main compounds of P. multiflorum. The contents of each components in the processing products didn't show certain regularity.
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Objective To explore the relationship between Toll-like receptor 2(TLR2) and autophagy marker protein in glioma. Methods Glioma tumors of a total of 74 patients from June 2012 to December 2017 were surgically resected, including WHO gradeⅠtoⅡ32 cases, grade Ⅲ 20 cases, gradeⅣ22 cases. Immunohistochemistry and Western blot were used to detect the expression of TLR2, autophagy related protein LC3B, Beclin 1 and apoptosis related protein Bax and Bcl-2. The correlation between TLR2 and autophagy related protein LC3B and Beclin 1 were analyzed. Results In high grade glioma (HGG) tissue and low grade glioma (LGG) tissue, the TLR2 positive expression rates were 92.9％(39/42) and 75.0％(24/32), and there was significant difference (P<0.05). In HGG tissue, autophagy related protein LC3B, Beclin1 protein was strongly positive and the positive expression rates were 45.2％(19/42) and 52.4％(22/42). In LGG tissue, LC3B and Beclin1 protein positive expression rates were 18.8％(6/32) and 15.6％(5/32), and there were significant differences (P<0.05). Spearman correlation analysis showed that TLR2 protein was closely related to autophagy related protein LC3B (r=0.5638, P<0.05) and Beclin1 (r=0.6101, P<0.05). Conclusions TLR2 is highly expressed in HGG tissue, and its expression level may be related to autophagy, which has potential value as a targeted therapy.
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Objective:To make the fixed partial dentures with different materials and the magnetic resonance imaging (MRI)examination of head and neck was carried out to investigate the effects of fixed partial dentures on MRI.Methods:A qualified volunteer was recruited,who was conventionally restored using fixed partial denture. Co-Cr alloy,Au-Pt alloy and Zirconia were chosen as the inner crown materials,respectively.Three kinds of fixed partial dentures were put into the mouth of patient,and 2 kinds of MRI scan sequences (T1-TSE and T2-TSE) were performed.The scanning images without restorations were used as controls.The change of shape,image signal and involving layers of artifacts of different materials in three groups were observed.The maximum diameter of artifact of three materials in coronal, sagittal and axial images were detected. The safeties of fixed partial dentures were observed. Results: The artifacts were found in all the restorations and showed the changes of strengthen and weaken of the signal and the changs of shapes of images.The range of artifacts was the largest in the involved central plane and varied in sagittal,coronal and axial images. The number of involving layers of artifacts in Co-Cr alloy group was significantly more than those in Au-Pt alloy and Zirconia groups;the artifacts were limited in the repaired lateral maxillofacial region without the cervical spine and head region involvement.The artifacts in Co-Cr alloy group involved or slightly involved in all adjacent tissues,and the artifacts in Au-Pt alloy and Zirconia groups only slightly affected the mandibular teeth,lingual muscles and maxillary crowns.The maximum diameter of artifacts in Co-Cr alloy group was larger than those in Au-Pt alloy group and Zirconia group (P <0.05). No displacement was found in the prosthesis,and the patient had no discomfort.Conclusion:The artifact of the fixed partial denture can be seen in MRI examination.Co-Cr alloy or zirconia can significantly reduce the effect of artifact.Fixed adhesive prosthesis in mouth does not affect the safety of MRI examination.
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Objective:To observe the clinical effects of split post crown and split post-core crown in restoring the molars with low occlusogingival distance and large root furcation,and to clarify its advantages and analyze its improvement methods.Methods:Forty-nine molars of twenty-nine patients,which had been completely treated with root canal therapy,were restored by split post crown or split post-core crown according to their wills.Split post crown was used in twenty-three cases,and split post core crown was applied in the other twenty-six cases.The clinical effects of the patients in two groups were observed after 12 and 24 months follow-up.The levels of MMP-8 in gingival crevicular fluid were checked and compared 12 months after restoration.Results:The restoration success rates of split post crown were 95.7％ after 12-month treatment and 82.6 ％ after 24-month treatment,respectively;there was no significant difference between them (P＞ 0.05).The success rates of split post-core crown were 84.6％ after 12-month treatment and 52.2％ after 24-month treatment,respectively;there was significant difference between them (P＜0.05).The success rate of split post crown was significantly higher than that of split post-core crown after 24-month treatment (P＜0.05).The levels of MMP-8 in gingival crevicular fluid of the patients were close to each other,there was no statistical significance (P＞0.05).Conclusion;The split post crown shows better clinical effect in restoring the molars with low occlusogingival distance in 24 months than split postcore crown.Targeted improvement will help to improve the clinical success rate.
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Objective:To observe the clinical effects of split post crown and split post-core crown in restoring the molars with low occlusogingival distance and large root furcation,and to clarify its advantages and analyze its improvement methods.Methods:Forty-nine molars of twenty-nine patients,which had been completely treated with root canal therapy,were restored by split post crown or split post-core crown according to their wills.Split post crown was used in twenty-three cases,and split post core crown was applied in the other twenty-six cases.The clinical effects of the patients in two groups were observed after 12 and 24 months follow-up.The levels of MMP-8 in gingival crevicular fluid were checked and compared 12 months after restoration.Results:The restoration success rates of split post crown were 95.7％ after 12-month treatment and 82.6 ％ after 24-month treatment,respectively;there was no significant difference between them (P＞ 0.05).The success rates of split post-core crown were 84.6％ after 12-month treatment and 52.2％ after 24-month treatment,respectively;there was significant difference between them (P＜0.05).The success rate of split post crown was significantly higher than that of split post-core crown after 24-month treatment (P＜0.05).The levels of MMP-8 in gingival crevicular fluid of the patients were close to each other,there was no statistical significance (P＞0.05).Conclusion;The split post crown shows better clinical effect in restoring the molars with low occlusogingival distance in 24 months than split postcore crown.Targeted improvement will help to improve the clinical success rate.
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Objective:To prepare the multilayer alginate chitosan microspheres loading vascular endothelial growth factor (VEGF) and vancomycin (VAN), and to study in vitro release characteristics.Methods:The microspheres were prepared by emulsion cross-linking and self-assembly techniques.The effects of sodium alginate concentration, calcium chloride concentration, oil/water ratio and span80 concentration on the entrapment efficiency(EE) and drug loading(DL) of VEGF and VAN were investigated by orthogonal experimental design to optimize the preparation process.The surface morphology and particle size of microspheres were observed by scanning electron microscope (SEM).Self-assembly was detected by Fourier transform infrared spectroscope (FTIR).The EE, DL and in vitro release of VEGF and VAN were detected by ELISA double antibody sandwich method and ultraviolet spectrophotometry,and the cumulative release curve was drawn.Results:The prepared microspheres were yellowish brown powder.The SEM results showed that the microspheres were spherical, the surface was smoothy, and the dispersity was better.The average particle size was about 50 μm.Sodium alginate concentration of 1.0 g·mL-1, CaCl2 concentration of 8 g·mL-1, oil to water ratio of 3∶1, and span80 concentration of 2% were the best formula.The EE of VEGF and VAN were 49.63% and 16.67%, respectively.In vitro, the cumulative release last 16.5 d and 12.5 d respectively and the amount reached up to 95%.Conclusion:The multilayer alginate chitosan microspheres loading VEGF and VAN present several advantages, such as smaller particle size, higher EE and better controlled release.
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Objective To study the level of clinical diagnosis of pulmonary tuberculosis and implementa-tion of tuberculosis prevention and control policy. Methods Frequencies and percentages of pulmonary tuberculosis, other lung diseases and health among 3315 cases with pulmonary tuberculosis suspicious symptoms ,transferred by non-tuberculosis control institutions during 2010-2015,were calculated and analyzed. Results Among the 3315 suspected cases of pulmonary tuberculosis ,cases of pulmonary tuberculosis ,tuberculosis ,other lung diseases and healthy group were 2068,598 and 649 based on final diagnosis and their percentages were 62.38%,18.04% and 19.58% respectively. As to groups of elder than fifteen years ,the proportion of patients with pulmonary tubercu-losis accounts for 72.62%,61.00%and 48.58% of the total of young group(15~44 years old ),middle age group (45 ~ 64 years old)and elderly group(≥ 65 years old )respectively. Conclusions Compared with pulmonary tuberculosis suspicious symptomscases from tuberculosis control institution during the same period ,the proportion of tuberculosis patients from transferred groups is roughly the same.It indicate high levels of tuberculosis diagnosis and implementation to tuberculosis control policy.
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OBJECTIVE:To investigate the effects of target-controlled infusion of etomidate combined with remifentanil on in-dexes of immune and stress response in elderly surgery patients. METHODS:Totally 60 patients undergoing elective surgery were randomly divided into control group(n=30)and observation group(n=30). Control group was given Propofol injection 1.5-2 mg/kg intravenously. Observation group was given Remifentanil hydrochloride for injection with pump volume of 0.5 μg/(kg·min), and then target controlled infusion of Etomidate injection 0.1-0.3 mg/kg;the dose of etomidate increased by 0.05-0.1 mg/kg accord-ing to physical activity during surgery. Postoperative eye opening time,recovery time of orientation and extubation time were com-pared between 2 groups as well as the levels of immune indexes(CD4+,CD8+,CD4+/CD8+),stress response indexes [serum norepi-nephrine(NE),adrenaline(E)and cortisol(Cor)]. The occurrence of ADR was recorded during surgery. RESULTS:Postopera-tive eye opening time,recovery time of orientation and extubation time in observation group were significantly shorter than control group,with statistical significance(P0.05). After surgery,CD4+ and CD8+ of 2 groups were significantly higher than before surgery,and the ob-servation group was significantly higher than the control group,CD4+/CD8+ of 2 groups was significantly lower than before,and the observation group was significantly lower than control group,with statistical significance(P0.05);after surgery,the levels of NE,E and Cor in 2 groups were significantly higher than before surgery,but the observation group was significantly lower than the control group, with statistical significance(P<0.05). There were no obvious adverse reaction occurred in 2 groups during the surgery. CONCLU-SIONS:The target-controlled infusion of etomidate combined with remifentanil is ideal for perioperative anaesthesia in the elderly patients and effectively improves related immune indexes and stress response indexes with good safety.
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Objective:To investigate the influence of multilayer alginate chitosan sustained-release microspheres loading vascular endothelial growth factor(VEGF) and vancomycin in the proliferation and osteogenic differentiation of human plaacenta-derived mesen chymal stem cells(HPMSCs),and to provide theoretical basis for its clinical application in the repair of bone defect.Methods:The microspheres were prepared based on the previous research and HPMSCs were co-cultured with drug (VEGF/vancomycin)-loaded microspheres (drug-loaded microspheres+HPMSCs group), non-drug loaded microspheres (microspheres+HPMSCs group) and without any microspheres (HPMSCs group).Then the proliferation rate of HPMSCs was identified by CCK-8 kit.The osteogenic differentiation potential of HPMSCs was detected by Alizarin red staining and alkaline phosphatase (ALP) kit when the HPMSCs had been co-cultured with drug loaded microspheres in osteogenic medium (HPMSCs+drug-loaded microspheres+induction group), non-drug loaded microspheres in osteogenic medium (HPMSCs+microspheres+induction group), without any microspheres in osteogenic medium (HPMSCs+induction group) and without any micropheres in normal medium (HPMSCs+PBS group) for 21 d.Results:Compared with HPMSCs group,the proliferation rates of HPMSCs in drug-loaded microspheres+HPMSCs and microspheres+HPMSCs groups had no significant changes (P>0.05).The calcium deposition in HPMSCs+drug-loaded microspheres+induction group was more than those in microspheress+HPMSCs+indution group and HPMSCs+induction group after Aalizarin red staining;the ALP activity in drug-loaded microspheres+HPMSCs+indution group was higher than those in microspheres+HPMSCs+indution group and HPMSCs+induction group (P<0.05),and the ALP activity in microspheres+HPMSCs+induction group was higher than that in HPMSCs+induction group(P<0.05).Conclusion:The sustained-release microspheres loading VEGF and vancomycin have no significant effect on the proliferation activity of HPMSCs and the microspheres could stimulate the osteogenic differentiation of HPMSCs.
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The rhizome of Gastrodia elata (GE), a herb medicine, has been used for treatment of neuronal disorders in Eastern Asia for hundreds of years. Parishin C is a major ingredient of GE. In this study, the i.c.v. injection of soluble Aβ 1-42 oligomers model of LTP injury was used. We investigated the effects of parishin C on the improvement of LTP in soluble Aβ 1-42 oligomer-injected rats and the underlying electrophysiological mechanisms. Parishin C (i.p. or i.c.v.) significantly ameliorated LTP impairment induced by i.c.v. injection of soluble Aβ 1-42 oligomers. In cultured hippocampal neurons, soluble Aβ 1-42 oligomers significantly inhibited NMDAR currents while not affecting AMPAR currents and voltage-dependent currents. Pretreatment with parishin C protected NMDA receptor currents from the damage induced by Aβ. In summary, parishin C improved LTP deficits induced by soluble Aβ 1-42 oligomers. The protection by parishin C against Aβ-induced LTP damage might be related to NMDA receptors.