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1.
Article in Chinese | WPRIM | ID: wpr-879400

ABSTRACT

OBJECTIVE@#To evaluate the effectiveness and security of posterior percutaneous endoscopic cervical discectomy (PPECD) in the treatment of single level cervical spondylopathy with intraspinal ossification.@*METHODS@#Twenty three patients with single level cervical spondylopathy with intraspinal ossification were treated by posterior percutaneous endoscopic cervical discectomy between August 2017 and July 2019. There were 16 males and 7 females, aged from 29 to 74 years old with an average of (50±13) years.The disease duration were 3 to 120 months with a median of 6 months. There were 9 cases of cervical spondylotic radiculopathy, 6 cases of cervical spondylotic myelopathy, and 8 cases of mixed cervical spondylopathy. According to the characteristics of ossification, 17 cases were osteophytes on the posterior edge of the vertebral body;3 cases were protrusion ossification;3 cases were posterior longitudinal ligament ossification. According to the position of ossification in spinal canal, 14 cases were medial and lateral type, 5 cases were central type, and 4 cases were mixed type. Posterior percutaneous cervical endoscopic cervical discectomy in patients performed by the same surgeon. Japanese Orthopaedic Association (JOA) score and visual analogue scale(VAS) were compared separately before and after operation. At 3 months after operation, clinical effect was assessed according to modified Macnab standard.@*RESULTS@#All operations were successful. The operative time was 30 to 155 (69.1±27.2) min. The bedridden time was 2 to 3(3.0±0.9) h, length of postoperative hospitalization was 2 to 7(4.1± 1.5) d. Three dimensional CT reconstruction of the cervical spine at 3 days after operation showed that ossified tissue of 13 cases were completely removed, and 10 cases were left after operation, and the residual was located at the posterior edge and/or center of the upper vertebral body. VAS score at discharge from hospital was significantly lower than that before operation (@*CONCLUSION@#For an experienced surgeon, percutaneous posterior cervical endoscopic discectomy is safe and reliable in treating single level cervical spondylopathy with intraspinal ossification, and can obtain good clinical results.


Subject(s)
Adult , Aged , Cervical Vertebrae/surgery , Diskectomy , Diskectomy, Percutaneous , Endoscopy , Female , Humans , Intervertebral Disc Displacement/surgery , Male , Middle Aged , Osteogenesis , Retrospective Studies , Treatment Outcome
2.
Cancer Research and Clinic ; (6): 811-817, 2021.
Article in Chinese | WPRIM | ID: wpr-912973

ABSTRACT

Objectvie:To investigate the infiltration patterns of immune cells in colorectal cancer, and to explore the correlation of immune cells infiltration with clinical characteristics and overall survival (OS) of patients.Methods:The RNA sequencing data of 615 patients with colorectal cancer were downloaded from The Cancer Genome Atlas (TCGA) database. The data was updated on July 19, 2019, and included 571 colorectal cancer tissues and 44 paracancerous tissues. There were 552 cases with clinical data, such as survival time, survival status, age, gender, clinical stage, grade, tumor location and so on. Using CIBERSORT deconvolution algorithm, the relative amounts of 22 immune cell types were calculated based on standardized gene expression data. According to the results of CIBERSORT algorithm, the samples with high accuracy of deconvolution result were selected ( P < 0.05), and they were used for analysis and graphing. The correlations between the infiltration patterns of immune cells and the clinical characteristics and OS of patients were analyzed. Results:After the CIBERSORT method was used to filter and remove samples with P ≥ 0.05, a total of 282 tumor tissue samples and 16 paracancerous tissue samples were screened. In 293 cases with clinical information, there were 277 tumor tissue samples and 16 paracancerous tissue samples. In 293 samples, M0 macrophages, M1 macrophages, M2 macrophages, CD8 + T cells and unactivated CD4 memory T cells accounted for a higher proportion of total immune cells; in tumor tissue samples, the expressions of M0 macrophages, M1 macrophages, activated CD4 memory T cells, and unactivated natural killer (NK) cells were higher; in paracancerous tissues, the expressions of naive B cells, M2 macrophages, activated NK cells, unactivated dendritic cells, unactivated mast cells and plasma cells were higher; with the increase of clinical stage, the expressions of follicular helper T cells, activated CD4 memory T cells, activated NK cells, M1 macrophages decreased, and the expressions of plasma cells and regulatory T cells increased, and the differences were statistically significant (all P < 0.05). M1 macrophages, unactivated mast cells, activated CD4 memory T cells, CD8 + T cells, and follicular helper T cells were highly expressed in right colon cancer, while M0 macrophages and activated mast cells were highly expressed in left colon and rectal cancer, and the differences were statistically significant (all P < 0.05). The patients were divided into high infiltration group and low infiltration group based on the median expression level of infiltrated immune cells, and the survival analysis was performed. The result of survival analysis showed that patients with high initial B cell infiltration had good OS; however, patients with high infiltration of M2 macrophages, activated mast cells, and neutrophils had poor OS. Conclusions:There are different types of immune cell infiltration patterns in the colorectal cancer samples of different stages and locations, which are closely related to tumor progression and OS of patients. They are expected to be applied to the development of therapeutic targets and prognosis prediction.

3.
Chinese Journal of Anesthesiology ; (12): 1227-1229, 2021.
Article in Chinese | WPRIM | ID: wpr-911347

ABSTRACT

Objective:To investigate the effect of diabetes mellitus on pulmonary uptake of sevoflurane.Methods:Twenty patients with type 2 diabetes mellitus, aged 40-64 yr, with body mass index of 18.5-22.9 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective surgery with general anesthesia, served as diabetes group (group D). Twenty non-diabetic patients matched by age, gender and surgery were selected as control group (group C). After anesthesia induction and tracheal intubation, sevoflurane was inhaled at a concentration of 2% (oxygen flow 2 L/min). The inhaled concentration (Fi) and exhaled concentration (Fa) at 1, 3, 5, 10, 15, 20 and 30 min of inhalation of sevoflurane were recorded, and the Fa/Fi ratio was calculated.The time required for the Fa/Fi ratio to reach 0.7 was recorded. Results:Compared with group C, the Fa/Fi ratio was significantly increased at each time point, and the time required for the Fa/Fi ratio to reach 0.7 was shortened in group D ( P<0.05). Conclusion:Diabetes mellitus can reduce pulmonary uptake of sevoflurane in the patients.

4.
Article in Chinese | WPRIM | ID: wpr-911269

ABSTRACT

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) at Neiguan on dexmedetomidine-induced bradycardia in patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-50 yr, weighing 48-60 kg, scheduled for elective gynecological surgery under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: control group (group C) and TEAS group (group T). Dexmedetomidine 1 μg/kg was infused intravenously over 10 min followed by intravenous infusion 0.5 μg·kg -1·min -1 in two groups, and the patients in group T simultaneously received TEAS (frequency 2/100 Hz, disperse-dense wave, intensity 5-10 mA according to the current that could be tolerated) at bilateral Neiguan acupoints.The stimulator was only connected, and no current was given in group C. Before the infusion of dexmedetomidine (T 0) and at 10 min of dexmedetomidine infusion (T 1), mean arterial pressure (MAP) and heart rate (HR) was recorded, and electrocardiogram (ECG) was collected to calculate the PR interval, QT interval, QT interval, Tp-e interval and index of cardiac electrophysiological balance (iCEB). The development of arrhythmia was recorded. Results:Compared with the baseline value at T 0, HR was significantly decreased, and QT interval and PR interval were prolonged at T 1 in two groups, and iCEB was increased, and Tp-e interval was prolonged at T 1 in group C ( P<0.05). Compared with group C, HR was significantly increased, PR interval and Tp-e interval were shortened at T 1, and the incidence of bradycardia and atrioventricular block was increased in group T ( P<0.05). Conclusion:TEAS at Neiguan can decrease the risk of bradycardia induced by dexmedetomidine, and the mechanism may be related to shortening atrioventricular conduction time and reducing heterogeneity of ventricular repolarization in patients.

5.
Article in Chinese | WPRIM | ID: wpr-911268

ABSTRACT

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative delirium (POD) in frail elderly patients.Methods:Sixty frail elderly patients of both sexes, aged 65-80 yr, with body mass index of 18.5-30.0 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with preoperative Fried frailty phenotype scale≥3, were divided into 2 groups ( n=30 each) using a random number table method: control group (group C) and TEAS group.In group TEAS, patients received TEAS of Shenmen, Neiguan and Zusanli acupoints starting from 30 min before anesthesia induction until the end of surgery.The frequency was 2/100 Hz, wave length was 0.25 ms and the intensity was maintained at about 1-30 mA according to the current that could be tolerated.The same acupoints were continuously stimulated for 30 min at 24, 48 and 72 h after operation.Electroacupuncture was performed for 30 min at the points 4 cm lateral to the same acupoints in group C. The occurrence of POD was evaluated by Confusion Assessment Method at 1-7 days after surgery.The intraoperative consumption of propofol, remifentanil and sufentanil, the effective pressing times of patient-controlled intravenous analgesia (PCIA) pump, the requirement for rescue analgesia at 0-8 h (T 1), 8-24 h (T 2) and 24-48 h (T 3) after operation and the development of rescue analgesia, POD, postoperative nausea and vomiting (PONV) and somnolence after operation were recorded. Results:Compared with group C, requirement for rescue analgesia and the incidence of POD, PONV and somnolence after operation were significantly decreased, and intraoperative consumption of propofol and remifentanil and the postoperative effective pressing times of PCIA at T 1-3 were decreased in group TEAS ( P<0.05). Conclusion:TEAS can reduce the occurrence of POD in frail elderly patients.

6.
Article in Chinese | WPRIM | ID: wpr-906336

ABSTRACT

Objective:To evaluate the 3-year survival outcomes of postoperative patients after high exposure to traditional Chinese medicine (TCM) for triple negative breast cancer (TNBC). Method:The complete 3-year follow-up data of 150 postoperative patients with stage I–III TNBC were retrospectively analyzed. All the patients received routine western medical treatments (surgery, chemotherapy, and/or radiotherapy) according to the National Comprehensive Cancer Network (NCCN) clinical practice guidelines in oncology as well as TCM. According to the degree of exposure to TCM, they were divided into the high- and low-exposure cohorts, with the oral administration of Chaihu Longmu Decoction with or without anti-cancer Chinese patent medicine for at least six months annually, or 18 months or more in the three years as the inclusion criterion for the former cohort. The metastatic sites of recurrent TNBC and the recurrent metastasis/death time were observed in both cohorts to compare the disease-free survival (DFS) and overall survival (OS). The influences of onset age, pathological type, histopathological grade, vascular invasion, clinical stage, and exposure to TCM on survival were subjected to statistical analysis, followed by the observation of adverse effects. Result:There was no significant difference in the metastatic sites between the two cohorts (<italic>P</italic>>0.05). The high-exposure cohort had a longer 3-year DFS than the low-exposure cohort, and the 3-year DFS rate in the high-exposure cohort was increased by 16.9% (χ<sup>2</sup>=6.995, <italic>P</italic>=0.008) as compared with that in the low-exposure cohort, exhibiting a significant difference (<italic>P</italic><0.05). As revealed by the Cox proportional-hazards model, patients in the low-exposure cohort had a 3.724-fold as high risk of recurrent metastasis as that in the high-exposure cohort (95%CI 1.399~9.915). There was no significant difference in the 3-year OS between the two cohorts (<italic>P</italic>>0.05). The overall incidence of adverse effects in both groups was 7.3%, mainly manifested as gastrointestinal discomfort. Conclusion:High exposure to TCM contributes to reducing postoperative recurrence and metastasis and prolonging DFS.

7.
Acta Physiologica Sinica ; (6): 835-844, 2021.
Article in Chinese | WPRIM | ID: wpr-921287

ABSTRACT

The mitochondrial unfolded protein response is an important component of the mitochondrial protein quality control program. It can effectively remove unfolded or misfolded proteins under stress, and maintain a stable and healthy mitochondrial pool. The mitochondrial unfolded protein response is coordinated by multiple signaling pathways. The classical ATF4/ATF5-CHOP pathway is induced by accumulation of unfolded or misfolded proteins in the mitochondrial matrix, which reduces stress toxicity by regulating molecular chaperones and proteases. Sirt3-FOXO3a-SOD2 pathway, located in the mitochondrial matrix, plays an important role in anti-oxidative damage. The ERα-NRF1-HTRA2 pathway mainly removes unfolded proteins in the mitochondrial membrane space and improves the quality control of mitochondrial proteins. These three signaling pathways work both independently and cooperatively to enhance mitochondrial capacity and maintain health under stress.


Subject(s)
Mitochondria , Mitochondrial Proteins/metabolism , Oxidative Stress , Signal Transduction , Unfolded Protein Response
8.
Chinese Acupuncture & Moxibustion ; (12): 1029-1035, 2021.
Article in Chinese | WPRIM | ID: wpr-921004

ABSTRACT

OBJECTIVE@#To investigate the mechanism of electroacupuncture (EA) with the involvement of sarcoplasmic reticulum Ca@*METHODS@#Thirty SPF-ranked SD rats were randomly divided into a control group, a model group, an EA group, an aconitine group and an EA plus aconitine group, with 6 rats in each group. The rat model of acute heart failure was established by infusion of high-dose propranolol hydrochloride solution into the right femoral vein. After stabilized for 10 min in the modeled rats, EA was exerted at "Neiguan" (PC 6), with disperse-dense wave, 2 Hz/15 Hz in frequency, 3 mA in intensity, for 30 min in the EA group and the EA plus aconitine group; aconitine solution (10 μg/kg) was injected from the left femoral veins in the rats in the aconitine group and the EA plus aconitine group. Hemodynamic indexes such as the left ventricular systolic pressure (LVSP) and the maximum rate of increase/decrease of left ventricular pressure (±dp/dt@*RESULTS@#Compared with the control group, LVSP and ±dp/dt@*CONCLUSION@#The intervention with electroacupuncture achieves the synergism/ attenuation effect of aconitine for the improvements in heart failure probably by up-regulating the expression of SERCA2a and down-regulating the expression of PLB in myocardial tissue.


Subject(s)
Aconitine , Animals , Calcium-Binding Proteins , Electroacupuncture , Heart Failure/therapy , Rats , Rats, Sprague-Dawley
9.
Article in Chinese | WPRIM | ID: wpr-885965

ABSTRACT

The study aims to improve the level of fine management of medical equipments, give full play to the functions and roles for better patient service, and explore methods for evaluating the benefits of medical equipment that can take into account and reflect the needs of multiple parties. Based on objectives and key results(OKR) methods and concepts, a benefit evaluation system was developed with the goal of giving full play to the functions and roles of medical equipments, with corresponding evaluation indexes and supervision and evaluation mechanisms formulated as well. This index system could take into account the needs and concerns of hospitals, the departments in use, the management authorities and patients at large, while contributing to process supervision and continuous improvement. In the OKR practice of large medical equipments(CT, MR) from 2018 to 2019, they had performed significantly better in inspections, inspection positive coincident rates, clinical service capabilities, maintenance assurance levels, patient satisfaction, scientific research and academics among others. The use of a medical equipment benefit evaluation system based on OKR concepts and methods can provide effective evaluation indicators for the operation and management of medical equipments. In addition, the system can maintain internal improvement momentum leveraging process supervision and continuous improvement methods, in order to assure the elevation of fine management level of medical equipments of modern hospitals, thus offering better medical services for patients at large.

10.
Article in English | WPRIM | ID: wpr-880516

ABSTRACT

OBJECTIVE@#To investigate the effects of different acupuncture manipulations on Deqi sensations and surface myoelectricity, and explore the correlation between Deqi sensations and needling manipulations.@*METHODS@#Forty-five healthy participants accepted twirling, lifting-thrusting, and twirling plus lifting-thrusting manipulanions at right Zusanli (ST 36), respectively. The acupuncturist's and participants' Deqi sensations were collected by MGH Acupuncture Sensation Scale (MASS). The intensity and occurrence rate of soreness, dull pain, pressure, heaviness, fullness, numbness, sharp pain, warmth, coolness, and throbbing feelings of participants, and tightness, smooth, and tangle feelings of acupuncturist were measured. The correlation between the acupuncturist's and participant's Deqi sensations was analyzed. Surface electromyogram (EMG) were recorded before, during and after needling in 30 participants. The integrated EMG (iEMG), mean power frequency (MPF) and media frequency (MF) were analyzed.@*RESULT@#Both fullness and soreness of participants and tightness of acupuncturist were the most frequently occurred ones. A positive correlation between participants' fullness and acupuncturist's tightness was observed during the three aforementioned needling manipulations (P1). Almost all the needling sensations measured in the present study could be induced by the three needling manipulations. However, strength of Deqi sensations was exhibited as lifting-thrusting > twirling plus lifting-thrusting > twirling according to MASS index. The iEMG values were increased and MPF, MF values were decreased during needling compaired to those before needling, especially during lifting-thrusting (P<0.01).@*CONCLUSIONS@#The intensity and occurrence rate of the different Deqi sensations induced by different needling manipulations were basically similar. The fullness and soreness were both the most frequently induced Deqi sensations. The strongest Deqi sensation could be induced by lifting-thrusting manipulation. There is a positive correlation between participants' fullness and acupuncturist's tightness during the three needling manipulations. The myoelectricity around the acupoint is related to Deqi responses. (Registration No. AMCTR-IOR-20000314).

11.
Article in Chinese | WPRIM | ID: wpr-781697

ABSTRACT

OBJECTIVE@#To investigate the risk factors for cow's milk protein allergy (CMPA) among infants through a multicenter clinical study.@*METHODS@#A total of 1 829 infants, aged 1-12 months, who attended the outpatient service of the pediatric department in six hospitals in Shenzhen, China from June 2016 to May 2017 were enrolled as subjects. A questionnaire survey was performed to screen out suspected cases of CMPA. Food avoidance and oral food challenge tests were used to make a confirmed diagnosis of CMPA CMPA. A multivariate logistic regression analysis was used to investigate the risk factors for CMPA.@*RESULTS@#Among the 1 829 infants, 82 (4.48%) were diagnosed with CMPA. The multivariate logistic regression analysis showed that maternal food allergy (OR=4.91, 95%CI: 2.24-10.76, P6 months (OR=0.38, 95%CI: 0.17-0.86, P<0.05) were protective factors.@*CONCLUSIONS@#The introduction of complementary food at an age of <4 months, maternal food allergy, and antibiotic exposure during pregnancy are risk factors for CMPA in infants.


Subject(s)
Animals , Cattle , China , Female , Humans , Infant , Milk Hypersensitivity , Milk Proteins , Pregnancy , Risk Factors , Surveys and Questionnaires
12.
Chinese Journal of Epidemiology ; (12): 111-114, 2020.
Article in Chinese | WPRIM | ID: wpr-787699

ABSTRACT

In prospective cohort study, multi follow up is often necessary for study subjects, and the observed values are correlated with each other, usually resulting in time-dependent confounding. In this case, the data generally do not meet the application conditions of traditional multivariate regression analysis. Sequential conditional mean model (SCMM) is a new approach that can deal with time-dependent confounding. This paper mainly summarizes the basic theory, steps and characteristics of SCMM.

13.
Article in Chinese | WPRIM | ID: wpr-872974

ABSTRACT

Intracerebral hemorrhage (ICH) refers to the primary non-traumatic parenchymal hemorrhage, which is one of the common cerebrovascular diseases, with a high incidence, rapid development, slow recovery and high disabling rate. After intracerebral hemorrhage, a series of pathological changes occur in the brain tissue, such as local hematoma and its space occupying effect, secondary cerebral edema, death of brain cells and destruction of blood-brain barrier, which may lead to brain injury and neurological defects, seriously affect the quality of life of patients, and even endanger the life. Therefore, it is great medical value to find effective therapeutic methods and drugs, explore the mechanisms and targets for improving neurological function, reduce sequelae and improve the quality of life of patients. According to the theory of traditional Chinese medicine (TCM), cerebral hemorrhage belongs to " abnormal flow of the blood" , which equals to blood stasis. In recent years, scholars conducted extensive research on drugs for promoting blood circulation to remove blood stasis with modern scientific methods, and made in-depth discussion for the mechanism, and found that therapies for activating blood and removing blood stasis, plays a key role in intervening a series of physiological and pathological changes after cerebral hemorrhage, with significant curative effects in removing hematoma, improving the microcirculation and reducing the mortality and morbidity. This article summarized drugs for promoting blood circulation to remove blood stasis (Notoginseng Radix et Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Hirudo), formulas (Buyang Huanwu Tang, Didangtang, Naoxueshu oral liquid, Tongqiao Huoxuetang) and compound injections (Danhong injection) for the treatment of cerebral hemorrhage targets, and discussed the experimental research progress TCM for promoting blood circulation to remove blood stasis in treatment of cerebral hemorrhage in terms of promoting hematoma absorption, reducing brain edema and apoptosis, promoting angiogenesis, inhibiting the inflammatory response, and promoting the repair and regeneration of nerve tissue in nearly five years, and summarized the therapeutic mechanism, so as to provide scientific basis for clinical application of the therapeutic methods for activating blood and removing stasis to treat cerebral hemorrhage and the modern scientific research.

14.
Article in Chinese | WPRIM | ID: wpr-872780

ABSTRACT

A good neural microenvironment is an important basis for improving the damaged nerves and promoting axonal repair and regeneration. The destruction of neural microenvironment, closely related to the lack of neurotrophic factors, microcirculation disorders and immune abnormalities, is the key pathogenesis leading to diabetic peripheral neuropathy (DPN). In traditional Chinese medicine, disharmony between Ying and Wei is considered as the key pathology in the development of DPN. It may be manifested as Ying and Wei deficiency, or Ying and Wei impassability, or Ying, Wei, Qi and blood intersection disorders, all of which may cause body fluid condensed into phlegm, blood into blood stasis, further leading to the mutual knot of phlegm and blood stasis, meridian obstruction, numbness and pain of limbs. "Regulating Ying and Wei and tonifying spleen and stomach" is the main therapeutic idea to promote intersection between Ying and Wei and unblock Qi and blood. The method has a significant effect on DPN. However, the current studies on the mechanism of regulating Ying and Wei in the treatment of DPN are still in lack of in-depth discussion, and the studies are mostly limited to the microcirculation disorders. Numerous studies have confirmed that the courses and distribution, physiological characteristics, functions of Ying and Wei are closely related to nerve, immune, metabolic substances and microcirculation. Based on the modern medicine essence of Ying and Wei, the author thinks that the discussion on connotation of the Ying and Wei from the perspective of neural microenvironment has a scientific basis, and regulating Ying and Wei is not only inherited from the traditional Chinese medicine theory, but also conforms to the modern understanding on DPN pathogenesis and treatment. Regulating Ying and Wei and smoothing middle-jiao can improve neural microenvironment and give play to the role of restoring damaged nerve, and its mechanism may be related to regulating neurotrophic factors, immune active substances, metabolites, and microcirculation dysfunction.

15.
Article in Chinese | WPRIM | ID: wpr-872670

ABSTRACT

The long-term existence of hyperglycemia leads to the occurrence of metabolic memory effect, which is an important reason for the formation of diabetic macrovascular disease, so the early control of metabolic memory is the key to the prevention and treatment of diabetes and its complications. The excessive formation of advanced glycation end products (AGEs) is not only an important factor to cause metabolic memory, but also the core mechanism for diabetic macrovascular disease. It is believed in traditional Chinese medicine(TCM) that Fu-xie (incubative pathogen) is the key pathogenesis of the formation of diabetic vascular diseases, and it is necessary to adopt the principle of removing pathogenic factors and opening collaterals as early as possible to prevent and cure the disease. During the Spring and Autumn Period and the Warring States Period, the theory of Fu-xie was germinated, and got mature in the Ming and Qing dynasties after the continuous development. The so-called Fu-xie means that the pathogens are of a potential nature but not cause diseases immediately. The theory of Fu-xie first appeared in Huangdi Neijing, with an original meaning of epidemic febrile disease occurring after incubation, and then its meaning continues to expand, now referring to all potential pathogenic factors that would not immediately cause diseases. As the cause and pathogenesis of many diseases, the theory of Fu-xie is widely used in clinical practice to guide the treatment of diseases. In the body, the accumulation of AEGs can induce the subsequent cascade effect in the body, and finally promote the formation and development of diabetic macrovascular diseases. This is very similar to the process of inducing metabolic disorder and disease in TCM due to the accumulation of phlegm and silt. Therefore, under the guidance of Fu-xie theory, the mechanism of AEGs in blocking metabolic memory and preventing and treating diabetic macrovascular disease was analyzed in this paper. On the one hand, it will provide a scientific basis for the exploration of Fu-xie theory affecting the disease course of diabetic macrovascular disease by regulating the generation of AEGs. On the other hand, it can also provide the material change basis for the development of Fu-xie theory in the occurrence and development of diabetic macroangiopathy.

16.
Chinese Journal of Digestion ; (12): 454-460, 2020.
Article in Chinese | WPRIM | ID: wpr-871484

ABSTRACT

Objective:To investigate the cost-effectiveness of Helicobacter pylori ( H. pylori) antimicrobial susceptibility testing-guided therapy versus an effective empiric modified bismuth quadruple therapy for first-line H. pylori treatment. Methods:This cost-effectiveness analysis was based on the data from a multicenter prospective randomized controlled clinical trial (NCT02935010), which included 382 patients with H. pylori infection. Among them, 286 cases were in the antimicrobial susceptibility testing group, which were diagnosed by biopsy under endoscopy. And according to the results of antimicrobial susceptibility testing of H. pylori, patients were treated with triple or quadruple therapy of eradicating H. pylori for 14 days. A total of 96 patients were in empirical therapy group, which were diagnosed by biopsy under endoscopy (96 cases, endoscopy empirical group), who were treated with 14-day empiric bismuth quadruple therapy. At the same time, based on the patients of empirical group, a simulated 13C-urea breath test (UBT) empirical group (UBT empirical group) was set up (96 cases, H. pylori infection was first diagnosed by 13C-UBT examination) and in the cost accounting the expenses related to endoscopy, biopsy and drug sensitivity test were removed and the expense of 13C-UBT was added. The information of patients of endoscopy empirical group was kept. Taking the eradication rate of H. pylori as an effectiveness indicator, the cost, cost-effective ratio (CER), incremental cost-effective ratio (ICER) among antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were compared by intention-to-treat (ITT) analysis and per-protocol (PP) analysis. Sensitivity analysis was conducted based on the results of ITT analysis to evaluate the reliability of the research results. Results:The results of ITT analysis indicated that the cost of antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were (1 747.41±149.30), 1 032.71 and 657.71 Yuan, respectively. The cost of antimicrobial susceptibility testing group was (714.70±149.30) and (1 089.70±149.30) Yuan higher than that of the endoscopy empirical therapy group and UBT empirical therapy group, respectively. The CER of antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were (19.08±1.49), 12.09 and 7.70 Yuan/%, respectively. ICER of antimicrobial susceptibility testing group was (115.27±1.49) and (175.76±1.49) Yuan /% in comparison with the endoscopy empirical group and the UBT empirical therapy group. Compared with that of empirical group, the ICER of antimicrobial susceptibility testing group was more likely to be affected by H. pylori eradication rate and the cost of antimicrobial susceptibility testing. When the H. pylori eradication rate decreased in the empirical group, the ICER of the antimicrobial susceptibility testing group also decreased; when the H. pylori eradication rate increased in antimicrobial susceptibility testing group, the ICER decreased, and vice versa. When the cost of antimicrobial susceptibility test was upregulated or downregulated by 20%, for every 1% increase in the eradication rate of H. pylori in comparison with that of the endoscopy empirical group, the cost of the antimicrobial susceptibility testing group increased by 99.15 and 131.40 Yuan; in comparison with that of the UBT empirical group, the cost of the antimicrobial susceptibility testing group increased by 159.63 and 191.89 Yuan. Conclusions:For patients diagnosed with H. pylori infection by 13C-UBT and without indications for endoscopy examination, the empirical quadruple therapy is the first choice. For patients intended to do endoscopy to confirm H. pylori infection, with additional affordability of 115.27 Yuan for every 1% increase in the eradication rate of H. pylori, antimicrobial susceptibility testing can be conducted and personalized. H. pylori eradication therapy can be carried out based on the results of antimicrobial susceptibility test. Reduced cost of the antimicrobial susceptibility test will be more conductive to the promotion of personalized treatment after antimicrobial susceptibility test.

17.
Article in Chinese | WPRIM | ID: wpr-870064

ABSTRACT

Objective:To observe whether parathyroid hormone (PTH) 1-34 can block the negative osteogenesis of advanced glycation end products (AGEs) on bone marrow mesenchymal stem cells (BMSCs) in rats and its possible signaling pathways.Methods:BMSCs from 4-week-old SD rats were isolated and cultured with whole bone marrow method. The osteogenic induction fluid, bovine serum albumin(BSA), AGEs, AGEs combined with PTH1-34 were pretreated respectively. After 7 days, realtime fluorescence quantitative PCR (RT-PCR) was used to measure alkaline phosphatase (ALP), collagen-Ⅰ (COL-Ⅰ) mRNA expression level, and the expressions of β-catenin, osterix (OSX), runt-related transcription factor 2 (RUNX2), and receptor for advanced glycation end products protein were examined by Western blotting. Alizarin red staining mineralized nodules and quantitative detection were performed on 21 days. After the addition of Wnt pathway specific blocker Dickkopf-1 (DKK1) (1 μg/ml) to 10 -8 mmol/L of PTH1-34, the protein expression levels of β-catenin, OSX, and RUNX2 were detected again by Western blotting. Results:AGEs significantly inhibited the expression of ALP, COL-Ⅰ mRNA, β-catenin, OSX, and RUNX2 proteins ( P<0.05). PTH1-34 inhibited AGEs after pretreatment, the expression of ALP, COL-Ⅰ mRNA, and β-catenin, OSX, RUNX2 protein were higher than those of AGEs group ( P<0.05). The mineralized nodules stained with alizarin red showed reddish brown and increased OD value was detected quantitatively in PTH1-34 group, which was higher than that of AGEs group ( P<0.05). DKK1(1 μg/ml) reduced the expression of β-catenin, OSX proteins as compared with the BSA group ( P<0.05). Conclusion:PTH1-34 blocks AGEs′ negative osteogenesis to BMSCs through Wnt/β-catenin signaling pathway.

18.
Article in Chinese | WPRIM | ID: wpr-869955

ABSTRACT

Objective:To determine the changes in the expression of myocardial miRNA and the target genes in the rats with hypothermic ischemia-reperfusion (I/R) arrhythmia.Methods:Clean-grade healthy male Sprague-Dawley rats, aged 2-3 months, weighing 300-400 g, were anesthetized, the chest was opened, and the heart was taken to establish an isolated heart perfusion model.Six successfully perfused isolated hearts were divided into 2 groups ( n=3 each) using a random number table method: control group (group C) and heart I/R group (IR group). The model of hypothermic global I/R injury was established by interrupting perfusion for 60-min followed by 30-min reperfusion in chloral hydrate-anesthetized rats.The arrhythmia score was recorded during reperfusion.High-throughput sequencing was used to identify the differentially expressed miRNAs in two groups.The RNAhybrid and miRanda databases were used to predict the target genes of mRNA regulated by the differentially expressed miRNAs, and the enrichment for target genes was performed by Gene Ontology and KEGG databases, and the miRNAs closely related to arrhythmia and with higher expression were selected to carry out the real-time polymerase chain reaction detection. Results:The results of high-throughput sequencing showed that there were 7 differentially expressed miRNAs (novel-miR-17, novel-miR-19, novel-miR-30, novel-miR-43, rno-miR-122-5p, novel-miR-16 and rno-miR-429) in group IR as compared with group C. There were 4 miRNAs that were closely related to arrhythmia and had higher expression: the expression of novel-miR-17, novel-miR-30 and rno-miR-122-5p was significantly up-regulated, and the expression of rno-miR-429 was down-regulated in group IR when compared with group C ( P<0.05). The miRNA-mRNA correlation analysis revealed that GJA1 gene was the target of novel-miR-17. Conclusion:Myocardial novel-miR-17 is involved in the occurrence of hypothermic I/R arrhythmia probably by acting on GJA1 gene in rats.

19.
Article in Chinese | WPRIM | ID: wpr-869935

ABSTRACT

Objective:To evaluate the changes in the electrical conduction of ventricular myocardium during hypothermic ischemia-reperfusion (I/R) in rats with arrhythmia.Methods:Healthy clean-grade adult male Sprague-Dawley rats, aged 2-3 months, weighing 200-300 g, were studied.The hearts were removed and retrogradely perfused with oxygenated K-H solution in a Langendorff apparatus. Sixteen isolated hearts were divided into 2 groups ( n=8 each) using a random number table method: normal control group (group C) and hypothermic I/R group (group I/R). In group C, the heart was perfused with K-H solution at 37 ℃ for 120 min.In group I/R, the heart was perfused with K-H solution at 37 ℃ for 30 min, and then perfusion was stopped, cardiac arrest was induced through injecting Thomas solution (4 ℃), the area around the heart was protected with low temperature (4 ℃) Thomas solution, and hearts were perfused with 4 ℃ Thomas solution at 30 min after cardiac arrest and with 37 ℃ K-H solution for 30 min staring from 60 min after cardiac arrest.The rats in group I/R were further divided into high-risk subgroup (I/R-H subgroup) and low-risk subgroup (I/R-L subgroup). The time of spontaneous recovery of heart beat and development of arrhythmia were recorded.At the end of reperfusion, the atrioventricular conduction 2∶1 block point (2∶1B) and ventricular electrical conduction velocity (CV) were measured and recorded by program-controlled electrical stimulation. Results:Compared with group C, CV and 2∶1B were significantly decreased in IR-L and IR-H subgroups ( P<0.05). Compared with IR-L subgroup, the time for restoration of spontaneous heart beat was significantly prolonged, the incidence of ventricular fibrillation and arrhythmia score were increased, and CV and 2∶1B were decreased in IR-H subgroup ( P<0.05). Conclusion:The electrical CV of ventricular myocardium is decreased during hypothermic I/R, which may be the mechanism of reperfusion-induced ventricular arrhythmia in rats with arrhythmia.

20.
Article in Chinese | WPRIM | ID: wpr-869865

ABSTRACT

Objective:To evaluate the effect of electroacupuncture (EA) on electrophysiological characteristics of ventricular myocardium during myocardial ischemia-reperfusion (I/R) in rats.Methods:Twenty-four clean-grade healthy adult male Sprague-Dawley rats, weighing 280-320 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (group SH), I/R group and group EA.The model of myocardial I/R injury was established by ligating the left anterior descending branch of coronary artery for 30 min followed by 30-min reperfusion in anesthetized rats.Bilateral Neiguan acupoints in forelimbs were stimulated for 30 min during the period of reperfusion in group EA.Heart rate (HR), monophasic action potential amplitude (MAPA), maximum depolarization rate (V max), and monophasic action potential duration at 90% repolarization (MAPD 90) were recorded.The development of arrhythmias and arrhythmias score were recorded during reperfusion. Results:Compared with group SH, HR was significantly decreased, MAPA and V max were decreased, MAPD 90 was prolonged, and the incidence of ventricular premature beat, ventricular tachycardia and ventricular fibrillation and arrhythmias score were increased at T 1, 2 in I/R and EA groups ( P<0.05). Compared with group I/R, HR was significantly increased, MAPA and V max were increased, MAPD 90 was shortened, and the incidence of ventricular tachycardia and ventricular fibrillation and arrhythmias score were decreased at T 2 in EA group ( P<0.05). Conclusion:EA can accelerate myocardial depolarization and shorten repolarization, thus decreasing the occurrence of reperfusion arrhythmia in rats.

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