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1.
Article in Chinese | WPRIM | ID: wpr-883169

ABSTRACT

Objective:To review the clinical prognosis and causes of death in children with extracorporeal membrane pulmonary(ECMO) assistance after congenital heart disease(CHD) operation in our center, so as to improve the survival rate of ECMO.Methods:All clinical data of 105 children with VA-ECMO assisted after CHD operation who were admitted to the Department of Cardiothoracic Surgery at Shanghai Children′s Medical Center from January 2017 to December 2019 were collected, and the clinical characteristics and causes of death were retrospectively analyzed.Results:The age of 105 children with ECMO was 110(38, 341)days, the weight was 5.30(3.75, 8.45)kg, and the risk adjustment for congenital heart surgery score was 3(2-3)points.There were no statistically significant differences in gender, age, weight, height, risk adjustment for congenital heart surgery score, the number of ECMO installed in the operating room, the number of ECMO installed after cardiopulmonary resuscitation and ECMO duration between the surviving group ( n=51) and the death group ( n=54)( P>0.05). While there was a significant difference in utilization of continuous renal replacement therapy[7.8% (4/51) vs.38.9% (21/54), P<0.001]. The death mainly occurred within one week after evacuating ECMO(83.3%, 45/54). ECMO installation was most in children aged 1 month to 1 year old(52.4%, 55/105), and the survival rate showed a rise over three years(2017 to 2019), increased from 31.6% (6/19) to 65.0% (13/20). Children with 3 to 5 kg were the most affected (39.0%, 41/105) when ECMO was installed, and the survival rate from 2017 to 2019 increased from 28.6%(4/14) to 75.0%(9/12). The main cause of death was heart failure(48.1%, 26/54), followed by bleeding(18.5%, 10/54)and pulmonary hypertension(13.0%, 7/54). Conclusion:With the progress of surgical technology and cardiopulmonary bypass, and the improvement of postoperative management, the mortality of children with CHD in our hospital after ECMO has decreased year by year during the last three years.However, the mortality of children requiring continuous renal replacement therapy assistance during ECMO is higher.Therefore, it is still necessary to strengthen the maintenance of each organ function during ECMO.

2.
Journal of Clinical Hepatology ; (12): 1053-1058., 2021.
Article | WPRIM | ID: wpr-876645

ABSTRACT

ObjectiveTo investigate the clinical effect of entecavir (ETV) rescue treatment in chronic hepatitis B (CHB) patients at the onset of rtA181V/T mutation. MethodsA total of 174 CHB patients who were treated in the outpatient and inpatient departments of The Affiliated Hospital of Xuzhou Medical University from January 2012 to January 2017 and underwent the detection of drug-resistance mutations of the genes in the reverse transcription (RT) polymerase region were enrolled, among whom there were 72 previously untreated patients and 102 treatment-experienced patients with virological breakthrough or poor response. The association between the previous medication history of nucleos(t)ide analogues and the mutation pattern (including rtA181V/T) was evaluated in the treatment-experienced CHB patients. A total of 155 patients were enrolled, among whom 72 patients had no drug-resistance mutations, 45 had rtA181V/T mutation, and 38 had rtA181V/T+rtN236T mutation. The three groups were compared in terms of virologic response and biochemical parameters at baseline and at weeks 24 and 48 of ETV rescue treatment. The t-test was used for comparison of normally distributed continuous data between two groups, and a one-way analysis of variance was used for comparison between multiple groups; the Kruskal-Wallis H test was used for comparison between multiple groups. The chi-square test was used for comparison of categorical data between two groups. A logistic regression analysis was used to screen out the influencing factors for poor prognosis. ResultsA analysis of the previous medication history of NAs and the mutation patterns for all patients suggested that the patients with the medication history of multiple NAs tended to have multisite mutations and multi-drug resistance (χ2=4295, P<0.05). The level of HBV DNA at the time of virological breakthrough was lower than that at the time of initial administration of NAs in the rtA181V/T mutation group [(6.22±1.48) log10 IU/ml vs (7.08±1.59) log10 IU/ml, t=3.098, P=0.002] and the rtA181V/T+rtN236T mutation group [(5.94±1.45) log10 IU/ml vs (6.94±1.61) log10 IU/ml,t=2.850, P=0.004]. At week 48 of ETV rescue treatment, there were no significant differences between the three groups in HBV DNA negative conversion rate (83.3% vs 82.2% vs 81.6%, P>0.05) and HBeAg negative conversion rate (22.2% vs 17.8% vs 21.1%, P>0.05), and there were also no significant differences in alanine aminotransferase normalization rate (77.1% vs 85.2% vs 83.3%, P>0.05), aspartate aminotransferase normalization rate (80.4% vs 75.9% vs 76.0%, P>0.05), and total bilirubin normalization rate (80.8% vs 79.3% vs 78.1%, P>0.05). HBV DNA level at the beginning of ETV treatment was the risk factor for the treatment outcome of 48-week antiviral therapy (odds ratio = 1.655, 95% confidence interval: 1.128-2.428, P=0.01). ConclusionETV has a good antiviral effect in treatment-experienced CHB patients with rtA181 drug-resistance mutation, and HBV DNA level at the initiation of ETV treatment can predict the outcome of 48-week ETV rescue treatment.

3.
Chinese Journal of Rheumatology ; (12): 540-543, 2020.
Article in Chinese | WPRIM | ID: wpr-868231

ABSTRACT

Objective:To explore the possible related factors of Beh?et's disease complicated with tendinitis, in order to better understand the etiology and development mechanism so to guide clinical diagnosis and treatment.Methods:The clinical data of patients with Beh?et's disease complicated with tendonitis treated at Department of Rheumatology and Immunology of Lanzhou University Second Hospital from October 2018 to September 2019 were retrospectively reviewed and related literature were reviewed.Results:Two patients were diagnosed as Beh?et's disease. Foot pain occurred during the treatment. Ultrasound showed tendonitis, and the corresponding treatment relieved the symptoms.Conclusion:Tendons may be involved and presents as a chronic change in patients with Beh?et's disease. In patients with rheumatic diseases, attention should be paid to the correlation between the disease and tendonitis. Aggressive treatment can prevent adverse consequences.

4.
Article in Chinese | WPRIM | ID: wpr-866557

ABSTRACT

Objective:To compare the effects of different anesthesia methods on postoperative analgesia, short-term cognitive function and deep venous thrombosis(DVT) in patients undergoing hip replacement.Methods:From March 2017 to March 2019, 96 patients with hip replacement were divided into group A (48 cases) and group B (48 cases) according to the random digital table method.Epidural anesthesia was used in group A, and general anesthesia was used in group B. The perioperative conditions, anesthesia effect, visual analogue scale (VAS) at postoperative 3, 12 and 24 hours, postoperative cognitive dysfunction (POCD) and DVT at postoperative 1, 3 and 7 days were compared between the two groups.Results:The operation time, intraoperative bleeding volume and time to get out of bed between the two groups had no statistically significant differences (all P>0.05). The recovery time[(14.98±2.31)min]and extubation time[(17.35±3.54) min]of group A were faster than those of group B[(19.13±3.42)min and (22.18±2.87)min]( t=6.967, 7.343, all P<0.05). The VAS scores of group B at postoperative 3 h[(3.27±0.73)points], postoperative 12 h[(2.45±0.38)points]and postoperative 24 h[(1.98±0.45)points]were higher than those of group A[(2.34±0.56)points, (1.65±0.43)points and (1.07±0.31)points]( t=7.003, 9.659, 11.538, all P<0.05). The incidences of POCD in group A at postoperative 3d(10.42%) and 7d(2.08%) were lower than those in group B (33.33% and 14.58%) (χ 2=7.357, 3.909, all P<0.05). The incidences of DVT in group A at postoperative 3d(4.17%) and 7d(8.33%) were lower than those in group B (20.83% and 29.17%) (χ 2=7.357, 3.909, all P<0.05). Conclusion:Epidural anesthesia is superior to general anesthesia in hip replacement.Postoperative analgesia is superior to general anesthesia, and can reduce the occurrence of short-term POCD and DVT, which is worthy of clinical reference.

5.
Article in Chinese | WPRIM | ID: wpr-864954

ABSTRACT

Objective:To explore the causes of death after congenital heart surgery, which may be benefit for improving postoperative outcome of children with congenital heart disease (CHD).Methods:All cases of in-hospital mortality from 2013 to 2018 were collected to analyze the epidemiological characteristics of mortality and causes of death.Results:The mortality showed a downtrend over the past 6 years, from 2.2% in 2013 to 1.2% in 2018.Of all the cases, 72.0% children died under the age of one year old.The death mainly occurred within one week postoperatively (254, 73.2%), especially during the first (101, 29.1%) and the second (51, 14.7%) days.The main cause of death was residual or remained anatomy issues (103, 29.7%), followed by arrhythmia (66, 19.0%) and pulmonary hypertension (57, 16.4%). The incidence of heart failure ( P=0.048) and pulmonary hypertension( P<0.001) in children with functional single ventricle was higher than that in biventricular patients. Conclusion:With the progress of surgical technology and cardiopulmonary bypass, and the improvement of postoperative management, early death after the open-heart surgery for CHD decreased year by year.Postoperative residual or remained anatomy issues was the main cause of death, and the management of it should be strengthened in clinic, especially in children under one year old.

6.
Article in Chinese | WPRIM | ID: wpr-863226

ABSTRACT

Bone tissue plays an important role in maintaining physical activity and health. The study of the biological functions of bone tissue cells and their application in tissue engineering is of great significance for clinical prevention and treatment of orthopedic-related diseases. Tea polyphenols are the main components of tea, with natural antioxidant, scavenging free radical activity and anti-inflammatory effects. Research results indicated that tea polyphenols can promote the bone remodeling process mainly by enhancing the formation of osteoblasts and reducing the occurrence of osteoclasts. In addition, tea polyphenols can also be used as surface modification molecules of artificial bone materials and are widely used in the field of bone tissue engineering. In this paper, the regulatory effects of tea polyphenols in bone tissue cells and its application in tissue engineering were reviewed, and related research contents were summarized and prospected, in order to provide reference and theoretical basis for subsequent research work.

7.
Journal of Medical Biomechanics ; (6): E276-E283, 2020.
Article in Chinese | WPRIM | ID: wpr-862381

ABSTRACT

Objective Hemodynamic disorder of the pulmonary artery (PA) is the main cause of pulmonary arterial hypertension related to congenital heart disease (PAH-CHD). To study the hemodynamic characteristics of PA, so as to understand biomechanical factors in the occurrence and development of PAH-CHD. Methods Clinical and imaging data were collected in five PAH-CHD patients and five matched controls (Non-PAH) to reconstruct subject-specific three-dimensional (3D) PA models. Computational fluid dynamics (CFD) was performed to compare the hemodynamic difference of flow patterns, wall shear stress (WSS) and normalized energy loss (E·) in the two groups. Results Hemodynamics-related parameters showed that the velocity and WSS were higher in the left and right PA branches of PAH-CHD patients, with significantly lower WSS in the main PA. The E· significantly increased in PAH-CHD patients and positively correlated with normalized PA diameter and inflow. Conclusions Compared with Non-PAH subjects, PAH-CHD patients have obviously higher velocity and WSS in PA branches, lower WSS in main PA and greater E·, indicating these hemodynamic parameters are related with the PAH-CHD, which can be used as potential biomechanical factors for the clinical evaluation of PAH-CHD.

8.
Journal of Medical Biomechanics ; (6): E629-E635, 2020.
Article in Chinese | WPRIM | ID: wpr-862357

ABSTRACT

Pulmonary hypertension (PH) is a devastating disease caused by different etiology and characterized by the progressive elevation of pulmonary vascular resistance and pulmonary artery pressure. As a new method that applied to clinical studies, computational fluid dynamics (CFD) gradually becomes a powerful tool for in-depth understanding of the disease progression. It can noninvasively obtain the patient-specific hemodynamic parameters at any point of the vessel and present them through the visualization technology. In this paper, an overall review of CFD with the focus on PH, including the numerical simulation method, boundary conditions, blood characteristics and relevant hemodynamic parameters was presented.

9.
Journal of Clinical Hepatology ; (12): 2261-2265, 2020.
Article in Chinese | WPRIM | ID: wpr-829405

ABSTRACT

ObjectiveTo investigate the clinical features of patients with Caroli disease. MethodsThe clinical data were collected from 41 patients who were diagnosed with Caroli disease in The Fifth Medical Center of Chinese PLA General Hospital from April 2015 to January 2020, and the patients were divided into type I group with 16 patients and type Ⅱ group with 25 patients. A retrospective analysis was performed for general information, laboratory markers, and clinical features. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data; a Spearman correlation analysis was also performed. ResultsThe type Ⅰ group had a significantly higher level of albumin (Alb) than the type Ⅱ group (t=0.976, P=0.048), and the type Ⅱ group had a significantly higher prothrombin time (PT) than the type I group (Z=3.115, P=0.001). Compared with the type I group, the type Ⅱ group had significantly higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (χ2=6.077, 5.468, and 2.403, P=0.002, 0.019, and 0.028). In the patients with type Ⅱ Caroli disease, the level of cholinesterase was negatively correlated with the incidence rates of esophageal and gastric varices and portal hypertension (r=-0.468 and -0.436, P=0.018 and 0.029); Alb level was negatively correlated with the incidence rate of esophageal and gastric varices (r=-0.561, P=0.004); red blood cell count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.662, -0.566, and -0.436, P<0.001, P=0.003, and P=0.029); hemoglobin count was negatively correlated with the incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension (r=-0.605, -0.590, and -0.510, P=0.001, 0.002, and 0.009); PT was positively correlated with the incidence rates of esophageal varices and portal hypertension (r=0.488 and 0.520, P=0.013 and 0.008). ConclusionCompared with the patients with type I Caroli disease, the patients with type Ⅱ Caroli disease have a higher incidence rates of esophageal and gastric varices, upper gastrointestinal bleeding and/or tarry stool, and portal hypertension, with the changes in clinical indicators such as the decrease of Alb level and the increase of PT level, and they tend to have poor prognosis.

10.
Journal of Clinical Hepatology ; (12): 2248-2252, 2020.
Article in Chinese | WPRIM | ID: wpr-829402

ABSTRACT

ObjectiveTo investigate the features and changing trend of drug-induced liver injury (DILI) in the elderly from 2009 to 2019, and to provide a reference for clinical prevention and treatment of DILI in the elderly. MethodsA retrospective analysis was performed for the clinical data of 2107 elderly patients, aged ≥60 years, who were diagnosed with DILI in The Fifth Medical Center of Chinese PLA General Hospital from January 2009 to December 2019, and they were divided into groups according to age. Related clinical data were analyzed, including age, sex, clinical features, prognosis, and regional distribution. The Chi-square test was used for comparison of categorical data between groups. ResultsAmong the 2107 patients with DILI, there were 802 male patients and 1305 female patients, with a male/female ratio of 1∶1.63. Cholestasis type was the most common clinical type and was observed in 1439 patients (68.3%). There was the highest number of patients in the 60-64 years group (942 patients, 44.7%), among whom 618(65.6%) were female, 589(62.5%) had cholestasis type, 471(50.0%) had chronic DILI, 421(44.7%) had drug-induced liver cirrhosis, and 25(2.7%) had drug-induced liver failure. There were 187 patients in the 75-79 years group, among whom 110 (58.8%) patients were male, 137(73.3%) had cholestasis type, 114(60.9%) had liver cirrhosis, 4(2.1%) had drug-induced liver failure. The results showed that chronic DILI was more common in the 60-64 years group, and liver cirrhosis was more common in the 75-79 years group. As for prognosis, in the 60-64 years group, 27 patients (2.9%) were cured, 885 (93.9%) were improved, 30(32%) had no response or died; in the 65-69 years group, 16 (2.8%) were cured, 528 (92.0%) were improved, and 30(5.2%) had no response or died; in the 70-74 years group, 9(2.8%) were cured, 305(94.1%) were improved, and 10 (3.6%) had no response or died. The results showed that there was no significant difference in mortality rate between the different age groups (P>0.05). The proportion of elderly DILI patients among hospitalized DILI patients increased from 15.90% in 2009 to 22.05% in 2013 and 27.51% in 2019, with a 1.73-fold increase in 11 years. As for regional distribution, the patients in North China accounted for the highest proportion of 47.08% (the patients from Hebei, Shanxi, and Inner Mongolia accounted for 24.92%, 10.96%, and 10.25%, respectively), followed by those in Northeast China who accounted for 17.85%. The patients in Beijing accounted for 11.53%. ConclusionThe proportion of elderly DILI patients among hospitalized DILI patients tends to increase in these years. Cholestasis type is the most common clinical type, and most of the patients with this clinical type progress to chronic DILI and drug-induced liver cirrhosis. Early diagnosis, early intervention, and standardized treatment of elderly DILI should be taken seriously.

11.
Article in Chinese | WPRIM | ID: wpr-872039

ABSTRACT

Objective:To investigate the journals and research directions of SCI papers published by the first affiliated hospital of Sun Yat-sen university from 2007 to 2016. To further study the trend of published journals, as well as the relationship between the research directions and departments.Methods:According to the data from Institute of Scientific and Technical Information of China and the Web of Science, SCI papers of our hospital from 2007 to 2016 were searched and collected, detailed information on published journals and research directions of the papers were analyzed.Results:From 2007 to 2016, scientists of our hospital published 2 999 SCI papers in 897 kinds of journals in total, among which almost 60% papers were published in 166 kinds of journals. PLoS One published the largest number, counted as 125 papers. There were 16 kinds of journals with impact factor (IF)> 10, published 25 papers from 12 departments. A total number of 76 research directions were involved in all these papers, and the largest number of papers was in oncology, accounted for 10.3%. There were 1 647 papers in the top 10 research directions, accounted for 54.92%. Among the 76 research directions, 62 research directions involved more than 2 departments.Conclusions:The distribution of SCI journals published by the first affiliated hospital of Sun Yat-sen university is centralized, with few high-impact achievements. Interdisciplinary research is common and widespread, but the degree of concentration is not enough.

12.
Article in Chinese | WPRIM | ID: wpr-799597

ABSTRACT

Objective@#To analyze the epidemiological characteristics of rotavirus in children under 5 years old in China (excluding China Hong Kong, Macau and Taiwan data, the same below) from 2005 to 2018.@*Method@#Data on other infectious diarrhea in the country from 2005 to 2018 were downloaded from the National Notifiable Disease Report System was to build a database for report cases of rotavirus diarrhea in children under 5 years of age, and descriptive epidemiological methods were used to analyze the data.@*Result@#In 2005-2018, a total of 820 588 cases of rotavirus infection in children under 5 years old were reported nationwide, with male 500 944 cases, and with an average annual incidence of 63.7/100 000. The reported incidence showed a fluctuating upward trend increased from 8.4/100 000 to 178.1/100 000. The number of reporting provinces increased from 17 to 30. The reported incidence showed a peak of season from November to following February. The reported cases of rotavirus diarrhea in children under 5 months of age was 13.1%(107 845 cases), and the high-incidence age ranged from 6 months to 2 years old, accounting for 70.3% (576 874 cases), with a peak of 11-13 months (163 947 cases). The top three provinces (cities) reporting the incidence rate were Zhejiang (535.2/100 000), Guangdong (334.3/100 000) and Beijing (317.3/100 000), the provinces with the low reported case rates were Shanxi (0.9/100 000), Heilongjiang (1.6/100 000) and Liaoning (2.5/100 000), but there was no case reported in Tibet; The report cases of south region (745 526 cases) were 9.9 times north region (74 935 cases).The cases of rotavirus infection and other diarrhea pathogens were detected simultaneously accounted for 1.8% (15 030 cases) and mainly were positive for rotavirus and adenovirus (90.1%, 13 544 cases).@*Conclusion@#The rate of rotavirus infection in children has increased rapidly since the age of 6 months, and 84.4% of the reported cases were infants before the age of 2 years.

13.
Article in Chinese | WPRIM | ID: wpr-827501

ABSTRACT

OBJECTIVE@#To investigate the changes in diversity, relative abundance and distribution of intestinal flora in patients with chronic rhinosinusitis and nasal polyps (CRSwNP) using high-throughput sequencing technology identify the intestinal flora significantly related to pathogenesis and progression of CRSwNP.@*METHODS@#Ten patients with CRSwNP hospitalized in the Department of Otolaryngology-Head and Neck Surgery of Guangdong Provincial People's Hospital were selected as the case group with 10 healthy volunteers recruited in the same period as the control group. Fecal genomic DNA extraction kit was used to extract the DNA in the fecal samples, and the DNA fragment length was measured and quantified. The V3 and V4 highly variable regions of the 16S rDNA gene of prokaryotes were amplified followed by library construction, Illumina MiSeq sequencing, sequence alignment and species identification analysis. The relative abundance, diversity and distribution characteristics of the intestinal flora were analyzed, and the relevant metabolic pathways were predicted.@*RESULTS@#Compared with the control group, the patients with CRSwNP had significant changes in the overall structure of the intestinal flora, highlighted by increased abundance of Saccharopolyspora and decreased contents of , , and . Among the metabolic pathways predicted to be associated with CRSwNP, 9 showed significant changes in patients with CRSwNP as compared with the control group ( < 0.05).@*CONCLUSIONS@#Patients with CRSwNP have significant changes in the structural characteristics of intestinal flora related with multiple metabolic pathways, and these changes may play an important role in the development of chronic rhinosinusitis.

14.
Article in English | WPRIM | ID: wpr-827396

ABSTRACT

OBJECTIVES@#To summarize the emergency management of the kidney transplantation for a large tertiary first-class hospital in response to the epidemic of coronavirus disease 2019 (COVID-19).@*METHODS@#The clinical data of inpatients in the Department of Kidney Transplantation from January 24, 2020 to February 29, 2020 were retrospectively analyzed. Since the outbreak of COVID-19, we conducted telephone, Wechat follow-up, and online education for kidney transplant recipients and patients on waiting-list for kidney transplantation one by one. We also strictly screened for COVID-19 in outpatients. To guarantee the security of medical staff and recipients and to reduce the transmission risk of COVID-19, we have made detailed approaches to prevent COVID-19, which mainly included 6 aspects of preventive approaches, such as kidney transplant clinic, kidney transplant ward, patients on waiting-list for kidney transplantation, kidney transplant operation, medical staff self-protection, and postoperative follow-up of kidney transplant recipients.@*RESULTS@#There were altogether 47 inpatients which included 20 recipients who had just received kidney transplantation in the meantime, 2 577 kidney transplant recipients, 1 689 patients on waiting-list for kidney transplantation, and 794 outpatients in our hospital. No case of COVID-19 occurred in this period.@*CONCLUSIONS@#Through strictly implementing proactive and preventive approaches, we avoid the occurrence of COVID-19 in carrying out kidney transplantation in the epidemic period.


Subject(s)
Betacoronavirus , Coronavirus Infections , Epidemiology , Humans , Kidney Transplantation , Pandemics , Pneumonia, Viral , Epidemiology , Retrospective Studies , Tertiary Care Centers , Transplant Recipients , Waiting Lists
15.
Neuroscience Bulletin ; (6): 831-844, 2020.
Article in English | WPRIM | ID: wpr-826774

ABSTRACT

The parahippocampal gyrus-orbitofrontal cortex (PHG-OFC) circuit in humans is homologous to the postrhinal cortex (POR)-ventral lateral orbitofrontal cortex (vlOFC) circuit in rodents. Both are associated with visuospatial malfunctions in Alzheimer's disease (AD). However, the underlying mechanisms remain to be elucidated. In this study, we explored the relationship between an impaired POR-vlOFC circuit and visuospatial memory deficits through retrograde tracing and in vivo local field potential recordings in 5XFAD mice, and investigated alterations of the PHG-OFC circuit by multi-domain magnetic resonance imaging (MRI) in patients on the AD spectrum. We demonstrated that an impaired glutamatergic POR-vlOFC circuit resulted in deficient visuospatial memory in 5XFAD mice. Moreover, MRI measurements of the PHG-OFC circuit had an accuracy of 77.33% for the classification of amnestic mild cognitive impairment converters versus non-converters. Thus, the PHG-OFC circuit explains the neuroanatomical basis of visuospatial memory deficits in AD, thereby providing a potential predictor for AD progression and a promising interventional approach for AD.

16.
Article in Chinese | WPRIM | ID: wpr-822554

ABSTRACT

@#Anxiety is a strong behavioral and psychological reaction with fear components, while depression is a mental disorder dominated by high or low mood, both of which are accompanied by cognitive and behavioral changes, and are common comorbidities in patients with heart disease. Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients. Persistent or initial depression and anxiety after surgery will not only increase surgical complications, short- or long-term mortality and medical costs, but also seriously affect patients' social function and quality of life. With the transformation of bio-psycho-social medical model, it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery. This article reviews the characteristics, related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.

17.
Article in Chinese | WPRIM | ID: wpr-871323

ABSTRACT

Objective:To investigate the expression of coxsackievirus-adenovirus receptor (CAR) in thymic carcinoma and the relationship between CAR and the antitumor activity of oncolytic adenovirus H101.Methods:The expression of CAR in thymic carcinoma tissues and cells were detected by RT-qPCR and Western blot. H101 expression and virus titers in Bcap-37, MP59 and T1889 cells after infection were detected by RT-qPCR and 50% tissue culture infectious dose (TCID 50). The proliferation activity and apoptosis rates of T1889 cells infected with H101 at different multiplicity of infection (MOI) were detected by CCK-8 and flow cytometry. CAR expression in T1889 cells treated with different concentrations of trichostatin A (TSA), a histone deacetylase inhibitor, was detected. H101 expression and virus titers in the TSA-treated and H101-infected cells were detected. Cell activity was detected by CCK-8. The phosphorylation levels of MARK and ERK1/2 and the expression of CAR at protein level in TSA-treated or TSA+ TBHQ (ERK activator) treated cells were detected. Results:CAR expression at both mRNA and protein levels were significantly lower in thymic carcinoma tissues than in adjacent normal tissues ( P<0.01), and lower in MP59 and T1889 cells than in thymic epithelial cells (TEC) and Bcap-37 cells ( P<0.01). H101 expression in MP59 and T1889 cells and the titers of H101 in culture supernatants were significantly lower than those in Bcap-37 cells ( P<0.01). Compared with Bcap-37 cell, the activity of MP59 and T1889 cells was significantly increased and the apoptosis rates were significantly decreased 48 h after H101 infection ( P<0.01). The expression of CAR at both mRNA and protein levels in T1889 cells treated with different concentrations of TSA increased in a dose-dependent manner. When T1889 cells were treated with 0.25 μmol/L of TSA, the expression of H101 at mRNA level and H101 titers were significantly increased ( P<0.05); the phosphorylation levels of MAPK and ERK1/2 proteins were continuously decreased; the expression of CAR was continuously increased. Compared with the TSA treatment group, the expression of CAR at protein level in the TSA+ TBHQ treatment group decreased significantly ( P<0.01), and the p-ERK1/2/ERK1/2 ratio increased significantly ( P<0.01). Conclusions:TSA could up-regulate CAR expression in thymic carcinoma by inhibiting the MARK/ERK1/2 pathway, thereby enhancing the antitumor activity of H101.

18.
Article in Chinese | WPRIM | ID: wpr-869913

ABSTRACT

Objective:To evaluate the role of reactive oxygen species (ROS) /nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway in desflurane preconditioning-induced reduction of lipopolysaccharide (LPS)-induced acute cerebral inflammation in rats.Methods:One hundred and twenty clean-grade healthy male Sprague-Dawley rats, aged 8-10 weeks, weighing 200-250 g, were divided into 4 groups ( n=30 each) using a random number table method: control group (group C), LPS-induced acute cerebral inflammation group (group L), desflurane preconditioning group (group D), and N-acetylcysteine plus desflurane preconditioning group (group ND). LPS 1 mg/kg was injected via the tail vein to establish the model of acute cerebral inflammation in L, D and ND groups.In group D, rats inhaled 8.2% desflurane for 1 h once a day for 5 consecutive days, and LPS was intravenously injected at 24 h after the end of the 5th inhalation.In group ND, ROS scavenger N-acetylcysteine 150 mg/kg was intraperitonealy injected at 30 min before each inhalation of desflurane, and the other treatments were similar to those previously described in group D. The expression of Nrf2 and kelch-like ECH-associated protein 1 (Keap1) in microglia and astrocytes in the hippocampal CA1 region was determined by immunofluorescence double staining before LPS injection (at 24 h after the last desflurane preconditioning). Morris water maze test was used to measure the escape latency, space exploration time spent in the original platform quadrant, and frequency of crossing the original platform at 6, 12 and 24 h after injecting LPS.The expression of NOD-like receptor family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, interleukin-18 (IL-18) and interleukin-1beta (IL-1β) in microglia and astrocytes in the hippocampal CA1 region was determined by immunofluorescence double staining at 6, 12 and 24 h after injecting LPS.Nissl staining and immunofluorescence were used to count normal neurons and activated microglia and astrocytes in the hippocampus at 24 h after LPS injection. Results:Compared with group C, no significant change was found in the expression of Nrf2 and Keap1 in microglia and astrocytes before LPS injection ( P>0.05), and the escape latency was significantly prolonged, the space exploration time spent in the original platform quadrant was shortened, the frequency of crossing the original platform was decreased, the number of normal neurons was decreased, the number of activated microglia and astrocytes was increased, and the expression of NLRP3, ASC, caspase-1, IL-18 and IL-1β was up-regulated after injecting LPS in group L ( P<0.05). Compared with group L, the expression of Nrf2 was significantly up-regulated, and the expression of Keap1 was down-regulated before injecting LPS ( P<0.05), and the escape latency was shortened, the space exploration time spent in the original platform quadrant was prolonged, the frequency of crossing the original platform was increased, the number of normal neurons was increased, the number of activated microglia and astrocytes was reduced, and the expression of NLRP3, ASC, caspase-1, IL-18 and IL-1β was down-regulated after injecting LPS in group D( P<0.05). Compared with group D, the expression of Nrf2 was significantly down-regulated, the expression of Keap1 was up-regulated before injecting LPS ( P<0.05), and the escape latency was significantly prolonged, the space exploration time spent in the original platform quadrant was shortened, the frequency of crossing the original platform was decreased, the expression of NLRP3, ASC, caspase-1, IL-18 and IL-1β was up-regulated, the number of normal neurons was reduced, and the number of activated microglia and astrocytes was increased after LPS injection in group ND ( P<0.05). Conclusion:ROS/Nrf2 signaling pathway is involved in desflurane preconditioning-induced reduction of LPS-induced acute cerebral inflammation in rats.

19.
Article in Chinese | WPRIM | ID: wpr-869841

ABSTRACT

Objective:To evaluate the role of O-linked-β-N-acetylglucosamine (O-GlcNAc) transferase (OGT) in methane-induced alleviation of oxygen-glucose deprivation and restoration (OGD/R) injury to rat spinal cord neurons and the relationship with Nrf2 expression.Methods:The primarily cultured spinal cord neurons of rats were seeded in 6-well plates at a density of 1×10 5 cells/ml and divided into 6 groups ( n=60 each) using a random number table method: control group (group C), group OGD/R, methane group (group M), and methane plus OGT inhibitor alloxan group (group MA). The medium was replaced with glucose- and serum-free Earle′s salt solution, and the neurons were exposed to 37 ℃ and 5%CO 2-95%N 2 in an incubator for 2 h followed by routine culture to establish the model of OGD/R.In group M, 200 μl methane-saturated saline (final concentration of methane 1.8 mmol/L) was added at oxygen-glucose restoration.Alloxan 8 mmol/L was added at 10 min after oxygen-glucose restoration to inhibit OGT in MA group.At 12 h of oxygen-glucose restoration, the neuronal survival rate, leakage rate of lactic dehydrogenase (LDH) and apoptotic rate of neurons were measured.The expression of OGT and H3K4me3 in Nrf2 promoter was measured by chromatin immunoprecipitation and fluorescent quantitative real-time polymerase chain reaction.Nucleoprotein was extracted for determination of O-GlcNAc glycosylation of RBBP5 (a H3K4 methyltransferase subunit) by immunoprecipitation and Western blot.The spatial proximity of MLL1 subunit of MLL complex to histone H3 was detected by proximity ligation assay.The expression of Nrf2 protein and mRNA was detected by Western blot and quantitative real-time polymerase chain reaction, respectively.The activities of superoxide dismutase (SOD) and catalase (CAT) and malonaldehyde (MDA) concentration were measured by enzyme-linked immunosorbent assay. Results:Compared with group C, the survival rate of neurons was significantly decreased, and the leakage rate of LDH, apoptotic rate and MDA content in supernatant were increased in OGD/R and M groups ( P<0.01). Compared with OGD/R, the survival rate of neurons was significantly increased, the leakage rate of LDH, apoptotic rate and MDA content in supernatant were decreased, the expression of OGT and H3K4me3 in Nrf2 promoter was up-regulated, O-GlcNAc glycosylation and spatial proximity level of MLL1 to histone H3 were increased, the expression of Nrf2 protein and mRNA was up-regulated, and the activities of SOD and CAT were increased in group M ( P<0.01). Compared with group M, the survival rate of neurons was significantly decreased, the leakage rate of LDH, apoptotic rate and MDA concentration were increased, the expression of OGT and H3K4me3 in Nrf2 promoter was down-regulated, O-GlcNAc glycosylation and spatial proximity level of MLL1 to histone H3 were decreased, the expression of Nrf2 protein and mRNA was down-regulated, and activities of SOD and CAT were decreased in group MA ( P<0.05 or 0.01). Conclusion:OGT is involved in methane-induced alleviation of OGD/R injury to rat spinal cord neurons, which is related to up-regulating Nrf2 expression.

20.
Article in Chinese | WPRIM | ID: wpr-869830

ABSTRACT

Objective:To evaluate the effect of methane on purinergic ion channel type 7 receptor (P2X 7R)/nod-like receptor protein 3 (NLRP3) signaling pathway during inflammatory responses in a rat model of spinal cord ischemia-reperfusion (I/R). Methods:Fifty-four clean-grade healthy male Sprague-Dawley rats, aged 3 months, weighing 350-380 g, were divided into 3 groups ( n=18 each) using a random number table method: sham operation group (group S), spinal cord I/R group (group I/R) and methane group (group M). Rats underwent sham operation in group S. Spinal cord ischemia was induced by occlusion of the thoracic aorta combined with controlled hypotension for 9 min, followed by reperfusion in anesthetized animals in group I/R.Methane-rich saline 10 mg/kg was intraperitoneally administered immediately after onset of reperfusion in group M. Motor sensory deficit index (MSDI) in hind limbs was measured at 12, 24 and 48 h of reperfusion.The L 3-5 segment of spinal cord was removed at 48 h of reperfusion for determination of the number of normal neurons (by Nissl staining), the number of activated microglia and expression of P2X 7R, NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), cysteine-requiring aspartate protease (caspase-1), interleukin-1beta (IL-1β) and IL-18 (by immunofluorescence staining) in anterior and posterior horns of spinal cord. Results:Compared with group S, the MSDI was significantly increased at 12, 24 and 48 h of reperfusion, and the number of normal neurons in anterior and posterior horns of spinal cord was decreased, the number of activated microglia was increased, and the expression of P2X 7R, NLRP3, ASC, caspase-1, IL-1β and IL-18 was up-regulated at 48 h of reperfusion in group I/R ( P<0.01). Compared with group I/R, the MSDI was significantly decreased at each time point of reperfusion, and the number of normal neurons in anterior and posterior horns of spinal cord was increased, the number of activated microglia was decreased, and the expression of P2X 7R, NLRP3, ASC, caspase-1, IL-1β and IL-18 was down-regulated at 48 h of reperfusion in group M ( P<0.05). Conclusion:The mechanism by which methane reduces inflammatory responses is related to inhibiting P2X7R/NLRP3 signaling pathway in a rat model of spinal cord I/R.

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