ABSTRACT
ObjectiveTo investigate the material basis of homologous and heterogeneous effect of Aurantii Fructus Immaturus（AFI） and Aurantii Fructus（AF） based on the total statistical moment analysis and molecular connectivity index（MCI）. MethodRelevant literature at home and abroad and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform（TCMSP） were consulted to establish the chemical composition database of AFI and AF， and set up their fingerprints by ultra-high performance liquid chromatography（UPLC）， and the total statistical moments and similarity parameters of the fingerprint were calculated. According to MCI， all components of AFI and AF were divided into different component groups， the average values of 0-8th order（0χ-8χ） MCI of the common component groups of AFI and AF were calculated. ResultThe values of total zero-order moment（AUCT） of AFI and AF were （10.57±2.45）×106， （5.09±0.89）×106 μV·s， the values of total first-order moment（MCRTT） were （11.57±1.58）， （12.10±1.29） min， the values of total second-order moments（VCRTT） were（24.49±2.30）， （26.49±2.54） min2， respectively. It showed that qualitative and quantitative parameters of AFI and AF were significantly different. The components with high similarity such as neohesperidin， hesperidin and narirutin were screened as the common potential pharmacodynamic components of AFI and AF. The non-common components of AFI， such as alysifolinone and imperatorin， and the non-common components of AF， such as neoeriocitrin and isosakuranin， with high similarity were screened out as potential heterogeneous components of AFI and AF. The composition groups of AFI and AF were classified into six categories， and the similarities between the composition groups of AFI and AF and the total constituents were 0.872-0.979 and 0.918-0.997， the average values of 0χ-8χ MCI of alkaloids in AFI and AF were 3.65 and 3.14， the average values of 0χ-8χ MCI of flavonoids were 8.47 and 8.47， the average values of 0χ-8χ MCI of volatile oils were 2.71 and 3.48， respectively. It showed that there were some differences in MCI of chemical constituents（groups） between AFI and AF. ConclusionThe chemical constituents（groups） of AFI and AF not only differ in content and species， but also in structural characteristics and structure-activity relationship， which can provide a basis for further explaining the scientific connotation of homologous and heterogeneous effect of AFI and AF.
ABSTRACT
Objective:To explore the risk factors for death within 1 year after hip fracture surgery in the elderly.Methods:A case control study was made on the clinical data of 551 elderly patients with hip fracture treated in Second Affiliated Hospital of Soochow University from January 2019 to December 2020, including 182 males and 369 females; aged 65-100 years [80(73,86)years]. Joint replacement, cannulated screw fixation or proximal femoral nail fixation were performed. The patients were divided into survival group ( n=494) and death group ( n=57) based on the death within 1 year after surgery recorded at postoperative telephone follow-up. The gender, age, hypertension, diabetes, cardiovascular diseases, chronic respiratory diseases, neurological diseases, chronic renal failure, anemia on admission, fracture types, American anesthesiologist Association (ASA) classification, operative methods, preoperative waiting time, duration of operation and perioperative blood transfusion were recorded in two groups. Univariate Cox regression was used to analyze the correlation between the above indexes and death within 1 year after surgery. All indexes with P<0.2 in the univariate analysis were included in multivariate Cox regression analysis to clarify the independent risk factors for death within 1 year after surgery. Results:Univariate Cox regression analysis showed that death within 1 year after surgery correlated with gender, age chronic respiratory diseases, chronic renal failure and anemia on admission (all P<0.01), but not with hypertension, diabetes, cardiovascular diseases, neurological diseases, fracture types, ASA classification, operative methods, preoperative waiting time, duration of operation or perioperative blood transfusion (all P>0.05). Multivariate Cox regression analysis showed that male ( HR=2.08, 95% CI 1.20, 3.61, P<0.01), age ≥ 80 years ( HR=2.22, 95% CI 1.15, 4.28, P<0.05), chronic respiratory diseases ( HR=2.54, 95% CI 1.19, 5.40, P<0.05), chronic renal failure ( HR=4.57, 95% CI 1.27, 16.44, P<0.05), anemia on admission ( HR=2.82, 95% CI 1.38, 5.76, P<0.01) were significantly associated with death within 1 year after surgery. Conclusion:Male age≥ 80 years, chronic respiratory disease, chronic renal failure and anemia on admission are independent risk factors for death within 1 year after hip fracture surgery in the elderly.
ABSTRACT
Objective: To explore two-dimensional speckle tracking imaging (2D-STI) in evaluation on the changes of left atrial function in patients with paroxysmal atrial fibrillation before and after radiofrequency catheter ablation (RFCA). Methods: Echocardiography was performed on 30 patients with paroxysmal atrial fibrillation (AF group) treated by radiofrequency catheter ablation in the preoperation and postoperative 3 days, 1 month, 3 months. Thirty healthy volunteers were selected as the control group. The left atrial anteroposterior diameter (LAD), early diastolic transmitral flow velocity (E peak), mitral annular early diastolic motion velocity (Em), left atrial maximum, minimum and pre-systolic volume (LAVmax, LAVmin and LAVP) were measured and E/Em, left atrial active ejection fraction (LAAEF), left atrial passive ejection fraction (LAPEF) were calculated by conventional echocardiography. Left atrial strain and strain rate curves of each segment were obtained by 2D-STI, and the mean peak strain (mSs, mSe, mSa) and strain rate (mSRs, mSRe, mSRa) of the left atrial in the left ventricular systolic, the early diastolic stage and the late diastolic stage, and left atrial stiffness (LASt) was measured and calculated. The changes of the left atrial structure and function in patients with paroxysmal atrial fibrillation before and after RFCA were compared. Results: Compared with the control group, LAD, LAVp, LAVmin, LAVmax, E/Em and LASt increased in the AF group, LAPEF, LAAEF, E peak, Em, mSs, mSe, mSa, mSRs, mSRe and mSRa decreased (all P<0.05). There were statistically significant differences in left atrial strain parameters and LASt of patients with paroxysmal atrial fibrillation before and 3 days, 1 month and 3 months after RFCA (all P<0.05). Compared with the preoperative, mSs, mSe, mSa, mSRs, mSRe and mSRa decreased and LASt was increased at 3 days after RFCA (all P<0.05); mSs, mSe, mSa, mSRs, mSRe and mSRa increased, and LASt decreased at 3 months after RFCA (all P<0.05). Compared with the postoperative 3 days, mSs, mSe, mSa, mSRs, mSRe and mSRa increased, LASt decreased (all P<0.05) at 1 month and 3 months after RFCA. Compared with the postoperative 1 month, mSRs increased at 3 months after RFCA (P<0.05). Conclusion: The left atrium function of patients with paroxysmal atrial fibrillation decrease at 3 days after RFCA, the pump function improved 1 month after RFCA, and the left atrial reservoir, conduit and pump function improve observably at 3 months after RFCA.