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1.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 178-186, 2024.
Article in Chinese | WPRIM | ID: wpr-1003780

ABSTRACT

Diabetic kidney disease (DKD) is the main cause of end-stage renal disease. Its high prevalence, mortality rate, and medical cost bring a heavy economic burden to society and families, and DKD has become one of the most important public health problems. Intestinal microecology is the most important and complex micro-ecosystem in the human body, which is involved in important life activities such as material and energy metabolism, immune system regulation, and signal transduction, thereby maintaining the dynamic balance of the human internal environment. The dynamic balance between the intestinal microecology and the body is essentially a Yin-Yang balance. Once this balance is broken, intestinal microbiota imbalance, intestinal mucosal barrier damage, immune dysfunction, and reduction of metabolite short-chain fatty acids (SCFAs) will occur, which play an important role in the progression of DKD. From the perspective of the Yin-Yang theory of traditional Chinese medicine (TCM), the imbalance of intestinal microecology in DKD is equivalent to the excessive or insufficient constraint of Yin and Yang, or Yin deficiency affecting Yang, or Yang deficiency affecting Yin, or waning and waxing of Yin and Yang. For different pathogenesis changes, "Yin disease treated through Yang", "treating Yin for Yang", or "treating Yang for Yin" methods are adopted to regulate intestinal microbiota, inhibit immune inflammation, protect intestinal mucosal barrier, and increase SCFAs through TCM, thereby reconciling Yin and Yang to achieve the condition where "Yin is at peace and Yang is compact". Based on the Yin-Yang theory, this paper intended to interpret the scientific connotation of TCM in the treatment of DKD with intestinal microecology as the target and TCM in the treatment of DKD by regulating intestinal microecology as the breakthrough point to provide a novel insight for the occurrence and development of DKD and the mechanism of TCM.

2.
Chinese Critical Care Medicine ; (12): 860-864, 2023.
Article in Chinese | WPRIM | ID: wpr-992040

ABSTRACT

Objective:To investigate the association between serum zinc levels and convulsive brain injury in infants with mild gastroenteritis complicated with benign infantile seizures (BICE) and febrile seizures (FC).Methods:A case-control study method was conducted. 120 children with mild gastroenteritis and convulsion admitted to the First Affiliated Hospital of Hebei North University from January 2020 to January 2022 were enrolled as the research subjects. They were divided into BICE group and FC group according to the type of convulsion. The serum zinc level, the frequency and duration of convulsion, and the occurrence of convulsive brain injury in the two groups were recorded. Multivariate Logistic regression analysis was used to screen the risk factors for convulsive brain injury. The Spearman correlation method was used to analyze the association between serum zinc levels, clinical characteristics of convulsion and convulsive brain injury.Results:A total of 120 children were enrolled, of which 81 developed to BICE and 39 developed to FC during hospitalization. The serum zinc level of children in the FC group was significantly lower than that in the BICE group (μmol/L: 39.24±6.50 vs. 48.65±7.21, P < 0.01). In the BICE group and FC group, the serum zinc level in children with more than 2 convulsions was significantly lower than that in the children with one convulsion (μmol/L: 37.65±6.50 vs. 53.17±7.55 in the BICE group, and 30.27±5.58 vs. 44.16±7.57 in the FC group, both P < 0.01). Serum zinc level in children with convulsion duration ≥5 minutes was significantly lower than that in the children with convulsion duration < 5 minutes (μmol/L: 38.75±6.74 vs. 51.21±7.58 in the BICE group, and 31.08±5.46 vs. 45.19±7.25 in the FC group, both P < 0.01). Moreover, the serum zinc level of children with different convulsion frequency and duration in the FC group was significantly lower than that in the BICE group (all P < 0.01). Among the 120 children, 9 cases of convulsive brain injury occurred, and the incidence rate was 7.50%. The incidence of convulsive brain injury in the BICE group was 1.23% (1/81), which was significantly lower than 20.51% in the FC group (8/39, P < 0.01). The serum zinc level of children with convulsive brain injury was significantly lower than that of children with non-brain injury (μmol/L: 28.50±5.00 vs. 60.22±7.31, P < 0.01), and the number of convulsion was significantly higher than that of non-cerebral injury (≥ 2 convulsions: 100.00% vs. 1.80%, P < 0.01), and the duration of convulsion in children with brain injury was significantly longer than that of non-brain-injured children (convulsion duration ≥5 minutes: 100.00% vs. 11.71%, P < 0.01). Multivariate Logistic regression analysis showed that decreased serum zinc level [odds ratio ( OR) = 2.147, 95% confidence interval (95% CI) was 1.354-3.403], increased number of convulsion ( OR = 3.452, 95% CI was 1.266-9.417), and prolonged convulsion duration ( OR = 3.117, 95% CI was 1.326-7.327) were independent risk factor for convulsive brain injury in children with mild gastroenteritis and convulsion (all P < 0.05). Spearman correlation analysis showed that serum zinc level, convulsion ≥2 times, duration of convulsion ≥5 minutes and convulsion ≥2 times + convulsion duration ≥5 minutes were significantly negatively correlated with the occurrence of convulsive brain injury in FC children ( r values were -0.546, -0.517, -0.522, and -0.528, all P < 0.01). There was no significant correlation between serum zinc level, convulsion ≥2 times, convulsion duration ≥5 minutes and convulsion ≥2 times+convulsion duration ≥5 minutes and convulsive brain injury in BICE children ( r values were -0.281, -0.129, -0.201, -0.243, all P > 0.05). Conclusions:Serum zinc level is related to the characteristics of convulsive symptoms in children with mild gastroenteritis complicated with FC, and has a strong negative correlation with the occurrence of convulsive brain injury. Active targeted intervention and treatment may help reduce the incidence of brain injury in children.

3.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 474-477, 2023.
Article in Chinese | WPRIM | ID: wpr-991768

ABSTRACT

Ilizarov technique is designed based on the "tension-stress principle". Application of the Ilizarov technique can help form a stable mechanical structure through external fixation. It only creates small wounds, without peeling off the surrounding tissue and periosteum. It connects different types of fixation pins and bone or soft tissue to form a traction force, which continuously stimulates the regeneration of bone and tissue and improves the local blood supply and early functional rehabilitation exercises, forming a complete set of minimally invasive orthopedic treatment systems. Ilizarov technique has achieved good results in fracture healing, deformity correction, tissue repair, osteomyelitis, bone nonunion, bone defect, and bone tumor. This paper will summarize the clinical application and research of the Ilizarov technique in orthopedics and explore the key problems of the Ilizarov technique that need to be solved at present.

4.
Shanghai Journal of Preventive Medicine ; (12): 466-470, 2023.
Article in Chinese | WPRIM | ID: wpr-978410

ABSTRACT

ObjectiveTo assess the coverage and effectiveness of COVID-19 vaccines in the elderly. MethodsThis study was conducted in Changning District of Shanghai, targeting people aged 60 years and above. Vaccination data between 21 December 2020 and 28 February 2022 was retrieved from the Shanghai Collective Immunization System. Information on confirmed cases of COVID-19 from March 2022 through May 2022 was collected from the National Notifiable Diseases Reporting System. Vaccine effectiveness was calculated using the screening method. ResultsAs of 28 February 2022, 69.89% of people aged ≥60 years had received ≥1-dose vaccine, 63.80% had received full primary vaccination and 31.91% had received a booster dose. Vaccination coverage declined over age, with the lowest coverage in the elderly aged ≥80 years. Moreover, COVID-19 vaccination provided the highest protection against severe/critical illness and death due to the Omicron variants in the elderly aged ≥60 years. Full primary vaccination showed 96.15%(95%CI:84.15‒99.06)of vaccine effectiveness and booster vaccination showed 100% of the effectiveness against severe/critical COVID-19 and death. ConclusionsFull primary and booster vaccination coverage in the elderly is low, especially in those aged 80 and above. Our study finds high protection against COVID-19 associated severe/critical illness and death from both full primary and booster vaccination of inactivated COVID-19 vaccines in the elderly aged ≥60 years.

5.
Frontiers of Medicine ; (4): 105-118, 2023.
Article in English | WPRIM | ID: wpr-971622

ABSTRACT

The third-generation epidermal growth factor receptor (EGFR) inhibitor osimertinib (OSI) has been approved as the first-line treatment for EGFR-mutant non-small cell lung cancer (NSCLC). This study aims to explore a rational combination strategy for enhancing the OSI efficacy. In this study, OSI induced higher CD47 expression, an important anti-phagocytic immune checkpoint, via the NF-κB pathway in EGFR-mutant NSCLC HCC827 and NCI-H1975 cells. The combination treatment of OSI and the anti-CD47 antibody exhibited dramatically increasing phagocytosis in HCC827 and NCI-H1975 cells, which highly relied on the antibody-dependent cellular phagocytosis effect. Consistently, the enhanced phagocytosis index from combination treatment was reversed in CD47 knockout HCC827 cells. Meanwhile, combining the anti-CD47 antibody significantly augmented the anticancer effect of OSI in HCC827 xenograft mice model. Notably, OSI induced the surface exposure of "eat me" signal calreticulin and reduced the expression of immune-inhibitory receptor PD-L1 in cancer cells, which might contribute to the increased phagocytosis on cancer cells pretreated with OSI. In summary, these findings suggest the multidimensional regulation by OSI and encourage the further exploration of combining anti-CD47 antibody with OSI as a new strategy to enhance the anticancer efficacy in EGFR-mutant NSCLC with CD47 activation induced by OSI.


Subject(s)
Humans , Mice , Animals , Carcinoma, Non-Small-Cell Lung/metabolism , Lung Neoplasms/metabolism , Acrylamides/pharmacology , ErbB Receptors/metabolism , Cell Line, Tumor , CD47 Antigen/therapeutic use
6.
Chinese Journal of Applied Clinical Pediatrics ; (24): 241-244, 2023.
Article in Chinese | WPRIM | ID: wpr-990021

ABSTRACT

World Health Organization (WHO) reported that a total of 559 meningitis cases and 18 deaths were reported in the southeast of Niger from November 1, 2022 to January 27, 2023.Children were the major of patients.Among the laboratory confirmed cases, 93.7%(104/111) were epidemic cerebrospinal meningitis.Since 2021, the epidemic of meningococcal disease has attacked the gay and bisexual men in Florida, USA.This paper briefly reviews the occurrence and development of the two outbreaks of epidemic cerebrospinal meningitis, as well as the causes and countermeasures.The current prevention and control measures of meningitis is discussed based on the " Defeating meningitis by 2030: Global Road Map" issued by WHO in 2021.This paper is expected to attract the attention and to improve awareness and vigilance of domestic clinical and public health workers, which would lead to strengthen the surveillance, prevention and control of meningitis.

7.
International Journal of Traditional Chinese Medicine ; (6): 160-164, 2023.
Article in Chinese | WPRIM | ID: wpr-989613

ABSTRACT

Objective:To observe the effect of modified Shengxian Decoction on extravascular lung water index (EVLWI) and lung injury prediction score (LIPS) in patients with acute respiratory distress syndrome (ARDS) caused by sepsis.Methods:Prospective cohort study. A total of 200 patients with ARDS caused by sepsis who were hospitalized in Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2019 to May 2021 were selected and divided into the observation group and control group by random number table method, with 100 in each group. The patients in the control group were given rountin western medicine treatment according to the guidelines, and the patients in the observation group were treated with modified Shengxian Decoction on the basis of the treatment in the control group. Both groups were treated for 7 days as a course of treatment. The PH value, oxygen volume index (FiO 2), oxygen partial pressure (PaO 2), arterial carbon dioxide partial pressure (PaCO 2) of the two groups before and after treatment, calculate the oxygenation index (PaO 2/FiO 2) were observed and compared. The C-reactive protein (hs-CRP), interleukin-6 (IL-6) levels were observed by ELISA, the procalcitonin (PCT) levels was detected by double antibody sandwich immunoluminescence method. The APACHE Ⅱ score and LIPS score, EVLWI and cardiac index (CI) of the two groups were observed and compared. The mechanical ventilation time and ICU hospitalization time of the two groups were compared. Results:After treatment, the PaCO 2 level [(37.15 ± 5.42) mmHg vs. (38.24 ± 3.24) mmHg, t=2.03] of the observation group was significantly lower than that of the control group, and the oxygenation index (292.34 ± 78.91 vs. 236.54 ± 70.58, t=5.27) was significantly higher than that of the control group ( P<0.05). After treatment, the levels of hs-CRP [(35.21 ± 6.73) mg/L vs. (48.97 ± 8.52) mg/L, t=12.67], IL-6 [(40.57 ± 8.51) ng/L vs. (47.61 ± 9.97) ng/L, t=5.37] and PCT [(0.75 ± 0.21) μg/L vs. (1.14 ± 0.38) μg/L, t=8.98] in the observation group were significantly lower than those in the control group ( P<0.01). After treatment, the APACHE Ⅱscore (11.14 ± 0.54 vs. 14.67 ± 0.89, t=33.91], LIPS score (2.21 ± 0.73 vs. 4.59 ± 0.88, t=20.82), and EVLWI [(6.19 ± 0.42) ml/kg vs. (8.24 ± 0.78) ml/kg, t=23.14) of the observation group were significantly lower than those in the control group, and the CI level [(4.49 ± 1.27) L/(min?m 2) vs. (3.61 ± 0.88) L/(min?m 2), t=5.70] was significantly higher than that of the control group ( P<0.01). The mechanical ventilation time and ICU stay in the observation group were shorter than those in the control group ( t=3.66, 5.74, P<0.01). Conclusion:The modified Shengxian Decoction can reduce the level of inflammation indexes in patients with ARDS caused by sepsis, reduce EVLWI and LIPS scores, improve blood gas analysis indexes, and shorten the time of mechanical ventilation and ICU hospitalization.

8.
Journal of International Oncology ; (12): 157-163, 2023.
Article in Chinese | WPRIM | ID: wpr-989537

ABSTRACT

Objective:To screen the factors influencing overall survival (OS) of patients undergoing radical resection for colorectal cancer (CRC) and to construct a prognostic model for OS of patients after CRC.Methods:The clinical data of 350 patients with stage Ⅰ-Ⅳ CRC who underwent radical resection in the People's Hospital of Wuhan University from March 2017 to December 2019 were collected retrospectively. Patients were divided into subgroups 0 ( n=70), 1 ( n=172), and 2 ( n=108) according to different preoperative systemic inflammation score (SIS). The relationship between different SIS, neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), systemic immune inflammation index (SII) and prognosis of CRC patients undergoing radical surgical resection were analyzed, and Cox regression models were used to perform univariate and multifactorial analyses of factors affecting patient prognosis, and column line graph models were constructed based on the results of multifactorial analyses. Results:By the deadline of follow-up, 80 of 350 CRC patients died, and the 5-year OS rate was 77.14%. The 5-year survival rates of patients in SIS group 0, group 1 and group 2 were 95.71%, 79.65% and 61.11% respectively, with a statistically significant difference ( χ2=30.19, P<0.001). Statistically significant differences in age ( χ2=19.40, P<0.001), tumor site ( χ2=8.18, P=0.017), T stage ( χ2=10.01, P=0.007), TNM stage ( χ2=14.80, P=0.001), tumor diameter ( χ2=13.91, P=0.001) and carcino-embryonic antigen (CEA) level ( χ2=10.12, P=0.006) among patients in SIS group 0, group 1 and group 2. The 5-year OS rates of patients in the low NLR and high NLR groups were 82.67% and 56.16% respectively, with a statistically significant difference ( χ2=24.96, P<0.001) ; the 5-year OS rates of patients in the low LMR and high LMR groups were 66.85% and 88.17% respectively, with a statistically significant difference ( χ2=22.45, P<0.001) ; the 5-year OS rates of patients in the low SII and high SII groups were 86.14% and 69.02% respectively, with a statistically significant difference ( χ2=14.76, P<0.001). Univariate analysis showed that age ( HR=2.58, 95% CI: 1.54-4.32, P<0.001), T stage ( HR=2.41, 95% CI: 1.24-4.68, P=0.009), N stage ( HR=3.03, 95% CI: 1.85-4.94, P<0.001), TNM stage ( HR=3.61, 95% CI: 2.15-6.04, P<0.001), nerve invasion ( HR=1.97, 95% CI: 1.27-3.08, P=0.002), vascular invasion ( HR=2.31, 95% CI: 1.49-3.59, P<0.001), preoperative SIS 1 score ( HR=5.09, 95% CI: 1.57-16.56, P=0.007), SIS 2 score ( HR=11.05, 95% CI: 3.42-35.65, P<0.001), NLR ( HR=2.97, 95% CI: 1.90-4.64, P<0.001), LMR ( HR=0.31, 95% CI: 0.19-0.52, P<0.001), and SII ( HR=2.50, 95% CI: 1.54-4.06, P<0.001) were all independent influence factors affecting the postoperative prognosis of CRC patients undergoing radical surgical resection; multivariate analysis showed that age >60 years ( HR=2.27, 95% CI: 1.31-3.91, P=0.003), TNM stage Ⅲ-Ⅳ ( HR=7.08, 95% CI: 1.89-26.59, P=0.004), and preoperative SIS 2 score ( HR=4.02, 95% CI: 1.09-14.83, P=0.037) were all independent risk factors affecting the postoperative prognosis of CRC patients undergoing radical surgical resection. The nomogram model built based on the screened variables has high prediction accuracy: the C-index of the nomogram was 0.75. Conclusion:Age>60 years old, TNM stage Ⅲ-Ⅳ, SIS 2 score are all independent risk factors for postoperative prognosis of colorectal cancer. The nomograph model constructed by this method has high prediction accuracy.

9.
Sichuan Mental Health ; (6): 131-136, 2023.
Article in Chinese | WPRIM | ID: wpr-986760

ABSTRACT

ObjectiveTo explore the mental health status and its influencing factors among middle school students in Xide County, Liangshan Yi Autonomous Prefecture, and to provide references for mental health interventions for local middle school students. MethodsUsing a cross-sectional study design, one junior middle school and one senior middle school in Xide County, Liangshan Prefecture, Sichuan Province, were randomly selected on September 16, 2021, and two classes per grade in each school involving 288 students were recruited. Subjects were assessed using Patients' Health Questionnaire Depression Scale-9 item (PHQ-9), Generalized Anxiety Disorder Scale-7 item (GAD-7), PTSD Checklist for DSM-5 (PCL-5), Multidimensional Scale of Perceived Social Support (MSPSS) and UCLA Loneliness Scale (ULS-3). Then the scores of above scales were compared among middle school students with different demographic characteristics, and binary Logistic regression analysis was conducted to screen the influencing factors of post-traumatic stress disorder (PTSD) symptoms. ResultsAmong the respondents, 17.71% (95% CI: 0.133~0.221), 8.68% (95% CI: 0.054~0.120), 2.78% (95% CI: 0.009~0.047) and 45.83% (95% CI: 0.400~0.516) were reported to have symptoms of depression, anxiety, PTSD and loneliness, respectively. Students in senior middle school scored lower on PCL-5 and ULS-3 than those in junior middle school [(6.46±8.91) vs. (8.87±9.42), t=2.202, P<0.05; (4.67±1.65) vs. (5.60±1.88), t=4.431, P<0.01]. Regression analysis denoted that depressive symptoms (OR=7.630, P<0.05) and anxiety symptoms (OR=3.789, P<0.01) were risk factors for PTSD symptoms among middle school students. ConclusionThe middle school students in Xide County, Liangshan Yi Autonomous Prefecture suffer a high prevalence rate of depressive symptoms and loneliness, and those in junior middle school are more likely to feel a sense of strong loneliness, furthermore, depressive symptoms and anxiety symptoms are risk factors for PTSD symptoms.

10.
Journal of Integrative Medicine ; (12): 369-376, 2023.
Article in English | WPRIM | ID: wpr-982694

ABSTRACT

OBJECTIVE@#Omicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, is responsible for numerous infections in China. This study investigates the association between the use of Seven-Flavor Herb Tea (SFHT) and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019 (COVID-19).@*METHODS@#This case-control study was conducted at shelter hospitals and quarantine hotels in China. A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31, 2022, while 2190 uninfected individuals served as healthy controls. Structured questionnaires were used to collect data on demographics, underlying diseases, vaccination status, and use of SFHT. Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score. Subsequently, a conditional logistic regression model was used for data analysis.@*RESULTS@#Overall, 7538 eligible subjects were recruited, with an average age of [45.54 ± 16.94] years. The age of COVID-19 patients was significantly higher than that of uninfected individuals ([48.25 ± 17.48] years vs [38.92 ± 13.41] years; t = 22.437, P < 0.001). A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio. The use of SFHT (odds ratio = 0.753, 95% confidence interval: 0.692, 0.820) was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals.@*CONCLUSION@#Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection. This is a useful study in the larger picture of COVID-19 management, but data from large-sample multi-center, randomized clinical trial are warranted to confirm the finding. Please cite this article as: Zhang SX, Chen XX, Zheng Y, Cai BH, Shi W, Ru M, Li H, Zhang DD, Tian Y, Chen YL. Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai, China. J Integr Med. 2023; 21(4):369-376.


Subject(s)
Humans , Adult , Middle Aged , Aged , COVID-19/epidemiology , SARS-CoV-2 , Case-Control Studies , China/epidemiology , Tea
11.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 253-262, 2023.
Article in Chinese | WPRIM | ID: wpr-953947

ABSTRACT

Embryo implantation is one of the most critical steps in the reproductive process. The failure of embryo implantation to continue development is one of the important reasons leading to infertility. The success of embryo implantation depends on the high receptivity of endometrium and the embryo with implantation ability. Autophagy is a process in which cytoplasm, organelles, and inclusions are absorbed by double-membrane vesicles and transported to lysosomes for degradation and recycling, which is a way to maintain the homeostasis. A large amount of evidence have shown that autophagy plays an important role in all aspects of embryo implantation. Based on this, this paper explored the relationship between autophagy and endometrial receptivity and embryo implantation ability. According to the latest research progress, this paper combed 5 mechanisms (promotion of decidualization of endometrial stromal cells, promotion of apoptosis, regulation of hormone levels, coordination of inflammation, and promotion of ovulation) of 14 kinds of Chinese medicine monomers, including emodin, catalpol, paeoniflorin, resveratrol, folic acid, zearalenone, curcumin, wogonin, quercetin, chrysin, berberine, apigenin, phisetine, and kaempferol, in regulating different links of autophagy intervention in embryo implantation. This paper is expected to provide references and ideas for future Chinese medicine monomers to improve the success rate of embryo implantation.

12.
Acta Pharmaceutica Sinica ; (12): 3400-3407, 2023.
Article in Chinese | WPRIM | ID: wpr-999101

ABSTRACT

In this study, we synthesized six tetrazine-dipyrromethene boron difluoride (BODIPY) probes and achieved a remarkable up to 14-fold increase in singlet oxygen yield via tetrazine bioorthogonal click-to-release reactions. We systematically investigated the photodynamic activity of these probes, revealing crucial structure-activity relationships. Additionally, we evaluated the stability and release kinetics of these probes and identified P5 and P6 as ideal candidates for photodynamic therapy in live cells. This innovative strategy opens new avenues for fine-tuning the photodynamic properties of BODIPY dyes, thereby expanding their utility in cancer therapy.

13.
Journal of Sun Yat-sen University(Medical Sciences) ; (6): 949-957, 2023.
Article in Chinese | WPRIM | ID: wpr-998986

ABSTRACT

ObjectiveTo identify acute phase features associated with the prognosis of traumatic brain injury (TBI). MethodsThrough two traditional strategies, correlation analysis and prediction model, and one innovative research strategy based on feature deconstruction, a retrospective analysis was conducted using demographic, acute phase and chronic phase features of 354 TBI patients to identify acute phase features associated with activities of daily living (ADL) in chronic phase of TBI. For feature deconstruction strategy, the LASSO (Least Absolute Shrinkage and Selection Operator) algorithm was used to build a prediction model that could effectively predict ADL based on non-ADL chronic phase features. The model could indicate the key chronic phase dimensions determining the ADL in TBI patients. We then identified demographic and acute phase variables that were significantly associated with these key chronic phase features. ResultsThe feature deconstruction strategy revealed that ADL could be deconstructed into chronic phase dimensions such as weak limbs in TBI population. Importantly, to the best of our knowledge, this strategy revealed for the first time the association of these important acute phase features with specific chronic phase impairment features. For example, TBI patients had a higher risk for chronic phase recent memory impairment if they had a prolonged coma time and low GCS scores at acute phase [scaled coma time OR95%CI = 94.288 (35.095, 273.231); scaled GCS OR95%CI = 0.068 (0.030, 0.147)]; the patients had a higher risk for insight impairment and disorientation at chronic phase if they had hydrocephalus at acute phase [insight impairment OR95%CI = 6.760 (3.653,12.855) ; disorientation OR95%CI = 6.538 (3.530, 12.490)]. All strategies showed that the strongest risk factors for ADL damage in the chronic phase included prolonged coma time and low GCS scores as well as hydrocephalus. ConclusionThis study provides an innovative research strategy to establish the association between acute injury features and chronic recovery features, and to identify demographic and acute phase features associated with the prognosis of TBI.

14.
Chinese Journal of Organ Transplantation ; (12): 440-445, 2023.
Article in Chinese | WPRIM | ID: wpr-994688

ABSTRACT

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a sole viable treatment for acute myeloid leukemia (AML). As the median age of AML is approaching 68 years and the global population is aging, allo-HSCT for is becoming more vital for elderly AML patients (60 years and over). Conditioning regimen is important in determining the clinical outcomes of post-allo-HSCT patients.This review summarized the classic and latest conditioning regimens and evaluated their respective clinical outcomes.Clinicians may appreciate the advantages of each conditioning regimen and formulate optimal options for elderly AML patients.

15.
Chinese Journal of Anesthesiology ; (12): 802-808, 2023.
Article in Chinese | WPRIM | ID: wpr-994262

ABSTRACT

Objective:To systematically evaluate the diagnostic value of lung ultrasound (LUS) in diagnosing postoperative atelectasis, pleural effusion and pneumothorax in adult patients.Methods:PubMed, Embase, Cochrane Library, Web of Science, Wanfang Database, China Science and Technology Journal Database and China National Knowledge Infrastructure were searched for studies comparing the accuracy of LUS Chest radiograph (CXR) or computed tomography (CT) in the diagnosis of postoperative atelectasis, pleural effusion and pneumothorax, and the parameters were the sensitivity and specificity of LUS in diagnosing postoperative atelectasis, pleural effusion and pneumothorax, and the area under the receiver operating characteristic curve (AUC). Analysis was performed using MetaDiSc 1.4, Review Manager 5.4, and STATA 16.0 softewares. CXR and CT were used as standard imaging examination methods, and the combined sensitivity, specificity and AUC of LUS were calculated. Meta regression analysis was conducted on the types of surgeries, standard imaging examination methods (CXR, CT), CXR (CT)/LUS examination intervals (>3 h, ≤3 h), and time points of postoperative LUS examination.Results:Fifteen studies involving 1 585 patients were finally enrolled in the present study. The combined sensitivity of LUS in diagnosing postoperative atelectasis, pleural effusion and pneumothorax was 0.91 (95% confidence interval [ CI] 0.88-0.93), 0.75 (95% CI 0.71-0.78) and 0.53 (95% CI 0.48-0.58), respectively, and the combined specificity was 0.96 (95% CI 0.95-0.97), 0.82 (95% CI 0.81-0.84) and 0.94 (95% CI 0.93-0.95), respectively, and AUC was 0.936 8 ( SE=0.044 2), 0.839 7 ( SE=0.076 7) and 0.914 7 ( SE=0.030 9), respectively. Meta-regression analysis showed that the type of surgery was a source of heterogeneity affecting the diagnosis of pneumothorax by LUS ( P=0.001), and the standard imaging examination method was the source of heterogeneity affecting the diagnosis of pleural effusion by LUS ( P=0.023). Conclusions:Although LUS has a weak ability in detecting non-clinically related pneumothorax (≤3 cm) and a low overall sensitivity in diagnosing postoperative pneumothorax, the specificity is high in adult patients.

16.
Chinese Journal of Orthopaedics ; (12): 841-848, 2023.
Article in Chinese | WPRIM | ID: wpr-993511

ABSTRACT

Objective:To explore the risk factors of recurrence after resection of thigh soft tissue malignant tumors and the evaluation of the postoperative lower limb function.Methods:A total of 211 patients who underwent thigh soft tissue malignant tumor resection in the Department of Orthopaedics of the second affiliated Hospital of Medical College of Zhejiang University from May 2011 to May 2021 were retrospectively analyzed, including 117 males and 94 females, aged 53 (43, 65) years. There were 59 cases of atypical/well-differentiated liposarcoma, 30 cases of other types of liposarcoma, 33 cases of malignant fibrous histiocytoma, 19 cases of fibrosarcoma, 12 cases of rhabdomyosarcoma, 12 cases of leiomyosarcoma, 9 cases of synovial sarcoma, and 37 cases of others. The tumor involvement of muscle, bone, blood vessel, nerve tissue and intermuscular compartment, postoperative Musculoskeletal Tumor Society (MSTS) functional score and recurrence were recorded. The relationship between anatomical structure and postoperative recurrence was analyzed by Cox logistic regression to determine risk factors; the cumulative recurrence rate of different compartment groups (medial compartment, anterior compartment, and posterior compartment) were compared; The Box plot was used to compare the postoperative function of patients with resection of different anatomical structures (e.g., vastus lateralis, biceps femoris, femur, etc.).Results:A total of 34 out of 211 patients relapsed, with a recurrence rate of 16.1%. The recurrence time ranged from 2.6 months to 91.6 months after operation, with a median recurrence time of 37.0 (18.2, 52.8) months. Three independent risk factors were found to be associated with recurrence, namely: pathological grade [ HR=3.86, 95% CI(1.75, 8.51)], involvement of vastus intermedius [ HR=3.05, 95% CI(1.53, 6.06)], and involvement of vastus medialis [ HR=3.17, 95% CI(1.56, 6.41)]. The recurrence rate of patients with anterior chamber tumor resection was 35.3%, which was higher than that of patients without tumor resection (16.2%), and the difference was statistically significant ( P=0.020). There was no significant difference in recurrence rate between patients with medial chamber tumor resection and patients without tumor resection ( P>0.05). The recurrence rate of patients with posterior compartment tumor resection was 12.3%, which was lower than that of unresectable patients (37.6%), and the difference was statistically significant ( P=0.002).The postoperative MSTS score of 167 patients averaged 26±3.2 points (9-30 points). After intraoperative resection of part of the femur, vastus intermedius, vastus medialis, and rectus femoris, the patient's function was relatively poor [corresponding median MSTS score: 25 (23, 28), 26 (24 28), 26 (24,28), 26(24, 27)]. Conclusion:The risk factors for local recurrence after resection of thigh soft tissue malignant tumors include: pathological grade of the tumor, and whether the vastus intermedius or vastus medialis is involved. Anterior compartment tumors have a higher recurrence rate after surgery. If the tumor involves the above-mentioned anatomical structures, more attention should be paid to the risk of local recurrence after surgery.

17.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 198-204, 2022.
Article in Chinese | WPRIM | ID: wpr-931924

ABSTRACT

Objective:To explore the effects of Chaihu-Shugan San (CSS) on the behavior and neurogenesis function of depression model mice induced by chronic unpredictable mild stress (CUMS).Methods:Thirty clean grade healthy male C57BL/6 adult mice were randomly divided into control group (Con group), model group (CUMS group) and Chaihu-Shugan San treatment group (CSS group), with 10 mice in each group.The mice in CUMS group and CSS group were given CUMS intervention to establish depression model. At the same time of modeling, the mice in CUMS group and CSS group were given distilled water and CSS(2.7 g/kg) by gavage respectively.While the mice in Con group were only given equal volume distilled water by gavage without CUMS stimulation.After the intervention, the depressive-like behavior of mice was evaluated by increased body weight, sugar water preference test (SPT), forced swimming test (FST) and tail suspension test (TST). The number of newborn neurons was detected by immunofluorescence staining. The mRNA expression levels of brain-derived neurotrophic factor (BDNF), fibroblast growth factor 2 (FGF2) and spindle and kinetochore-associated protein 2(SKA2) in mice hippocampus were detected by qRT-PCR.Statistical analysis was performed by SPSS 22.0 software. One-way ANOVA was used for multi group comparison, and Tukey test was used for pairwise comparison.Results:(1) After modeling, there was significant difference in body weight increment among the three groups ( F=8.859, P <0.05). The body weight increment of CUMS group was lower than those of Con group and CSS group (both P< 0.05). There were significant differences in sugar water preference rate, tail suspension immobility time and swimming immobility time among the three groups ( F=10.544, 12.957, 8.095, all P<0.05). The sugar water preference rate in CUMS group was lower than that in Con group ((87.46±2.78)%, (93.90±3.31)%, P<0.05), and that in CSS group was higher than that in CUMS group ((91.65±2.61)%)( P<0.05). The tail suspension immobility time ((198.00±27.57) s) and swimming immobility time ((322.20±46.98) s) in CUMS group were higher than those in Con group ((138.80±38.50) s, (238.50±50.51) s, both P<0.05). The tail suspension immobility time ((139.00±21.29) s) and swimming immobility time ((265.20±44.90) s) in CSS group were lower than those in CUMS group (both P<0.05). (2) Immunofluorescence showed that there was significant difference in the number of newborn neurons labeled by BrdU and NeuN in the dentate gyrus of hippocampus among the three groups ( F=9.486, P<0.05). The number of double labeled cells (31.66±3.21) in CUMS group was lower than that in Con group(63.66±15.17) and CSS group (58.00±6.00) (both P<0.05). (3) RT-PCR results showed that the mRNA levels of BDNF, FGF2, SKA2 in hippocampal dentate gyrus of the three group were significantly different( F=14.522, 9.337, 8.701, all P<0.05). The levels of BDNF mRNA (0.79±0.06), FGF2 mRNA (0.74±0.18) and SKA2 mRNA (0.52±0.32) in the dentate gyrus of hippocampus in CUMS group were lower than those in Con group (BDNF mRNA (1.03±0.10), FGF2 mRNA (1.04±0.11), SKA2 mRNA (1.05±0.37), all P<0.05). Compared with CUMS group, the mRNA levels of BDNF (1.07±0.80), FGF2 (1.30±0.29) and SKA2 (1.40±0.55) in CSS group were higher (all P<0.05). Conclusion:CSS can alleviate the depressive like behavior of depression model mice, which may be related with increasing the mRNA expression levels of BDNF, FGF2, SKA2 and promoting the proliferation of neural stem cells in hippocampus.

18.
Acta Pharmaceutica Sinica B ; (6): 2417-2428, 2022.
Article in English | WPRIM | ID: wpr-929405

ABSTRACT

Glycosite-specific antibody‒drug conjugatess (gsADCs), harnessing Asn297 N-glycan of IgG Fc as the conjugation site for drug payloads, usually require multi-step glycoengineering with two or more enzymes, which limits the substrate diversification and complicates the preparation process. Herein, we report a series of novel disaccharide-based substrates, which reprogram the IgG glycoengineering to one-step synthesis of gsADCs, catalyzed by an endo-N-acetylglucosaminidase (ENGase) of Endo-S2. IgG glycoengineering via ENGases usually has two steps: deglycosylation by wild-type (WT) ENGases and transglycosylation by mutated ENGases. But in the current method, we have found that disaccharide LacNAc oxazoline can be efficiently assembled onto IgG by WT Endo-S2 without hydrolysis of the product, which enables the one-step glycoengineering directly from native antibodies. Further studies on substrate specificity revealed that this approach has excellent tolerance on various modification of 6-Gal motif of LacNAc. Within 1 h, one-step synthesis of gsADC was achieved using the LacNAc-toxin substrates including structures free of bioorthogonal groups. These gsADCs demonstrated good homogeneity, buffer stability, in vitro and in vivo anti-tumor activity. This work presents a novel strategy using LacNAc-based substrates to reprogram the multi-step IgG glycoengineering to a one-step manner for highly efficient synthesis of gsADCs.

19.
Journal of Central South University(Medical Sciences) ; (12): 390-395, 2022.
Article in English | WPRIM | ID: wpr-928982

ABSTRACT

Pseudomyogenic hemangioendothelioma (PHE) is a rare angiogenic tumor. Histologically, the morphological characteristics of neoplastic vessels and endothelial differentiation are not obvious, and it is easy to be confused with epithelioid sarcoma, epithelioid hemangioendothelioma and myogenic tumor. PHE usually occurs in arms and legs in young people and has a significant male predominance. The tumor has a predilection for the distal extremities and its typical manifestation is multiple center invasion of a single limb, which can involve all layers of skin and subcutaneous tissues,and is often accompanied by abvious pain. Histologically, PHE is characterized by infiltrative growth of tumor. Most tumor lesions are composed of sheets and loose fascicles of plump spindle or epithelioid cells within a background of variably prominent inflammatory infiltration, which was commonly composed of neutrophils. Some cells may resemble rhabdomyoblasts, and nuclear atypia and mitosis were rare. The tumor cells generally expressed positive cytokeratin (CK), ETS-related gene (ERG), Friend leukemia virus integration 1 (FLI1) and integrase interactor 1(INI1). In some cases, the tumor cells expressed CD31. A case of a young woman was reported in this paper, who presented with a subcutaneous mass with severe pain and was chronologically misdiagnosed with herpes zoster, low-grade malignant fibrous histiocytoma and epithelioid hemangioendothelioma. In this study, the clinical and pathological features, differential diagnosis and the latest progress in therapy of PHE were analyzed based on relevant literature.


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Biomarkers, Tumor , Diagnosis, Differential , Diagnostic Errors , Hemangioendothelioma, Epithelioid/pathology , Hemangioma , Histiocytoma, Malignant Fibrous/diagnosis , Pain , Precancerous Conditions/diagnosis
20.
Chinese Journal of Anesthesiology ; (12): 527-533, 2022.
Article in Chinese | WPRIM | ID: wpr-957486

ABSTRACT

Objective:To evaluate the effect of start time of surgery on short-term prognosis in the patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).Methods:A total of 928 patients of both sexes, aged 18-81 yr, with body mass index of 14.5-37.7 kg/m 2, scheduled for elective cardiac surgery with CPB from November 14, 2019 to May 14, 2020, were selected.Based on the start time of skin incision, the patients were divided into morning group (08: 00-13: 59) and afternoon group (14: 00-20: 00) or into on-hour group (08: 00-15: 59 on weekday) and off-hour group (16: 00-20: 00 on weekday, 08: 00-20: 00 on weekend). Propensity score matching was used to calibrate confounding factors.The primary outcomes were 30-day mortality and serious cardiovascular and cerebrovascular events after surgery.Secondary outcomes included the development of acute kidney injury within 3 days after surgery and development of pulmonary complications within 30 days after surgery, occurrence of surgical site infection, postoperative length of hospital stay, length of intensive care unit stay and duration of mechanical ventilation, and total hospitalization costs. Results:There was no significant difference in 30-day mortality and serious cardiovascular and cerebrovascular events after surgery, development of acute kidney injury within 3 days after surgery, and incidence of pulmonary complications within 30 days after surgery and of surgical site infection, postoperative length of hospital stay, length of intensive care unit stay and duration of mechanical ventilation, and total hospitalization costs between morning group and afternoon group and between on-hour group and off-hour group ( P>0.05). Conclusions:The start time of surgery exerts no effect on short-term prognosis in the patients undergoing elective cardiac surgery with CPB.

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