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1.
China Pharmacy ; (12): 313-318, 2022.
Article in Chinese | WPRIM | ID: wpr-913089

ABSTRACT

OBJECTIVE To study different extraction fractions of Agrimonia pilosa against h epatic fibrosis. METHODS Using hepatic stellate cells HSC-T 6 of rats as objects ,the effects of different extraction fractions (total extract ,ethyl acetate fraction , petroleum ether fraction and n-butanol fraction )with different concentrations (0.5,5,50,500,5 000 μg/mL,calculated by raw drug)of A. pilosa on the proliferation of HSC-T 6 cells were detected (after treated for 24,48,72 h);median inhibition concentration(IC50)was also caculated. Platelet-derived growth factor (PDGF-BB)was used to induce the activation of HSC-T 6 cells to establish hepatic fibrosis cell model. Flow cytometry was used to detect the effects of different extraction fractions of A. pilosa on apoptosis of HSC-T 6 cells. The expression of collagen Ⅰ(Col-Ⅰ)in the supernatant was detected by enzyme linked immunosorbent assay. The expressions of α-smooth muscle actin (α-SMA),Col-Ⅰ,B-cell lymphoma- 2(Bcl-2),Bcl-2-associated X protein (Bax)and caspase- 3 were detected by Western blot assay. RESULTS Total extract ,ethyl acetate fraction ,petroleum ether fraction and n-butanol fraction of A. pilosa could significantly increase the apoptotic rate of HSC-T 6 cells(P<0.01). After treated for 24 h,IC50 of above fractions were 50.17,20.75,5.82,4.09 μg/mL,respectively. After intervened with PDGF-BB ,the expression of Col- Ⅰ in supernatant of HSC-T 6 cells as well as protein expression of Col- Ⅰ,α-SMA,Bcl-2,Bax and caspase- 3 in HSC-T6 cells were increased significantly (P<0.01). After intervened with different extraction fractions of A. pilosa ,most of the expressions of above proteins in HSC-T 6 cell culture supernatant or cells were significantly reversed compared with PDGF-BB group (P<0.05 or P<0.01), and the intervention effect of n-butanol fraction of A. pilosa was the most significant. CONCLUSIONS Different extraction fractions of A. pilosa can inhibite the proliferation of HSC-T 6 cells and induce their apoptosis;n-butanol fraction from A. pilosa may be an effective fraction to exert the effect of anti-hepatic fibrosis.

2.
Braz. j. med. biol. res ; 54(3): e10426, 2021. graf
Article in English | LILACS | ID: biblio-1153520

ABSTRACT

The prognosis of COVID-19 (coronavirus disease 2019) is usually poor when it occurs in aged adults or in patients with chronic diseases, which brought a great challenge to clinical practice. Furthermore, widespread depression, anxiety, and panic related to SARS-CoV-2 (severe acute respiratory syndrome-coronavirus 2) infection affected treatment compliance and recovery. Here we report the successful treatment of a 57-year-old male with severe COVID-19, schizophrenia, hypertension, and type 2 diabetes. The patient's negative emotions (such as tension, panic, and anxiety), particularly his aggression and paranoia, seriously hindered treatment, leading to a deteriorating condition. Psychological counseling and supportive psychotherapy were given but the effect was weak. To improve adherence, risperidone and quetiapine fumarate were replaced by olanzapine for anti-schizophrenic treatment to reduce insomnia and anxiety side effects, associated with sedative-hypnotic drugs as well as psychological counseling. The treatment compliance of the patient improved significantly. The patient's serum alanine aminotransferase increased abnormally in the late stage of hospitalization, suggesting potential liver damage after complex medication strategies. We also monitored the changes of lymphocyte subsets and retrospectively analyzed the virus-specific antibody response. The results suggested that dynamic monitoring of lymphocyte subsets and virus-specific antibody response could facilitate disease progression evaluation and timely treatment plan adjustments. An effective psychotropic drug intervention associated with psychological counselling and psychotherapy are essential for the successful adherence, treatment, and rehabilitation of psychiatric disorders in COVID-19 patients.


Subject(s)
Humans , Male , Middle Aged , Schizophrenia/complications , Schizophrenia/drug therapy , COVID-19 , Chronic Disease , Retrospective Studies , Diabetes Mellitus, Type 2 , SARS-CoV-2
3.
Cancer Research and Clinic ; (6): 579-584, 2021.
Article in Chinese | WPRIM | ID: wpr-912927

ABSTRACT

Objective:To investigate the expression changes of farnesoid X receptor (FXR) in the evolution of normal intestinal mucosa, colorectal adenoma (CRA) and colorectal cancer (CRC), and the correlation of FXR expression with clinicopathological features and prognosis of patients with colorectal tumors.Methods:The UALCAN website tool was used to analyze the expression level of FXR gene transcripts of CRC and normal colorectal tissues in The Cancer Genome Atlas (TCGA) database. The patients undergoing colonoscopy and treatment in the Aerospace Center Hospital from January 2019 to September 2020 were selected, and the immunohistochemistry was used to detect the expression of FXR protein in 100 CRA tissues, 47 CRC tissues and 11 normal colonic mucosal tissues from healthy people (healthy control). Combining with clinical data, the relationship between FXR protein expression and clinicopathological characteristics of patients with colorectal tumors was analyzed. According to the Kaplan-Meier Plotter online database, the median expression level of FXR gene transcripts in CRC patients was analyzed, and the patients were divided into FXR low-expression group and high-expression group, the relationship between the expression of FXR gene and prognosis of CRC patients was investigated.Results:The analysis of data from TCGA database showed that the expression level of FXR gene transcripts in CRC tissues was lower than that in normal colorectal tissues ( P < 0.01). Immunohistochemical examination of the collected tissues showed that the positive rate of FXR protein gradually decreased from the cecum to the rectum. The positive rates of FXR protein in healthy control, CRA patients and CRC patients were 90.9% (10/11), 24.0% (24/100), 6.3% (3/47), and the difference was statistically significant ( χ2 = 35.56, P < 0.01); the positive rate of FXR protein in cancer tissues from CRC patients was lower than that in normal tissues adjacent to cancer [6.3% (3/47) vs. 65.2% (15/23)], and the difference was statistically significant ( χ2 = 27.98, P < 0.01). There was no statistical difference in the positive rate of FXR among CRA patients with different gender, age, maximum diameter of adenoma, and aggression (all P > 0.05). There was also no statistical difference in the positive rate of FXR among CRC patients with different gender, age, tumor site, maximum diameter of tumor, degree of differentiation, TNM staging, and vascular tumor thrombus (all P > 0.05). According to the survival analysis of Kaplan-Meier Plotter online database, the recurrence-free survival of CRC patients with high expression of FXR was better than that of patients with low expression of FXR ( P = 0.003). Conclusions:The expression level of FXR gradually decreases in the intestinal tissues of healthy people, CRA patients and CRC patients. The prognosis of CRC patients with low FXR expression is poor.

4.
Article in Chinese | WPRIM | ID: wpr-912091

ABSTRACT

Objective:To investigate the protective effect of two doses of varicella vaccine in a population at high risk for varicella.Methods:The case group involved all varicella cases in classes with no less than three patients during varicella outbreaks in Tianjin schools from 2017 to 2019. A case-control study was carried out in a 1∶3 ratio. According to the seat position of each case, three nearby students who did not suffer from varicella were selected as controls. The protective effect of two doses of varicella vaccine was evaluated.Results:The total protective effect of varicella vaccine was 46.0% (95% CI: 42.7%-49.0%). The protective effect was 44.7% (95% CI: 41.2%-48.0%) for one-dose varicella vaccine and 80.0% (95% CI: 63.1%-89.2%) for two-dose varicella vaccine. For two doses of varicella vaccine, the protective effect was 87.6% (95% CI: 52.0%-96.8%) after 0-2 years and 76.6% (95% CI: 33.6%-91.5%) after 3-5 years.Conclusions:The protective effect of two doses of varicella vaccine is better than that of one dose. However, both one-dose and two-dose vaccines show decreased protective effect over time. A booster immunization could be considered in high-risk population with longer intervals since the last vaccination.

5.
Article in Chinese | WPRIM | ID: wpr-911946

ABSTRACT

Objective:To explore the role of parental origin verification in chromosomal microarray analysis (CMA) on the determination of the clinical significance of copy number variations (CNVs).Methods:This retrospective study collected clinical information from 73 core families who underwent prenatal diagnosis at Peking University First Hospital from November 2017 to December 2019. Indications for prenatal diagnosis included ultrasound abnormality in 54 cases (including 12 with thickened nuchal translucency (≥2.5 mm), four with fetal growth restriction, seven with abnormal pregnancy history, and 31 with isolated ultrasound abnormality), NIPT indicated high-risk in four cases, advanced age in nine cases, abnormal pregnancy history alone in three cases, intrauterine death in two cases and one with maternal mental retardation. Genomic DNA of amniotic fluid sample, chorionic villi, cord blood, fetal tissues, and fetal heart blood were extracted using genomic DNA extraction kit. The CNVs of prenatal samples in 73 subjects were analyzed using array-based comparative genomic hybridization (array-CGH) analysis and single nucleotide polymorphism array (SNP-array). Peripheral blood DNA of the couples, and relevant families if necessary, were collected and analyzed in the same way. The results of parental origin detection in CMA were summarized.Results:A total of 76 CNVs were detected in these 73 samples, out of which nine were pathogenic and parental origin detection revealed that six were de novo, two were maternally, and one was paternally inherited; six CNVs were likely pathogenic, including three de novo, two maternally inherited and one paternally inherited; 20 CNVs were variants of uncertain significance, including five paternally inherited, three maternally inherited and 12 de novo; 41 CNVs were likely benign, among which 38 were inherited from parents with normal phenotype. Conclusions:Parental origin verification plays an important role in explaining the clinical significance of detected fetal CNVs and thereby can help to analyze its clinical effect and reproductive risk.

6.
Chinese Journal of Nephrology ; (12): 739-748, 2021.
Article in Chinese | WPRIM | ID: wpr-911897

ABSTRACT

Objective:To explore the effect and involved mechanism of naringenin on acute kidney injury (AKI) induced by ischemia-reperfusion (IR).Methods:The IR-AKI rat model was constructed using the classic bilateral renal pedicle clamping method, then renal function and pathological change were assessed, as well as inflammation-associated genes were detected by quantitative real-time PCR. The hub genes were selected through differential gene analysis and protein-protein interaction network analysis, and their transcription factors were predicted, which constructed a protein library together. The proteins binding to naringenin were selected by reverse molecular docking analysis and further their binding patterns were predicted to explore the mechanism of naringenin. Finally, the results of bioinformatics were verified by experimental methods.Results:Compared with the AKI group, the kidney pathology of the rats in the naringenin pretreatment group was significantly improved, and the renal tubular injury score was reduced ( P<0.01); meanwhile the serum creatinine level and the mRNA expression of the kidney injury molecule 1 (KIM-1) were significantly decreased (both P<0.05). Compared to sham group, IR-AKI increased the level of nuclear factor κB (NF-κB), tumor necrosis factor-α and interleukin-1β (all P<0.05), which reversed by naringenin indicated that naringenin inhibited inflammation in IR-AKI. Differential gene analysis was performed on the GSE98622 data set, and 359 differential genes were obtained. In reverse molecular docking, the proteins with smallest binding energy including NFKBIA, BCL3, NFKB2 and RELA were considered to be related to the preventive effect of naringenin, which were mainly enriched in NF-κB-related inflammation pathways. Domain functional analysis of NF-κB-related genes showed that naringenin could stably bind to its key domain. According to quantitative real-time PCR results, naringenin increased BCL3 level after AKI ( P<0.05), and further decreased the expression level of RELA and NFKB2 (both P<0.05). Conclusion:Naringenin protects IR-AKI by alleviating inflammation, and its mechanism is related to increasing BCL3 and thereby inhibiting the NF-κB pathway.

7.
Article in Chinese | WPRIM | ID: wpr-911659

ABSTRACT

Objective:To explore the effect of personalized psychological intervention based upon acceptance and commitment therapy on paternal donors and spouses after pediatric liver transplantation.Methods:From July 2017 to November 2019, a total of 160 parental donors and spouses undergoing pediatric liver transplantation were selected as research objects.Through a random number table, 40 donors and 40 liver donor spouses were assigned into control and experimental groups.The control group received routine psychological intervention while the experimental group had personalized psychological intervention with acceptance and commitment therapy based upon conventional psychological intervention.Symptom checklist-90, numeric rating scale, chronic pain acceptance questionnaire-8, length of stay, hospitalization cost, complication rate, initial postoperative ambulation time and hospital satisfaction were employed as evaluation tools.Results:After interventions, SCL-90 score, pain assessment score and initial ambulation time of donor group were significantly lower than those of control group( P<0.05). Hospitalization satisfaction and chronic pain acceptance were significantly higher than those of control group( P<0.05). SCL-90 score was significantly lower in liver spouse observation group than that in control group and hospitalization satisfaction higher than control group( P<0.05). Conclusions:Personalized psychological intervention based upon acceptance and commitment therapy can help parental donors and spouses to improve their mental health, help donors to recover sooner and boost hospitalization satisfaction.

8.
Chinese Journal of Geriatrics ; (12): 1015-1019, 2021.
Article in Chinese | WPRIM | ID: wpr-910958

ABSTRACT

Objective:Immunologic characteristics of differed between younger and older patients.This study aimed to screen potentially key genes related to tumor-infiltrated immune cells(TIICs)in senile patients with lung adenocarcinoma(LUAD).Methods:In this retrospective study, the gene expression data for the training set were extracted from the Cancer Genome Atlas(TCGA)database, and the GSE72094 data set from Gene Expression Database was selected as the validation set.The 91 LUAD patients aged ≥75 years and 14 matched normal samples were screened for analysis.The components of tumor infiltrated immune cells(TIICs)were estimated by the deconvolution algorithm.Then a weighted gene co-expression network analysis was conducted in the training set so as to identify key genes correlating to TIICs.The GSE72094 dataset was used for validation.Results:In elderly patients with LUAD, the high expressions of IKZF1 and PRKCB were related to autoimmune diseases and T cell receptor signaling pathway.And their gene encoding proteins could interact with various immunomodulatory factors, such as IL2RB, LCK, and CD5.In the high expression group of IKZF1 and PRKCB, the expression levels of immunological checkpoint genes such as PD-L1, PD-1 and CTLA-4 were significantly higher than those of the low expression group(all P<0.01). The results of the validation set showed that CD8 + T cells were significantly correlated with the expression of IKZF1( r=0.75, P<0.01)and PRKCB( r=0.65, P<0.01). Conclusions:The expressions of IKZF1 and PRKCB in the tumor tissues are related to tumor infiltrating CD8 T cells and expression of immune checkpoint genes in elderly patients with LUAD.

9.
Article in Chinese | WPRIM | ID: wpr-910782

ABSTRACT

Objective:To explore the influence of time of flight (TOF) and point spread function (PSF) on PET/CT image quality and standardized uptake value (SUV) based on a phantom study.Methods:PET/CT imaging were performed using Jaszczak phantom and International Electrotechnical Commission (IEC) body phantom respectively, and conventional clinical imaging protocol (3 min/bed) was used for three consecutive imaging. The ordered subsets expectation maximization (OSEM), OSEM+ TOF, OSEM+ PSF and OSEM+ TOF+ PSF were used to reconstruct the raw data respectively. The differences of image resolution, image uniformity, contrast, signal to noise ratio (SNR) and SUV among different reconstruction algorithms were compared by using one-way analysis of variance and the least significant difference (LSD) t test. The correlations between SNR, mean SUV (SUV mean), maximum SUV (SUV max) and the sphere diameter were analyzed by Pearson correlation analysis. Results:The minimum image resolution for the hot column was 6.4 mm by OSEM and OSEM+ PSF reconstruction, while it was 4.8 mm by OSEM+ TOF and OSEM+ TOF+ PSF reconstruction. The contrast was significantly better by OSEM+ TOF ((78.56±1.21)%) and OSEM+ TOF+ PSF ((78.85±1.17)%) reconstruction than that by OSEM reconstruction ((73.44±1.47)%; F=61.068, t values: 9.503, 10.018, both P<0.001). The maximum and minimum nonuniformity percentages were significantly better for images reconstructed with OSEM+ PSF than those reconstructed with OSEM ( F values: 10.286, 27.630, t values: -2.599, 7.698, both P<0.05). In IEC phantom imaging, the SNR and SUV max of hot sphere were higher by OSEM+ PSF and OSEM+ TOF+ PSF reconstruction than those by OSEM reconstruction (SNR: (98.99±34.76)%, (98.29±28.66)%, (73.64±26.05)%; F=5.712, t values: 3.209, 3.412, both P<0.05; SUV max: 8.96±2.72, 9.28±2.17, 8.01±2.21; F=3.931, t values: 2.154, 2.863, both P<0.05), but there was no significant difference between OSEM+ TOF and OSEM reconstruction ( t values: 0.297, 0.272, both P>0.05). Among the four reconstruction methods, the SNR and SUV mean increased with the increase of the sphere diameter ( r values: 0.913-0.963, all P<0.05), but SUV max in images reconstructed with OSEM+ PSF and OSEM+ TOF+ PSF had no significant correlations with the sphere diameter ( r values: 0.496, 0.614, both P>0.05). Conclusions:Under specific acquisition and reconstruction conditions, TOF mainly improves image resolution and contrast, while PSF mainly improves image uniformity and SNR. The combination of the two method can obtain better image quality and significantly improve the SUV of hot lesions.

10.
Chinese Journal of Orthopaedics ; (12): 1324-1332, 2021.
Article in Chinese | WPRIM | ID: wpr-910719

ABSTRACT

Objective:To explore the clinical effect of open reduction in the treatment of Tile C pelvic fracture combined with acetabular fracture in a specific sequence.Methods:Retrospectively analyzed the clinical data of 53 patients with Tile C type pelvic fracture combined with acetabular fracture from January 2014 to January 2019, and were divided into specific sequence group and non-specific sequence group according to the sequence of intraoperative reduction. A total of 29 cases were observed in the specific sequence group, including 20 males and 9 females; aged 43.8±14.8 years old (18-71 years), and the fractures were reduced in the sequence of "inside and out, then up and down" during the operation. There were 24 cases in the non-specific sequence group, including 14 males and 10 females; aged 44.4±14.7 years old (18-69 years), and fracture reduction was not performed in this sequence during the operation. According to the type of pelvic and acetabular fracture injury, we choose the appropriate position and surgical approach. After open reduction, the fracture was fixed with internal plants. The intraoperative blood loss, operation time, visual analogue scale (VAS) score were compared between the two groups. The quality of fracture reduction was evaluated by Matta score, pelvic fracture function recovery was evaluated by Majeed score, and acetabular fracture was evaluated by hip joint modified Merle d'Aubigné-Postel score.Results:There was no statistically significant difference in general data between the two groups before operation ( P>0.05), which was comparable. The intraoperative blood loss of the specific sequence group and the non-specific sequence group were 1 031.1±513.7 and 1 406.3±738.1 ml, and the operation time was 3.5±1.0 and 4.8±1.4 h; The differences between the two groups were statistically significant ( P<0.05). 53 patients were followed up for 14.8±1.6 months (12-18 months) after operation. The average postoperative VAS scores of specific sequence group and non-specific sequence group were 1.3±1.1 and 1.5±1.3 respectively, and there was no statistically significant difference. The effectiveness of the pelvic fracture Matta score standard was evaluated in the specific sequence group: excellent in 22 cases, good in 5 cases, fair in 2 cases, excellent and good rate was 93.1%; non-specific sequence group excellent in 10 cases, good in 6 cases, fair in 5 cases, poor in 3 cases, excellent and good rate was 66.7%, the difference was statistically significant ( P<0.05). Matta score of acetabular fracture: 21 cases were excellent in specific sequence group, 5 cases were good, 3 cases were poor, excellent and good rate was 89.7%; 9 cases were excellent in non-specific sequence group, 8 cases were good, 7 cases were poor, excellent and good rate was 70.8 %, the difference is statistically significant ( P<0.05). The results of the last follow-up pelvic fractures were evaluated by Majeed score: 20 cases were excellent in the specific sequence group, 7 were good, 2 were fair, excellent and good rate was 93.1%; 10 were excellent in the non-specific sequence group, 5 were good, 5 were fair, and 4 were poor, excellent and good rate was 62.5%, the difference was statistically significant ( P<0.05). At the last follow-up, the modified Merle d'Aubigné-Postel score was used to evaluate the efficacy: 20 cases were excellent in the specific sequence group, 5 were good, 4 were fair, the excellent and good rate was 86.2%; In the non-specific sequence group, 9 cases were excellent, 7 cases were good, 4 cases were fair, and 4 cases were poor, excellent and good rate was 66.7%, the difference was statistically significant ( P<0.05). During the follow-up period, none of the patients in the two groups developed fracture nonunion, heterotopic ossification, iatrogenic neurovascular injury, and femoral head necrosis. Trauma arthritis occurred in 4 patients in the non-specific sequence group. Conclusion:"Inside and out, then up and down" sequential reduction of Tile C pelvis combined with acetabular fracture can significantly shorten the operation time and reduce the amount of intraoperative blood loss. The surgical procedure is reasonable, which helps to improve the quality of fracture reduction and promote the functional recovery of patients.

11.
Chinese Journal of Orthopaedics ; (12): 1066-1072, 2021.
Article in Chinese | WPRIM | ID: wpr-910692

ABSTRACT

Objective:To explore the clinical diagnosis and treatment experience of pelvic fracture complicated with anterior sacroiliac joint dislocation.Methods:The data of 19 patients with pelvic fracture and anterior sacroiliac joint dislocation admitted from June 2013 to September 2019 were retrospectively analyzed. There were 12 males and 7 females; aged 9-67 years, with an average of 28.0 years. There were 11 cases of traffic accident injury, 6 of falling injury and 2 of crashing injury caused by machine extrusion. According to the Tile classification, there were 8 cases of type C1, 2 of type C2, and 9 of type C3; 6 cases of modified mangled extremity severity score (MESS) were greater than or equal to 7, of which 2 cases underwent hip amputation, 4 cases underwent king-steelquis semipelvectomy. 13 cases underwent limb-salvage surgery, of which 3 cases underwent external fixation surgery, and the remaining 10 cases underwent open reduction and internal fixation with steel plate. The reduction quality was evaluated according to the Matta imaging criteria of pelvis, the pain was evaluated according to the visual analogue scale (VAS), and the pelvic function was evaluated according to the Majeed score.Results:The operation time was 2 to 4 hours, with an average of 3.2 hours; the intraoperative blood loss was 400 to 1 200 ml, with an average of 768.4 ml. The 18 surviving patients were followed up for 6 to 24 months, with an average of 11.6 months. One of the 6 amputation patients died one week after the operation due to septic shock and multiple organ failure. The overall survival rate of the patients was 94.7% (18/19), and the amputation rate was 31.6% (6/19). The pelvic fractures of the 18 surviving patients were all healed, and the fracture healing time was 3 to 6 months, with an average of 4.2 months. No delayed union or nonunion occurred. At the last follow-up of the 18 surviving patients, the VAS was 2.4±1.9 points (range, 0-6 points). Among them, there were no pain in 3 cases, mild pain in 9 cases and moderate pain in 6 cases. At the last follow-up, 13 patients undergoing limb salvage treatment evaluated the quality of reduction according to Matta imaging criteria. Among them, 6 cases were excellent, 4 were good, 2 were fair, and 1 was poor. The excellent and good rate was 76.9% (10/13). The Majeed functional score was 81.8±11.9 points (range, 53-95 points). Among them, 6 cases were excellent, 5 were good, 1 was fair, and 1 was poor. The excellent and good rate was 84.6% (11/13). In the limb salvage treatment group, 4 patients with lumbosacral nerve injury caused limited hip joint movement function, and unilateral lower limb sensation and movement were weakened. After neurolysis and nutritional support treatment, the patient's sensorimotor function was significantly improved.Conclusion:The mortality and disability rate of pelvic fractures combined with anterior sacroiliac joint dislocation is high. In order to save the patient's life, early diagnosis of limb injury and early surgical intervention should be performed. If necessary, hip disarticulation or king-steelquis should be selected.

12.
Chinese Journal of Orthopaedics ; (12): 1018-1024, 2021.
Article in Chinese | WPRIM | ID: wpr-910685

ABSTRACT

Objective:To investigate the application value of magnetic resonance neurography (MRN) in pelvic fractures with lumbosacral plexus injury.Methods:From January 2014 to June 2020, data of 9 patients with pelvic fractures combined with lumbosacral plexus injury who were diagnosed with MRN and were performed surgical treatment were analyzed retrospectively. Among them, there were 8 males and 1 female, aged from 18 to 54 years, with an average age of 40.6±11.0 years. There were 2 fresh fractures within 3 weeks and 7 old pelvic fractures in 9 patients. According to AO classification, there were 6 cases of C1.3 type, 3 cases of C3 type. According to Denis classification of sacral fracture, there were 8 cases of Denis II type, 1 case of Denis III. Gibbons classification of nerve injury: 2 cases of grade II, 4 cases of grade III, 3 cases of grade IV; According to the criteria by the Nervous Injury Committee of British Medical Research Council (BMRC): 2 cases of M1, 3 cases of M2, 2 cases of M3, 2 cases of M4. Before the operation, the MRN technology was used to accurately locate the location and extent of the lumbosacral nerve injury, and nerve exploration release or internal fixation combined with nerve exploration release was employed for treatment.Results:All 9 patients underwent surgery successfully. The operation time ranged from 150 to 360 min, with an average of 217.8±63.8 min; intraoperative blood loss ranged from 200 to 1 100 ml, with an average of 388.9±293.4 ml. All patients were followed up for 21.6±19.3 months. All the fractures were healed, and the healing time was 12.7±2.2 months (range, 10-18 months). At the last follow-up, Gibbons classification of nerve injury: 3 cases of grade I, 5 cases of grade II, and 1 case of grade III. According to the criteria of BMRC: the muscle strength achieved M5 in 6 cases, M4 in 2 cases, M3 in 1 case. One patient developed a urinary system infection 2 months after discharge and recovered after treatment.Conclusion:MRN technique can assist the surgeon to fully understand the compression and traction damage of the lumbosacral nerve by the fracture before the operation, and make clear qualitative and localized diagnosis of the nerve damage, making the operation more precise and minimally invasive, which is a supplement to the traditional diagnosis method of lumbosacral plexus injury.

13.
Chinese Journal of Trauma ; (12): 129-135, 2021.
Article in Chinese | WPRIM | ID: wpr-909843

ABSTRACT

Objective:To investigate the clinical effect of open reduction and internal fixation for the treatment of double-column acetabular fractures by lateral rectus abdominis approach.Methods:A retrospective case series study was conducted to analyze the data of 44 patients with double-column acetabular fractures admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University from June 2015 to June 2019. There were 29 males and 15 females, with the age of 21-72 years [(41.3±8.4)years]. All patients were treated by open reduction and internal fixation through a single lateral rectus abdominis approach. Operation time, intraoperative blood loss and fracture healing time were recorded. The quality of fracture reduction was assessed according to the Matta reduction criteria, and hip function by the modified Merle D'Aubigne and Postel score at last follow-up. Postoperative complications were observed.Results:A total of 40 patients were followed up and 4 patients were lost to follow-up. The follow-up time was 12-46 months [(30.5±6.4)months]. The operation time ranged from 45 to 150 minutes[(111.2±20.6)minutes], and the intraoperative blood loss was 200-1 200 ml [(398.5±78.5)ml]. The fractures were healed, with the healing time of 10 to 16 weeks [(11.8±3.3)weeks]. At last follow-up, according to the Matta criteria, the results were excellent in 29 patients, good in 7, fair in 3, poor in 1, with the excellent and good rate of 90%. At last follow-up, according to the Merle D'Aubigne and Postel score, the results were excellent in 27 patients, good in 6, fair in 6, poor in 1, with the excellent and good rate of 83%. One patient had heterotopic ossification with no impact on hip function, and no special treatment was given. One patient with the reaction of foreign body was finally controlled by anti-infection treatment, and the internal fixation was removed again one year after operation. Three patients with mild osteoarthritis were relieved by oral anti-inflammatory and analgesic drugs. Two patients with deep venous thrombosis of lower extremities were cured by anti-coagulation therapy such as low molecular weight heparin.Conclusions:The single rectus abdominis approach for open reduction and internal fixation of double-column acetabular fractures can take into account the anterior column, quadrilateral body and posterior column. Meanwhile, this approach has advantages of satisfactory acetabular reduction and functional recovery, and less postoperative complications, suggesting an alternative procedure for treatment of double-column acetabular fractures.

14.
Clinical Medicine of China ; (12): 503-508, 2021.
Article in Chinese | WPRIM | ID: wpr-909785

ABSTRACT

Objective:To explore the effect of the implantation of absorbable stents on the prognosis of patients with inferior knee artery balloon dilatation.Methods:From March 2018 to January 2021, twenty-five patients with drug absorbable stent implantation after inferior knee artery balloon dilatation (stent group) and 25 patients without absorbable stent implantation after inferior knee artery balloon dilatation (control group) were included in Qingdao Haici Medical Group Affiliated to Qingdao University. The improvement of symptoms, ankle brachial index, Rutherford classification and claudication distance before and after operation were compared. The symptoms, ankle brachial index, Rutherford grade, claudication distance and patency rate of the two groups were compared 6 months after operation. The preoperative and postoperative data were analyzed by independent sample t-test, and the patency rate was analyzed by χ 2 test. Results:The ankle brachial index in the stent group and the control group on the first day after operation was significantly higher than that before operation (0.18±0.11 vs. 0.85±0.15, t=18.5, P<0.05, 0.22±0.15 vs. 0.87±0.10, t=20.8, P<0.05), and the Rutherford classification decreased significantly (4.66±0.21 vs. 2.1±0.11, t=9.2, P<0.05, 4.58±0.33 vs. 2.3±0.22, t=12.9, P<0.05), the limp distance increased significantly ((27±8) m vs. (300±43) m, t=20.8, P<0.05, (42±14) m vs. (320±18) m, t=32.6, P<0.05). There was no significant difference in preoperative ankle brachial index, postoperative ankle brachial index, Rutherford grade and claudication distance between the two groups ( P>0.05). Six months after operation, the ankle brachial index (0.72±0.03 and 0.54±0.12; t=10.2, P<0.05), Rutherford classification ((1.72±0.17) and (3.23±0.22); t=12.8, P<0.05) and claudication distance ((580.00±137.00) m and (267.00±54.00) m; t=8.2, P<0.05) in the stent group and the control group were significantly better than those in the control group. The patency rate of stent group at 6 months was 68% (17/25), which was better than that of ordinary balloon dilatation group by 56% (14/25). Conclusion:Implantation of drug absorbable stents can significantly improve the prognosis of patients undergoing arterial balloon dilatation.

15.
Journal of Chinese Physician ; (12): 1357-1361, 2021.
Article in Chinese | WPRIM | ID: wpr-909710

ABSTRACT

Objective:To investigate the changes in the expression of toll like receptor 4 (TLR4), pentamerin-3 (PTX3) and Apelin in the blood of patients with sepsis and their relationship with the condition and prognosis.Methods:From March 2015 to March 2020, 82 patients with sepsis in the First People′s Hospital of Chenzou were retrospectively selected, including 22 patients in septic shock group, 34 patients in severe sepsis group and 26 patients in general sepsis group. 82 healthy people in the same period were selected as the control group. The expression of serum TLR4, PTX3, Apelin, Sequential Organ Dysfunction Score (SOFA), Acute Physiology and Chronic Health Score System Ⅱ (APACHE Ⅱ) were measured and compared. The relationship between the expression of serum TLR4, PTX3 and Apelin and the scores of SOFA and APACHE Ⅱ in patients with sepsis were analyzed. The general data and the expression of serum TLR4, PTX3 and Apelin in patients with sepsis with different prognosis (28 day survival and death) were counted. The influencing factors of prognosis in patients with sepsis were observed, and the predictive significance of serum TLR4, PTX3 and Apelin on the prognosis of patients with sepsis was analyzed.Results:Comparison of serum TLR4, PTX3 and Apelin level in the groups: septic shock group>severe sepsis group>general sepsis group>control group ( P<0.05); The serum level of TLR4, PTX3 and Apelin in patients with high SOFA and APACHE Ⅱ scores were higher than those in patients with low SOFA and APACHE Ⅱ scores ( P<0.05); Pearson correlation showed that serum level of TLR4, PTX3 and Apelin was positively correlated with the SOFA and APACHE Ⅱ scores of sepsis patients ( P<0.05); The levels of serum TLR4, PTX3, Apelin and the scores of SOFA and APACHE Ⅱ in the dead patients with sepsis were higher than those in survival patients ( P<0.05); Logistic regression analysis found that serum level of TLR4, PTX3, Apelin, SOFA score, and APACHE Ⅱ score were all important risk factors for 28 day death of sepsis patients ( P<0.05); The receiver operating characteristic (ROC) curve showed that the sensitivity and specificity of combined blood indexes (TLR4, PTX3 and Apelin) in predicting the prognosis of patients with sepsis were 85.71% and 85.25%. Conclusions:The expression of serum TLR4, PTX3 and Apelin in patients with sepsis can be significantly increased, which is related to the patient′s condition and prognosis and can provide a certain basis for clinical diagnosis and treatment.

16.
Article in Chinese | WPRIM | ID: wpr-909574

ABSTRACT

Chaetocin is a natural metabolite product with various biological activities and pharmacological functions isolated from Chaetomium species fungi belonging to the thiodiketopyrazines. Numerous studies have demonstrated a wide range of antitumor activities of chaetocin in vitro and in vivo. Several studies have demonstrated that chaetocin sup?presses the growth and proliferation of various tumour cells by regulating multiple signalling pathways related to tumour initiation and progression, inducing cancer cell apoptosis (intrinsic and extrinsic), enhancing autophagy, inducing cell cycle arrest, as well as inhibiting tumour angiogenesis, invasion and migration. The antitumor effects and molecular mechanisms of chaetocin are reviewed and analysed in this paper, and the prospective applications of chaetocin in cancer prevention and therapy are also discussed. Our review provides the theoretical basis for exploiting the clinical applica?tion of chaetocin in cancer treatment.

17.
Article in Chinese | WPRIM | ID: wpr-908878

ABSTRACT

Objective:To explore the application effect of online-offline mixed teaching mode in the teaching of histology and embryology.Methods:Two classes of students majoring in psychiatry from Batch 2020 were randomized into experimental group ( n = 100), and two classes of students majoring in general practice in 2020 grade were randomized into the control group ( n = 99). The online-offline mixed teaching mode was used in the experimental group, while a traditional teaching mode was used in the control group. The online test scores, final scores and questionnaire satisfaction of the two groups of students were evaluated on the teaching effect. All data were statistically processed by SPSS 19.0, and the comparison between groups was performed by t test. Results:The online test scores of the experimental group [(8.55±1.18) vs. (6.33±0.91)] and final scores [(85.56±3.32) vs. (72.24±2.71)] were significantly higher than those of the control group ( P < 0.05). Compared with the control group, the experimental group's satisfaction scores of the online-offline mixed teaching mode were significantly higher in students' learning interest, learning autonomy, time management ability, teamwork, interactive communication, knowledge understanding and memory ability ( P < 0.05). Conclusion:The online-offline mixed teaching mode can improve the histology and embryology teaching effect and promote the students' interest in learning and autonomous learning ability.

18.
Article in Chinese | WPRIM | ID: wpr-908871

ABSTRACT

Objective:To study whether the "combination of medical care and pension" service model can effectively control the development of chronic disease in the elderly and reduce the direct economic burden caused by the disease.Methods:A total of 180 elderly participants who received the "combination of medical care and pension" service model for chronic disease management in Chongqing, China were investigated and analyzed statistically. Epidata 2.0 was used for data entry, SPSS 20.0 was used for data analysis, and paired sample t test was used for comparison between groups. Results:After 12 months of chronic disease management, hospitalization events and expenses of the elderly were reduced, among which the number of hospitalization was reduced by 0.24 timed on average, the length of hospitalization was reduced by 10.41 days on average, and the hospitalization expenses were reduced by 11 144 yuan on average. The direct economic burden due to chronic diseases was reduced by approximately 8 844.5 yuan, accounting for 33.8% of the average cost of hospitalization for the elderly without the application of the model.Conclusion:The chronic disease of the elderly is well controlled by chronic disease management through the "combination of medical care and pension" service model.

19.
Article in Chinese | WPRIM | ID: wpr-907533

ABSTRACT

Extensive stage small cell lung cancer (ES-SCLC) has a poor prognosis and short survival. Although platinum based combined with etoposide regimens and prophylactic craniocerebral irradiation have become the treatment regimens for ES-SCLC, it still faces the challenges of low local control rate and overall survival rate. As a local treatment, radiotherapy has a wide range of applications, which can not only be used for the radical treatment of local lesions, but also for the selective palliative treatment of advanced patients. Thoracic radiotherapy can improve the local control of ES-SCLC, among them, patients with residual intrathoracic lesions after chemotherapy benefit the most. There is still no unified standard for the appropriate population, optimal dose and segmentation of thoracic radiotherapy, and further research is needed.

20.
Article in Chinese | WPRIM | ID: wpr-907125

ABSTRACT

ObjectiveTo understand the infection of AIDS, syphilis, and gonorrhea in men who have sex with men (MSM), and the factors influencing the acceptance of gonorrhea testing in Dehong Dai Jingpo Autonomous Prefecture (Dehong Prefecture), Yunnan Province. MethodsAcross-sectional survey was conducted to describe and analyze the acceptance of AIDS, syphilis, and gonorrhea testing among MSM tracked in Dehong Prefecture in 2018. ResultsA total of 385 MSM were included in the analysis, with a 100.0% HIV and syphilis testing rate. The HIV antibody positivity rate was 10.6% (41/385) and the positivity rate of syphilis antibody was 14.8%(57/385). Only 30.4% of the subjects were willing to test for gonorrhea, and 13.7%(16/117)of them were test positive. Further multifactorial analysis revealed that local MSM and syphilis co-infected individuals were more likely to be tested for gonorrhea (aOR=2.48, 95%CI=1.33-4.65, P=0.004; aOR=2.59, 95%CI=1.43-4.71, P=0.002). ConclusionThe positive rates of AIDS, syphilis and gonorrhea in MSM population in Dehong Prefecture are relatively high. Integrated interventions of STD/AIDS and gonorrhoea detection should be strengthened.

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