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1.
Article in Chinese | WPRIM | ID: wpr-920547

ABSTRACT

Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research, we believe that five aspects need to be prioritized for a strong system. First, we should change the perspective on public health, using the word “gonggong jiankang” to replace “gonggong weisheng” and the word “gonggong jiankang tixi” to replace “gonggong weisheng tixi”, to lead the public health system development. Second, we should develop a suitable public health system and continuously improve the health capacity for governance. Third, we should make it clear that the goal of building a strong system is not far-fetched, and we need to consolidate the existing institutional advantages of China’s public health system: when encountering major problems, we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However, we need to make up for shortcomings one by one, especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth, we should pursue excellence and consolidate the“suitable” mechanism proven in the process of coping with the COVID-19, so that efficient mechanisms to deal with major issues can be used in routine work, and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response,so as to achieve the balanced development of regions categories and units.Finally, it is necessary to strengthen the coordination of government and research institutions, in the aspects of technological innovation, talent team building and accurate consulting services, and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.

2.
Acta Pharmaceutica Sinica ; (12): 809-817, 2022.
Article in Chinese | WPRIM | ID: wpr-922883

ABSTRACT

The bone formation promoter recombinant human parathyroid hormone 1-34 [PTH (1-34)] has a short half-life and low bioavailability. In this study, we prepared a biodegradable and temperature-sensitive hyaluronic acid-poly-N-isopropyl acrylamide (AHA-g-PNIPAAm), and further investigated its effects of PTH (1-34) release and cell behavior as drug carrier. The structure of AHA-g-PNIPAAM was confirmed by hydrogen nuclear magnetic resonance spectroscopy and infrared spectroscopy. Next, PTH (1-34) loaded thermo-sensitive hydrogels were prepared by physical swelling method and their stability was investigated. The morphology of hydrogel was observed by scanning electron microscope. The minimum critical transition temperature and drug release behavior of hydrogels were investigated by ultraviolet spectrophotometry. The tetrazolium-based colorimetric assay (MTT assay) was used to investigate the toxicity and proliferation effects of PTH (1-34)-loaded thermo-sensitive hydrogel on mouse mononuclear macrophage RAW264.7 and mouse precranial osteoblasts MC3T3-E1. The effect of PTH (1-34)-loaded thermo-sensitive hydrogel on the differentiation of RAW264.7 was investigated by the tartrate-resistant acid phosphatase assay. The results showed that the PTH (1-34)-loaded thermo-sensitive hydrogel prepared in this study displayed regular three-dimensional honeycomb structure, and had good stability, thermo-sensitivity and sustained and controlled release properties, which could promote the proliferation of MC3T3-E1 cells more effectively and inhibit the differentiation of RAW264.7 into osteoclasts.

3.
Journal of Experimental Hematology ; (6): 1907-1910, 2021.
Article in Chinese | WPRIM | ID: wpr-922222

ABSTRACT

OBJECTIVE@#To proceed the clinical evaluation of DNA microarray for thalassemia gene detection.@*METHODS@#Peripheral blood samples of 166 thalassemia gene test subjects were collected and tested for thalassemia genes by microarray chip method and Gap-PCR method combined with PCR-reverse dot blot hybridization method according to double-blind control test. The specificity, sensitivity, positive predictive value, negative predictive value, and total coincidence rate of the microarray chip method were evaluated. When the two methods were inconsistent, multiplex ligation dependent probe amplification (MLPA) was used to verify the deletional α-thalassemia.@*RESULTS@#Compared with Gap-PCR method, specificity, sensitivity, positive predictive value, negative predictive value, Youden index, and total coincidence rate of microarray chip method was 100% (70/70), 96.88% (93/96), 100% (93/93), 95.89% (70/73), 0.969, and 97.59% (162/166), respectively, while compared with PCR-reverse dot blot hybridization method was 100% (125/125), 100% (41/41), 100% (41/41), 100% (125/125), 1, and 100% (166/166), respectively.@*CONCLUSION@#The microarray chip method for α-thalassemia gene detection shows the advantages of high specificity, sensitivity, and throughput.


Subject(s)
Genetic Testing , Humans , Multiplex Polymerase Chain Reaction , Oligonucleotide Array Sequence Analysis , alpha-Thalassemia/genetics
4.
Article in Chinese | WPRIM | ID: wpr-921687

ABSTRACT

To evaluate the efficacy and safety of Chinese patent medicines in the treatment of insomnia by frequency network Meta-analysis. Randomized controlled trials of Chinese patent medicines for insomnia were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library databases from the time of database establishment to October 2020. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 11 kinds of Chinese patent medicines in 27 RCTs were included. According to Meta-analysis, in term of the effective rate, Tianmeng Liquid, Zaoren Anshen Capsules, Shumian Capsules, Shensong Yangxin Capsules, Shenqi Wuweizi Tablets, Shugan Jieyu Capsules, Anshen Bunao Liquid and Qiye Anshen Tablets combined with nonbenzodiazepine drugs(NBZDs) were superior to NBZDs alone. In term of the improvement of Pittsburg sleeping quality index(PSQI) score, Tianmeng Liquid, Shumian Capsules, Shensong Yangxin Capsules, Bailemian Capsules, Shenqi Wuweizi Tablets, Shugan Jieyu Capsules, Yangxue Qingnao Granules and Yindan Xinnaotong Capsules combined with NBZDs were superior to NBZDs alone. In terms of the safety, Shumian Capsules, Shensong Yangxin Capsules, Shenqi Wuweizi Tablets and Qiye Anshen Tablets combined with NBZDs were superior to NBZDs alone. In terms of the avoidance of dizziness and headache, Qiye Anshen Tablets combined with NBZDs were superior to NBZDs alone. The results of Network Meta-analysis indicated that in term of the effective rate, top three optimal medication regimens were NBZDs combined with Shugan Jieyu Capsules, combined with Zaoren Anshen Capsules and combined with Shensong Yangxin Capsules in the order from high to low. With the respect of improvement of PSQI score, top three optimal medication regimens were NBZDs combined with Yangxue Qingnao Granules, combined with Tianmeng Liquid and combined with Yindan Xinnaotong Capsules in the order from high to low. In terms of the safety, top three optimal medication regimens were NBZDs combined with Qiye Anshen Tablets, combined with Shensong Yangxin Capsules and combined with Shenqi Wuweizi Tablets in the order from high to low. In terms of the avoidance of dizziness and headache, top three optimal medication regimens were NBZDs combined with Qiye Anshen Tablets, combined with Zaoren Anshen Capsules and combined with Shumian Capsules in the order from high to low. In terms of the avoidance of fatigue, top three optimal medication regimens were NBZDs combined with Shensong Yangxin Capsules, combined with Shumian Capsules and combined with Qiye Anshen Tablets in the order from high to low. In conclusion, Chinese patent medicines combined with NBZDs can effectively alleviate the symptoms of insomnia with a high safety. However, the conclusion of this study needs to be verified by more high-quality studies because of the low methodological quality of the included studies.


Subject(s)
China , Drugs, Chinese Herbal , Humans , Medicine, East Asian Traditional , Network Meta-Analysis , Nonprescription Drugs , Sleep Initiation and Maintenance Disorders/drug therapy
5.
Article in Chinese | WPRIM | ID: wpr-921673

ABSTRACT

Triptolide(TP), the main active and toxic component of Tripterygium wilfordii, has the limitations of low bioavailability, poor absorption, low concentration in plasma, and small lethal dose. Microneedle(MN), the hybrid of hypodermic needle and transdermal patch, is a physical penetration-enhancing system. Dissolving microneedles(DMNs) can be tailored to specific needs of degradation rate. In this study, the TP-loaded DMNs(DMNs-TP) were prepared with the two-step centrifugation method. The optimal ratio of PVA to PVP K30, water content in matrix solution, demoulding method, and plasticizer for preparing DMNs were investigated with the indexes of formability and mechanical strength. The drug loading capacity was determined by HPLC and morphological characteristics were observed under an optical microscope. The mechanical properties were investigated by H&E staining and Franz diffusion cell was used to detect the in vitro skin permeation characteristics. Through the experiment, we confirmed that the optimal backing material should be PVA and PVP K30(3∶1) and the optimal ratio of matrix material to water should be 3∶4. The prepared DMNs-TP were pyramidal with smooth surface and length of approximately 550 μm. Each patch(2.75 cm~2) had the drug loading capacity of(153.41±2.29) μg, and TP was located in the upper part of the needle. The results of in vitro skin permeation assay demonstrated that the cumulative penetration of TP in DMNs-TP reached 80% in 24 h, while little TP solution penetrated the skin, which proved that DMNs promoted the transdermal delivery of TP.


Subject(s)
Administration, Cutaneous , Diterpenes , Drug Delivery Systems , Epoxy Compounds , Needles , Phenanthrenes , Skin
6.
Article in English | WPRIM | ID: wpr-921371

ABSTRACT

OBJECTIVES@#This study aims to explore the effect of acidic culture conditions on the proliferation, apoptosis, and migration ability of human tongue squamous cell carcinoma SCC15 and CAL27 cells and its potential molecular mechanism.@*METHODS@#After acidic culture for different periods, methyl thiazolyl tetrazolium (MTT) method was adop-ted to detect the cell proliferation of SCC15 and CAL27. Flow cytometry was employed to detect the apoptosis level of SCC15 and CAL27 cells. The migration ability of SCC15 and CAL27 after acidic culture was detected by scratch hea-ling test. Real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) was used to detect the mRNA expression of cyclooxygenase 2 (COX-2) and survivin in SCC15 and CAL27 cells after acidic culture.@*RESULTS@#After culture for 24 h under acidic microenvironment, SCC15 and CAL27 cells grew rapidly and reached the stationary phase after adjustment for 3 days. The apoptosis levels of SCC15 and CAL27 cells decreased after acidic culture, but the most significant reduction occurred after 6 h of acidic culture. The scratch healing rates of SCC15 and CAL27 cells increased after acidic culture. The results of FQ-PCR showed that the mRNA expression levels of COX-2 and survivin in SCC15 and CAL27 cells increased after acidic culture.@*CONCLUSIONS@#Extracellular acidic microenvironment can inhibit the apoptosis of tongue squamous carcinoma cells, promote their migration, and induce more adaptable and malignant tongue squamous carcinoma cells. The mechanism may be related to COX-2 and survivin and their signal pathways.


Subject(s)
Apoptosis , Carcinoma, Squamous Cell , Cell Line, Tumor , Cell Proliferation , Humans , Mouth Neoplasms , Tongue , Tongue Neoplasms , Tumor Microenvironment
7.
Chinese Medical Journal ; (24): 2922-2930, 2021.
Article in English | WPRIM | ID: wpr-921237

ABSTRACT

Colorectal cancer (CRC) is one of the most prevalent, most lethal cancers in the world. Increasing evidence suggests that the intestinal microbiota is closely related to the pathogenesis and prognosis of CRC. The normal microbiota plays an essential role in maintaining gut barrier function and the immune microenvironment. Recent studies have identified carcinogenic bacteria such as enterotoxigenic Bacteroides fragilis (ETBF) and Streptococcus gallolyticus (S. gallolyticus), as well as protective bacterial such as Akkermansia muciniphila (A. muciniphila), as potential targets of CRC treatment. Gut microbiota modulation aims to restore gut dysbiosis, regulate the intestinal immune system and prevent from pathogen invasion, all of which are beneficial for CRC prevention and prognosis. The utility of probiotics, prebiotics, postbiotics, fecal microbiota transplantation and dietary inventions to treat CRC makes them novel microbe-based management tools. In this review, we describe the mechanisms involved in bacteria-derived colorectal carcinogenesis and summarized novel bacteria-related therapies for CRC. In summary, we hope to facilitate clinical applications of intestinal bacteria for preventing and treating CRC.


Subject(s)
Colorectal Neoplasms/therapy , Dysbiosis , Fecal Microbiota Transplantation , Gastrointestinal Microbiome , Humans , Prebiotics , Tumor Microenvironment
8.
Chinese Medical Journal ; (24): 2944-2953, 2021.
Article in English | WPRIM | ID: wpr-921173

ABSTRACT

BACKGROUNDS@#Azithromycin mass drug administration (MDA) is a key part of the strategy for controlling trachoma. This systematic review aimed to comprehensively summarize the present studies of azithromycin MDA on trachoma; provide an overview of the impact of azithromycin MDA on trachoma in different districts; and explore the possible methods to enhance the effectiveness of azithromycin MDA in hyperendemic districts.@*METHODS@#PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched up to February 2021 with no language restriction. Studies reporting the effect of azithromycin MDA on trachoma were included. Mathematical modeling studies, animal studies, case reports, and reviews were excluded. The trachomatous inflammation-follicular (TF) 30.0%), especially with baseline TF >50.0%, annual MDA was unable to achieve the TF 10.0% is not appropriate for all eligible districts.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Humans , Infant , Mass Drug Administration , Prevalence , Trachoma/epidemiology
9.
Article in Chinese | WPRIM | ID: wpr-912851

ABSTRACT

Objective: To explore whether acupuncture can improve sleep disturbance, cognitive impairment and emotional disorders caused by sleep deprivation, and its association with the attenuation of oxidative stress injury in prefrontal cortex. Methods: Fifty-two male Sprague-Dawley rats were randomly divided into a control group (n=10), a model group (n=14), a manual acupuncture (MA) group (n=14), and a sham-MA group (n=14). All the groups were established as sleep deprivation models via the modified multiple platform method, except for the control group. Rats in both the MA group and the sham-MA group received corresponding intervention, respectively. After modeling and intervention, the four groups received three behavioral tests, namely sleep monitoring, by comprehensive lab animal monitoring system (CLAMS), Morris water maze (MWM) test and open-field test (OFT), followed by oxygen free radical level test and Western blot (WB) detection for the expression levels of Bax and Bcl-2. Results: The MA group derived more sleep time within 24 h than either the model group or the sham-MA group (both P<0.05). On MWM orientation navigation test day 1, there were no significant differences in escape latency among the control, MA and sham-MA groups (P>0.05), and the escape latency was significantly shorter in these three groups than that in the model group (all P<0.05). On test day 4, the escape latency was markedly shorter in the MA group than that in either the model group or the sham-MA group (both P<0.05); meanwhile, the MA group showed significantly better performance compared with these two groups in space probe test (both P<0.05). In OFT, compared with the control group, there was a significant decline in the horizontal movement score in the other three groups (all P<0.05), and the decrease was more significant in the model group and the sham-MA group than that in the MA group (both P<0.05). The superoxide dismutase (SOD) content was markedly higher and the malondialdehyde (MDA) content was markedly lower in the MA group than those in the model group and the sham-MA group (all P<0.05). Compared with the model group and the sham-MA group, the expression of Bax was significantly lower and the expression of Bcl-2 was significantly higher in the MA group (all P<0.05). Conclusion: MA therapy can lengthen the sleep time in sleep-deprived rats and improve learning and memory impairments induced by sleep deprivation, and the underlying mechanism may be associated with the enhancement of antioxidant capacity in the prefrontal cortex and the inhibition of hippocampal neuronal apoptosis.

10.
Chinese Journal of Digestion ; (12): 397-401, 2021.
Article in Chinese | WPRIM | ID: wpr-912199

ABSTRACT

Objective:To explore the similarities and differences between children and adults with eosinophilic gastroenteritis (EGE), and to guide the diagnosis and treatment of EGE.Methods:From February 2013 to August 2018 at Xi′ an Children′ s Hospital, 18 children with EGE (child group) and from June 2008 to June 2018 at Xijing Hospital of Digestive Diseases, Air Force Medical University, 24 adults with EGE (adult group) were retrospectively selected as study subjects. The general data, clinical symptoms, laboratory examinations, imaging, endoscopy manifestations, pathological biopsy, treatment and prognosis of the two groups were analyzed. Chi-square test was used for statistical analysis. Results:The proportion of child group with allergic history was higher than that of adult group (9/18 vs. 20.8%, 5/24), the incidence of nausea and vomiting was higher than that of adult group (13/18 vs. 29.2%, 7/24), the incidence of diarrhea and weight loss were both lower than those of adult group (4/18 vs. 58.5%, 14/24; 3/18 vs. 54.2%, 13/24), and the proportion of patients with elevated peripheral blood eosinophil count was lower than that of adult group (4/18 vs. 58.3%, 14/24), and the differences were statistically significant ( χ2=3.938, 7.644, 5.477, 6.133 and 5.477, P=0.047, 0.006, 0.019, 0.013 and 0.029). The main endoscopic manifestations of the two groups were mucosal congestion and edema (13 cases of child group and 22 cases of adult group). Mucosal roughness (7 cases) and erosion (6 cases) were also common in child group, while mucosal erosion (18 cases, 75.0%) and ulcer (8 cases, 33.3%) were more common in adult group. There was a statistically significant difference in the incidence of mucosal erosion between the two groups ( χ2=7.292, P=0.007). The positive rates of biopsy in the terminal ileum, colorectum and duodenum of child group and adult group were both high (6/6, 14/15, 9/18 and 8/10, 12/15, 6/8, respectively). The response time of glucocorticoid treatment was 4.5 d (2.0 to 27.0 d) and 3.7 d (1.0 to 14.0 d) in child group (8 cases) and adult group (13 cases), respectively. There was no statistically significant difference in the recurrence rate after glucocorticoid treatment between the two groups (5/8 vs. 6/13, P > 0.05). Conclusions:The clinical characteristics of children and adults with EGE are different, which may provide references for clinicians to understand, diagnose and treat EGE.

11.
Article in Chinese | WPRIM | ID: wpr-911939

ABSTRACT

Objective:To investigate the power and prenatal diagnosis strategies of cell-free fetal DNA (cffDNA) testing for chromosomal aneuploidy screening apart from trisomy-13/18/21.Methods:This study collected the clinical data of three cases at high risk of trisomy-16 indicated by cffDNA testing in Hunan Provincial Maternal and Child Health Care Hospital from March 2019 to March 2020. Results of the conventional G-banding karyotype analysis of amniotic fluid, single nucleotide polymorphism array (SNP-array) and low-coverage massively parallel copy number variation sequencing (CNV-seq) of placenta/fetal skin samples were analyzed.Results:(1) cffDNA testing results suggested that case 1-3 were at high risk of trisomy-16 and the Z values of chromosome 16 were 20.57, 24.88 and 17.87, respectively. (2) Karyotype analysis of amniotic fluid samples did not identify any abnormalities in Case 1 and 2, while SNP-array revealed a 19.2 Mb and 23.0 Mb heterozygous deletion at 16p13.3p12.3 and 16q22.1q24.3 in Case 1, and a 16.0 Mb loss of heterozygosity at 16q22.3q24.3 in Case 2. Case 3 had a mosaicism karyotype of 47,XY,+16[3]/46,XY[97] and SNP-array analysis showed no heterozygous deletion greater than 5 Mb or copy number variation. (3) Ultrasonography indicated fetal growth restriction in Case 1 and 2 and fetal death in Case 3. All three pregnancies were terminated. CNV-seq analysis of placental tissue in the center of both fetal and maternal side revealed mosaic trisomy 16, with the copy numbers of chromosome 16 of 2.56/2.70, 2.73/2.82, 2.80/2.81, respectively. However, no copy number variation was detected in Case 1 or 2 by CNV-seq analysis of fetal skin tissues. Conclusions:cffDNA testing has a certain power in detecting trisomy-16 apart from trisomy-13/18/21. For high-risk cases of trisomy-16 indicated by cffDNA testing, SNP-array analysis combined with karyotype analysis is suggested to rule out low-level mosaicism and loss of heterozygosity.

12.
Article in Chinese | WPRIM | ID: wpr-911738

ABSTRACT

Objective:To analyze the clinical characteristics and prognostic factors in patients with new-onset acute heart failure (AHF) and acutely decompensated chronic heart failure (ADCHF).Methods:Patients with heart failure (HF) admitted to Beijing Hospital during January 2009 to December 2017 with follow-up records were retrospectively enrolled. According to the duration of heart failure, the patients were divided into new-onset AHF group (duration of HF<1 month) and ADCHF group (duration of HF ≥1 month). Clinical data were collected and endpoint events (all-cause death and cardiovascular death) were recorded. The Kaplan-Meier survival curve and the log-rank method was used to compare survival between different groups. The multivariate Cox regression model was used to analyze the independent risk factors for the end-point events in patients with new-onset AHF and ADCHF.Results:The study enrolled 562 patients,292 (52.0%) with new-onset AHF and 270 (48.0%) with ADCHF. Patients with new-onset AHF were more likely to have coronary heart disease, acute myocardial infarction, higher diastolic blood pressure and higher troponin I levels(χ2=12.999,15.018, t=-2.088, Z=-2.727; all P<0.05). Patients with ADCHF were more likely to have poor cardiac function, atrial fibrillation, larger left ventricle and left atrium diameter, higher proportion of patients with pulmonary hypertension(χ2=16.565, 15.688, t=2.714, 5.029, χ2=15.274; all P<0.05). There were 205 (36.5%) all-cause deaths and 132 (23.5%) cardiovascular deaths during 28 (14, 60) months of follow-up. All-cause mortality rate [33.2%(97/292) vs. 40.0%(108/270), log-rank P=0.010] and cardiovascular mortality rate [18.8%(55/292) vs. 28.5%(77/270), log-rank P=0.001]were significantly lower in patients with new-onset AHF than those in ADCHF group. Multivariate Cox regression analysis showed that low body mass index (BMI), reduced hemoglobin, reduced resting heart rate, enlarged left atrium, and segmental wall motion abnormalities were independent risk factors for poor prognosis in new-onset AHF patients. It was different with ADCHF patients. Conclusion:Patients with new-onset AHF are more likely to have coronary heart disease; and lower BMI, reduced hemoglobin, acute coronary disease are associated with poor prognosis of patients. It is necessary to identify the underlying diseases early and actively standardize treatment to avoid the deterioration of cardiac function and readmission.

13.
Chinese Journal of Geriatrics ; (12): 716-721, 2021.
Article in Chinese | WPRIM | ID: wpr-910904

ABSTRACT

Objective:To assess the correlation between frailty and cardiac autonomic nervous system function in elderly patients.Methods:Elderly hospitalized patients aged 65 years and over were enrolled and assessed for frailty by using the clinical frailty scale.Cardiac autonomic modulation was evaluated by heart rate variability analysis through 24 h electrocardiogram recording.Results:A total of 180 elderly patients were enrolled in this study, including 66 patients with frailty and 114 patients without frailty.The mean age of the frailty group was higher than that of the non-frailty group(79.8±6.0 vs.75.0±6.3, t=5.030, P<0.001). The proportions of patients with hypertension, stroke/transient cerebral ischemia attack(TIA), heart failure and osteoarthritis were higher in the frailty group than in the non-frailty group(all P<0.05). Compared with the non-frailty group, the standard deviation of normal-to-normal intervals(SDNN)[103.0(76.0, 121.2) vs.107.5(92.0, 136.0), Z=-2.108, P=0.035], the standard deviation of the averages of NN intervals in all 5-min segments(SDANN)[86.0(67.7, 106.5) vs.97.5(78.0, 126.0), Z=-2.694, P=0.007], normalized low frequency(LFnorm)(53.1±13.0 vs.59.3±13.9, t=-3.024, P=0.003)and low frequency/high frequency(LF/HF)ratio[1.2(1.0, 1.4) vs.1.4(1.1, 1.7), Z=-3.041, P=0.002]were decreased and normalized high frequency(HFnorm)(36.8±9.2 vs.32.2±10.7, t=3.033, P=0.003)was increased in the frailty group.HFnorm in the frailty group was significantly higher than that in the non-frailty group.The incidents of SDANN<92 ms, LFnorm<50 nU, HFnorm>32 nU and LF/HF ratio<1.5 were higher in the frailty group than in the non-frailty group(59.1% or 39/66 vs.41.2% or 47/114, 42.4% or 28/66 vs.22.8% or 26/114, 72.7% or 48/66 vs.49.1% or 56/114, 84.8% or 56/66 vs.65.8% or 75/114, χ2=5.346, 7.660, 9.547, 7.664, P=0.021, 0.006, 0.002, 0.006). Logistic multivariate regression analysis showed that LFnorm, HFnorm and LF/HF ratio were correlated with frailty( OR=0.971, 1.039 and 0.333, all P<0.05), and HFnorm>32 nU and LF/HF ratio<1.5 were risk factors for frailty( OR=2.401 and 2.773, both P<0.05). Conclusions:Cardiac autonomic nerve system function is impaired in elderly frail patients, with the imbalance between the sympathetic and vagus nerves.Therefore particular attention should be paid to heart rate variability in elderly patients with frailty.

14.
Chinese Journal of Orthopaedics ; (12): 1692-1700, 2021.
Article in Chinese | WPRIM | ID: wpr-910762

ABSTRACT

Objective:To investigate the surgical methods of sacroiliac joint dislocation with ipsilateral sacrosacral wing fracture through the lateral-rectus approach (LRA) for exposure, fracture reduction and fixation, and nerve exploration and decompression, and to evaluate its clinical efficacy.Methods:Data of 12 patients with sacroiliac joint dislocation and ipsilateral sacral wing fracture treated with LRA for exposure, reduction and fixation of sacroiliac wing fracture and sacroiliac joint dislocation, lumbosacral trunk nerve exploration and decompression (combined with lumbosacral trunk nerve injury) were retrospectively analyzed from January 2016 to July 2019. They were 3 males and 9 females, aged 34.35±16.32 years (13-58 years). The time from injury to operation was 29.25±25.49 d (7-96 d). By the Tile classification, there were 7 cases of type C1.3, 1 case of type C2, 4 cases of type C3. Among them, 8 cases were combined with ipsilateral or bilateral lumbosacral nerve injury. The grade of nerve injury: 6 cases of complete injury and 2 cases of partial injury. Interval time from injury to surgery: less than 1 week: 1 case, 1-2 weeks: 2 cases, 2-3 weeks: 4 cases, >3 weeks: 5 cases. Surgery was performed through LRA, the sacroiliac joint was exposed outside the peritoneum, and the sacral fracture and sacroiliac joint dislocation were reduced. At the same time, the lumbosacral nerve was decompressed and loosened for patients with lumbosacral nerve injury. Then the posterior ring was fixed with a sacroiliac screw or a transsacroiliac joint plate attached to the bony surface.Results:All the 12 cases underwent the operation successfully. The average surgical time was 172.08±36.8 min (range, 105-230 min) and the mean blood loss was 981.67±369.44 ml (range, 400-1 700 ml). Postoperative X-ray and CT indicated an excellent reduction of fracture. One patient with bladder dysplasia had wound fat liquefaction after operation, and no other surgery-related complications. During the follow-up period of 12-72 months, all sacral fractures healed, and the healing time was 7.7±3.38 weeks (6-12 weeks) without complications such as loss of fracture reduction and internal fixation failure. At the 1-year follow-up, 6 of the 8 patients with lumbosacral nerve injury recovered completely, one recovered partially, and the other one had no recovery without nerve exploration.Conclusion:LRA is an ideal surgical approach for treatment of sacroiliac joint dislocation complicated with ipsilateral sacral wing fracture and lumbosacral nerve injury, because it can well expose the medial pelvic joint from the sacroiliac joint to the symphysis pubis, allow direct release of the lumbosacral plexus nerve compressed and stretched, and together with traction of the lower limbs, lead to satisfactory fracture reduction.

15.
Chinese Journal of Orthopaedics ; (12): 1426-1433, 2021.
Article in Chinese | WPRIM | ID: wpr-910732

ABSTRACT

Objective:To investigate the surgical technique and the clinical effects of direct posterior approach (DPA) with the fixation of percutaneous tunnel screw and plate for acetabular posterior comminuted fractures.Methods:Thirty-six cases with acetabular posterior comminuted fractures treated by this technique from January 2016 to July 2020 were retrospectively analyzed in this study. There were 28 males and 8 female, aged 42.0±12.1 (range 19-64) years. According to Letournel-Judet classification, there were 28 cases of transverse associated with posterior wall fractures, 6 cases of posterior column with posterior wall fractures and 2 cases of T shape with posterior wall fractures. DPA was adopted in prone position. The anterior and posterior column fractures of the acetabulum were reduced under direct vision and then fixed with percutaneous tunnel screw. Further, the posterior wall fractures of the acetabulum were reduced and fixed with plate and screws. The operation duration, intraoperative blood loss, incision length, fracture union time, fracture reduction quality, postoperative complications and hip function were recorded.Results:The incision was 9.8±1.2 (range 8-12) cm. The operation duration was 102.9±21.4 (range 65-145) min. Intraoperative bleeding was 214.0±116.9 (range 100-640) ml. Postoperative X-ray and CT examinations showed perfect reduction. All the patients were followed up for 20.9±9.2 (range 10-38) months. The fracture healing time was 4.6±1.0 (range 3-6) months. There was no patient with damaged superior gluteal nerve and blood vessel. There were 2 cases of femoral head cystic changes without pain in walking, 1 case of postoperative infection and bacteremia who was cured at 1 month after debridement and anti-infection treatment, 1 case of sciatic nerve injury but recovered at 3 months after operation, and 1 case of heterotopic ossification at 3 months after surgery without affecting hip motion. According to the Matta's criteria, the reduction quality of the acetabular fracture was rated as excellent in 28 cases, good in 6 cases, fair in 2 cases. According to the modified Merle D'Aubigné and Postel scoring system, hip joint function was excellent in 24 cases, good in 10 cases and fair in 2 cases.Conclusion:DPA approach can directly reduce acetabular posterior comminuted fractures through a minimal incision. Combined with the technique of percutaneous tunnel screw, it displays great advantages of less trauma and with good clinical effects.

16.
Chinese Journal of Orthopaedics ; (12): 1396-1403, 2021.
Article in Chinese | WPRIM | ID: wpr-910728

ABSTRACT

Objective:To explore the surgical method and clinical efficacy of lateral-rectus approach (LRA) in the treatment of fragility fractures of the pelvis (FFP) in the elderly.Methods:A retrospective study was conducted for elderly FFP patients from January 2011 to December 2019. All the pelvic fractures should be exposed and reduced through LRA and fixed with pelvic reconstruction plates and channel screws. Then, a total of 30 elderly patients were included in the study, including 9 males and 21 females, with an average age of 72.5 years (range, 60-87 years). Fractures were caused by car accident in 5 cases, by falling from high places in 8 cases and by tumbling in 17 cases. According to the FFP classification, there were 6 cases of type IIc (6/30, 20%), 22 cases of type III (22/30, 73.33%, of which 13 cases were type IIIa, 7 cases were type IIIb, and 2 cases were type IIIc), 2 cases of type IVa (2/30, 6.67%). Among that, 2 cases suffered ipsilateral acetabular fractures, 17 suffered medical diseases such as hypertension, coronary heart disease, diabetes, etc., and none suffered extremities fractures or other types of injuries. Surgical field was exposed retroperitoneally through LRA, combined with lower limb traction to reduce the anterior and posterior pelvis ring fractures. Then, the reductions were done in direct visions and verified through X-ray fluoroscopy. After that, the posterior ring was fixed with reconstruction plate and/or sacroiliac screws, and the anterior ring was fixed with reconstruction plate or INFIX. The quality of fracture reduction was evaluated by Matta score and the postoperative function was evaluated by Majeed score.Results:All the 30 patients were surgical treated through LRA. The time from injury to operation was 5 to 20 days, with an average of 9.9 days. The operating time ranged from 35 to 150 min (mean, 73.5 min) and the intraoperative bleeding ranged from 220 to 2 400 ml (mean, 586.7 ml). Fractures were successfully reduced under direct vision and the positions of the plates and screws were monitored through X-ray fluoroscopy during the operation. Postoperative X-rays and CT scans showed satisfactory reduction of the pelvic ring. According to Matta criteria, the quality of fracture reduction was evaluated as excellent in 18 cases, good in 6 cases, fair in 4 cases and poor in 2 cases. The overall excellent and good rate was 80% (24/30). All patients were followed up for 6-24 months, the fractures were all healed, and all fractures healed for 2-5 months, with an average of 3.5 months. At the last follow-up, Majeed scores were 86.1±6.11 (range, 66-92), including 21 excellent cases, 7 good cases and 2 fair cases, with an excellent and good rate of 93.3% (28/30). As for complications, 1 patient developed deep venous thrombosis of the affected lower limb, and the thrombosis disappeared after thrombolytic therapy. One patient had fat liquefaction in the incision, and the wound healed after intensive dressing change. After INFIX fixation, 2 patients showed numbness on the lateral thigh of the affected side, and the symptoms were relieved after symptomatic treatment. Four patients were found to have internal fixation screws loosening during follow-up, but still achieved good fracture healing.Conclusion:The entire hemipelvic ring could be exposed through LRA without cutting the peritoneum, so that the sacroiliac joint, ilium wing and anterior ring fractures could be reduced under direct version. In the treatment of pelvis fragility fractures of the elderly, effective reduction and fixation could be achieved using reconstruction plates or channel screws through LRA.

17.
Article in Chinese | WPRIM | ID: wpr-879129

ABSTRACT

Nanocrystals self-stabilized Pickering emulsion(NSSPE) is a new kind of emulsion where only nanocrystals of poorly soluble drugs are used as stabilizers. Our previous study showed that NSSPE with Ligusticum chuanxiong oil as the main oil phase can significantly promote oral absorption of puerarin. The present study aimed to explore its absorption mechanism in oral administration. The in vitro dissolution test was carried out to study the effect of NSSPE on release of puerarin. The effects and mechanism of NSSPE on uptake and transport of puerarin across Caco-2 cell were investigated. The results showed that the drug release rate of NSSPE was similar to that of nanocrystals, with their cumulative dissolution of puerarin not affected by pH of releasing mediums, both significantly higher than that of crude material. The uptake of puerarin in NSSPE was concentration-dependent and significantly higher than that of solution or surfactant stabilized emulsion. Genistein and indomethacin, inhibitors of lipid rafts/caveolin, could significantly reduce the uptake of puerarin in NSSPE. Compared with solution, NSSPE and surfactants stabilized emulsion obviously increased transport rate K_a and apparent permeability coefficient P_(app) of puerarin in AP → BL direction, but there was no significant difference in BL → AP direction. It could be inferred that there were both passive and active transport mechanisms, as well as lipid raft/caveolin mediated endocytosis for absorption of NSSPE. The promoted oral absorption of puerarin in NSSPE was mainly related to the existing nanocrystal form which could promote dissolution, puerarin as well as Ligusticum chuanxiong oil which could promote drug transmembrane transport and inhibit drug efflux. It is the unique structure and composition of the compound NSSPE that promoted the oral absorption of puerarin.


Subject(s)
Caco-2 Cells , Drugs, Chinese Herbal , Emulsions , Humans , Isoflavones , Nanoparticles
18.
Article in Chinese | WPRIM | ID: wpr-879054

ABSTRACT

This study is to observe whether platycodin D has the guiding role in treatment of mouse lung cancer with doxorubicin and explore its guiding mechanism. In vitro, platycodin D and doxorubicin(alone or in combination) were added into Lewis lung cancer(LLC) cells to detect the cell proliferation and doxorubicin uptake. Cell morphological changes were analyzed by cell holographic analysis system; cell gap junctional intercellular communication(GJIC) was tested by fluorescent yellow tracer; lyso-tracker red was used to examine lysosomal function; LC-3 B(Light chain 3 beta)and P62(heat shock 90-like protein)staining were used to test auto-phagy and autophagic degradation respectively; and P-glycoprotein(P-gp) expression was examined by Western blot. In vivo, lung solid tumor was formed in mouse LLC cells via intravenous injection. Platycodin D and doxorubicin(alone or in combination) were used to treat tumor-bearing mice for four weeks, and then the tumor size was examined, mouse survival time was recorded, doxorubicin uptake in lung tissues was tested, and lung tissues were stained for observation by HE(hematoxylin-eosin) and immunohistochemistry. The results showed that platycodin D at the experimental concentration had no effect on LLC cell proliferation but decreased LLC cell volume, promoted the cells to uptake doxorubicin and enhanced the inhibitory action of doxorubicin on cell proliferation. Platycodin D could promote GJIC and lysosomal function, increase autophagy and autophagic degradation and suppress P-gp expression. Platycodin D at the experimental dose in this study had no effect on LLC lung solid tumors in mice, increased doxorubicin uptake in lung tissues and enhanced the therapeutic efficacy of doxorubicin on lung solid tumors. Platycodin D could improve the extracellular matrix deposition in lung solid tumors, decreased the lung mucin 5 AC secretion and pulmonary vessel permeability. In summary, platycodin D had the guiding role in treating mouse lung cancer with doxorubicin, and its guiding mechanism may be associated with the promotion of cell communication, lysosomal function, and improvement of extracellular environment.


Subject(s)
Animals , Cell Line, Tumor , Doxorubicin , Lung Neoplasms/drug therapy , Mice , Saponins , Triterpenes
19.
Article in Chinese | WPRIM | ID: wpr-878713

ABSTRACT

Objective To investigate the effect of sarcopenia on the efficacy of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic spinal compression fracture(OSCF)in elderly patients. Methods From February 2017 to June 2018,a total of 77 elderly patients who met the inclusion and exclusion criteria were included in this study.Grip strength of dominant hand was measured by an electronic grip dynamometer with cut-off values of 27 kg for males and 16 kg for females.The cross-sectional area of the pedicle level muscle of the 12th thoracic vertebra(T12)was measured by chest CT.The skeletal muscle index(SMI)was calculated by dividing the T12 pedicle level muscle cross-sectional area by the square of body height.The SMI cut-off value used to diagnose sarcopenia was 42.6 cm


Subject(s)
Aged , Female , Fractures, Compression/surgery , Humans , Kyphoplasty , Male , Osteoporotic Fractures/surgery , Retrospective Studies , Sarcopenia/complications , Spinal Fractures , Treatment Outcome
20.
Article in English | WPRIM | ID: wpr-878357

ABSTRACT

Objective@#The aim of the present study was to evaluate the performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one dried blood spot (DBS) as an alternative sample to plasma.@*Method@#A total of 571 paired DBS/plasma samples were collected from men who have sex with men (MSM) and injection drug users (IDUs), and serological and molecular assays were performed. Using plasma results as the reference standard, the performance of DBS tests for HIV-1 RNA, HIV-1 DNA, and HCV RNA was evaluated. Pearson's correlation coefficients and Bland-Altman analysis were performed to assess the correlation and concordance between DBS and plasma.@*Results@#Among paired plasma/DBS samples with detectable HIV-1 RNA and HCV RNA, five samples (5/32) were not detectable in DBS, while measurable HIV-1 RNA levels were present in plasma (1.44 to 3.99 log @*Conclusion@#The performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one DBS was acceptable. DBS, as an alternative sample to plasma, may be a viable option for the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA in resource-limited settings or for individuals living in areas that are difficult to access.


Subject(s)
DNA, Viral/analysis , Diagnostic Tests, Routine/methods , Dried Blood Spot Testing/methods , HIV Infections/diagnosis , HIV-1/isolation & purification , Hepacivirus/isolation & purification , Hepatitis C/diagnosis , RNA, Viral/analysis , Sensitivity and Specificity , Specimen Handling/methods , Syphilis/diagnosis , Treponema pallidum/isolation & purification
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