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ObjectiveTo explore the mechanism of Wutou Chishizhi Wan in regulating autophagy and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/glycogen synthase kinase-3β （GSK-3β） signaling pathway in rats with myocardial ischemia-reperfusion injury （MIRI）. MethodSixty male SD rats were randomly assigned into the normal group （normal saline）， model group （normal saline）， positive control （trimetazidine， 5.4 mg·kg-1） group， and low-， medium-， and high-dose （1.63， 4.9， 14.7 g·kg-1， respectively） Wutou Chishizhi Wan groups， with 10 rats in each group. The rats in other groups except the normal group underwent left anterior descending coronary artery ligation for modeling. Electrocardiogram was employed to detect the ST-segment elevation to evaluate the modeling. Hematoxylin-eosin （HE） staining was performed to reveal the damage of myocardial tissue. The levels of aspartate aminotransferase （AST） and creatine kinase （CK） were determined by colorimetry， and those of cardiac troponin T （cTnT） and myoglobin （MYO） by enzyme-linked immunosorbent assay （ELISA）. Western blot was carried out to determine the protein levels of microtubule-associated proteins 1 light chain 3 （LC3）， autophagy-related gene Beclin-1， PI3K， Akt， GSK-3β， p-GSK-3β， and p-Akt. ResultCompared with the normal group， the modeling elevated the serum levels of AST， CK， cTnT， and MYO （P<0.01）， destroyed the arrangement of myocardial cells abd nucle， twisted and broken myocardial fibers， up-regulated the protein levels of LC3Ⅱ/Ⅰ and Beclin-1 （P<0.01）， and down-regulated the protein levels of PI3K， p-Akt， and p-GSK-3β （P<0.01）. Compared with the model group， trimetazidine and Wutou Chishizhi Wan （all the doses） lowered the levels of AST， CK， cTnT， and MYO in serum （P<0.01）， restored the arrangement of myocardial cells and muscle fibers， reduced necrosis， down-regulated the protein level of Beclin-1 （P<0.01）， and up-regulated the protein levels of PI3K， p-Akt， and p-GSK-3β （P<0.01）. Additionally， Wutou Chishizhi Wan （all the doses） down-regulated the protein level of LC3Ⅱ/Ⅰ （P<0.05， P<0.01）. Compared with those in the trimetazidine group， the serum AST level rose in the low-dose Wutou Chishizhi Wan group （P<0.05） and declined in the high-dose group （P<0.01）， and the protein level of Beclin-1 was down-regulated in the medium-dose group （P<0.01）. Additionally， the trimetazidine group had higher protein level of LC3Ⅱ/Ⅰ than medium- and high-dose Wutou Chishizhi Wan groups （P<0.05， P<0.01）， higher protein level of PI3K than low-， medium-， and high-dose groups （P<0.01）， lower protein level of p-Akt than low- and medium-dose groups （P<0.01）， and higher p-GSK-3β protein level than the medium-dose group （P<0.01）. ConclusionDifferent doses of Wutou Chishizhi Wan can ameliorate MIRI， and the high dose has the best effect. Wutou Chishizhi Wan can reduce the activity of myocardial injury markers AST， CK， cTnT， and MYO， and alleviate the pathological damage of myocardial tissue. It can down-regulate the protein levels of beclin-1， LC3Ⅱ/Ⅰ， and up-regulate those of PI3K， p-Akt， and p-GSK-3β. In summary， Wutou Chishizhi Wan may inhibit excessive autophagy and regulate the PI3K/Akt/GSK-3β signaling pathway to exert protective effect on MIRI rats.
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Objective:To analyze locoregional recurrence (LRR) pattern of patients with pT 1-2N 1 breast cancer after modified radical mastectomy, with and without adjuvant radiotherapy (RT). Methods:A total of 5442 eligible patients with breast cancer from 12 Chinese centers were included. The LRR sites and the effect of RT at different sites on recurrence in patients with and without RT were analyzed. The Kaplan-Meier method was used to calculate the cumulative LRR rate, and the difference was compared by the log-rank test.Results:With a median follow-up time of 63.8 months for the entire cohort, 395 patients developed LRR. The chest wall and supraclavicular fossa were the most common LRR sites, regardless of RT or molecular subtypes. The 5-year chest wall recurrence rates for patients with and without chest wall irradiation were 2.5% and 3.8%( P=0.003); the 5-year supraclavicular lymph nodal recurrence rates for patients with and without supraclavicular fossa irradiation were 1.3% and 4.1%( P<0.001); the 5-year axillary recurrence-free rates for patients with and without axillary irradiation were 0.8% and 1.5%( HR=0.31, 95% CI: 0.04-2.23, P=0.219); and the 5-year internal mammary nodal recurrence-free rates for patients with and without internal mammary nodal irradiation were 0.8% and 1.5%( HR=0.45, 95% CI: 0.11-1.90, P=0.268). Conclusions:The chest wall and supraclavicular fossa are the most common LRR sites of patients with pT 1-2N 1 breast cancer after modified radical mastectomy, which is not affected by adjuvant RT or molecular subtypes. The chest wall and supraclavicular fossa irradiation significantly reduce the risk of recurrence in the corresponding area. However, axillary and internal mammary nodal irradiation has no impact on the risk of recurrence in the corresponding area.
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OBJECTIVE@#To explore the effectiveness and feasibility of dexamethasone combined with oxybuprocaine hydrochloride gel on the prevention of postoperative sore throat after nasal endoscopy.@*METHODS@#In the study, 60 patients with American Society of Anesthesiologist (ASA) physical statuses Ⅰ to Ⅱ, aged 18 to 72 years, scheduled for elective nasal endoscope surgery under general anesthesia requiring endotracheal intubation were randomly divided into dexamethasone combined with oxybuprocaine hydrochloride gel group (G group, n=30) and control group (C group, n=30). The patients in the G group received dexamethasone 0.1 mg/kg before induction and the oxybuprocaine gel was applied to the endotracheal catheter cuff and the front end within 15 cm. The patients in the C group received the same dose of saline and the saline was applied to the endotracheal catheter cuff and the front end within 15 cm. Then, all the patients in the two groups received the same induction and anesthesia maintainance. The operation time, anesthesia time, emergence time, extubation time and departure time were recorded. The intraoperative infusion volume, blood loss volume, propofol, remifentanil, rocuronium dosage were also recorded. The adverse reactions such as intraoperative hypotension, bradycardia and postoperative agitation were recorded. The postoperative sore throat score was recorded at the end of operation and 4 h, 8 h, 12 h, and 24 h after operation.@*RESULTS@#Compared with the C group, the emergence time [(8.4±3.9) min vs. (10.8±4.7) min], extubation time [(8.8±3.7) min vs. (11.9±4.8) min], and departure time [(20.0±5.3) min vs. (23.0±5.8) min] were significantly shorter, and the propofol dosage [(11.8±1.8) mg/kg vs. (15.9±4.6) mg/kg], remifentanil dosage [(10.9±4.7) μg/kg vs. (14.1±3.6) μg/kg] were significantly less in the G group, and there was no difference of rocuronium dosage in the two groups. Compared with the C group the incidence of intraoperative hypotension [10%(3/30) vs. 30%(9/30)], bradycardia [16.7%(5/30) vs. 20%(6/30)] and postoperative agitation [6.7%(2/30) vs. 23.3%(7/30)] were significantly lower in the C group. The postoperative sore throat score at the end of operation, 4 h, 8 h, 12 h and 24 h after operation in the G group were significantly lower than in the C group respectively [0 (0, 1) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (0.75, 1), 0 (0, 0) vs. 1 (0, 1)].@*CONCLUSION@#Dexamethasone combined with oxybuprocaine hydrochloride gel was effective and feasible on the prevention of postoperative sore throat after nasal endoscopy.
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Adolescent , Adult , Aged , Bradycardia/drug therapy , Dexamethasone/therapeutic use , Endoscopy/adverse effects , Humans , Hypotension/drug therapy , Intubation, Intratracheal/adverse effects , Middle Aged , Pain/drug therapy , Pharyngitis/prevention & control , Postoperative Complications/prevention & control , Procaine/analogs & derivatives , Propofol , Remifentanil , Rocuronium , Young AdultABSTRACT
Objective: To analyze the epidemiological characteristics of pneumoconiosis in Qinghai Province from 2011 to 2020, and to provide a basis for the formulation of prevention and control strategy. Methods: In April 2021 , the cases of pneumoconiosis were monitored by the Occupational Disease and Health Hazard Factors Monitoring Information System in Qinghai Province from 2011 to 2020. The distribution of pneumoconiosis, the composition of diseases and the working years exposed to dust were analyzed. Results: All 1026 cases of pneumoconiosis were newly diagnosed in Qinghai Province from 2011 to 2020, silicosis and coal worker pneumoconiosis were the main diseases (78.36% ,804/1026). Stage Ⅰ pneumoconiosis were 484 (47.17%,484/1026) cases. 359 (34.99%,359/1026) cases, 315 (30.70%,315/1026) cases and 252 (24.56%, 252/1026) cases had been diagnosed respectively in Xining City, Haidong City and Haixi Prefecture; 628 (61.21%,628/1026) cases and 418 (40.74%, 418/1026) cases engaged in mining industry and large-sized enterprise, respectively. The working years exposed to dust in silicosis cases were shorter than that in coal worker pneumoconiosis and other pneumoconiosis (P <0.05). Conclusion: The pneumoconiosis area and industry focus in Qinghai Province is obvious. The supervision and adninistration of small and micro scale employers should be strengthened to protect the health rights and interests of workers, especially for the key area and industry.
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Anthracosis/epidemiology , China/epidemiology , Coal Mining , Dust , Health Services Accessibility , Human Rights , Humans , Pneumoconiosis/epidemiology , Silicosis/epidemiologyABSTRACT
Objective: To explore the mediating effect of job burnout of nursing staff in clinical departments on occupational stress and anxiety, and to provide scientific basis for the formulation of intervention measures to relieve anxiety. Methods: From November 2020 to January 2021, a cross-sectional survey was conducted to investigate the basic situation, occupational stress, job burnout and anxiety of 653 nursing staff in a third class A general hospital in Hebei Province. Spearman rank correlation was used to analyze the relationship between occupational stress, job burnout and anxiety, stepwise regression and mediating effect model were used to verify the mediating effect of job burnout on the relationship between occupational stress and anxiety. Results: 551 valid questionnaires were collected with effective recovery of 84.38%. The incidence of high occupational stress was 68.06% (375/551) , the incidence of job burnout was 63.70% (351/551) [high, moderate and moderate were 11.07% (61/551) and 52.63% (290/551) respectively], and the incidence of anxiety was 55.72% (307/551) [mild, moderate and severe were 38.11% (210/551) , 8.53% (47/551) and 9.08% (50/551) respectively]. Occupational stress was positively correlated with job burnout and anxiety (r=0.545, 0.479) , and job burnout was positively correlated with anxiety (r=0.542, P<0.05) . The mediating effect analysis showed that occupational stress had a statistically significant effect on anxiety (c=0.509, P<0.001) , and the mediating effect of job burnout on the relationship between occupational stress and anxiety accounted for 44.99% of the total effect. Conclusion: The anxiety level of the nursing staff in this third-class A general hospital was relatively high. Job burnout has a mediating effect between occupational stress and anxiety, and anxiety of nursing staff can be alleviated by reducing occupational stress or job burnout.
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Anxiety/epidemiology , Burnout, Professional/epidemiology , Cross-Sectional Studies , Hospitals, General , Humans , Job Satisfaction , Nursing Staff , Occupational Stress/epidemiology , Surveys and QuestionnairesABSTRACT
Objective:To preliminarily investigate the efficacy and safety of bevacizumab plus neoadjuvant chemotherapy combined with concurrent chemoradiotherapy in the treatment of locally advanced giant cervical cancer (LACC).Methods:Twenty-four patients with LACC who were treated with bevacizumab combined with neoadjuvant chemotherapy were assigned into the study group, and 30 patients receiving neoadjuvant chemotherapy in phase Ⅱ clinical trial (ChiCTR-TRC-11001832) were allocated in the control group. The survival rate was calculated by the Kaplan- Meier method, and the significance of differences between the variables was determined by the log-rank test. Results:The tumor volumes were (1.64±23.15) cm 3 and (12.83±15.08)( P=0.037), and the complete remission (CR) rates were calculated as 45.8% and 13.3%( P=0.004) in the study and control groups after neoadjuvant chemotherapy. The tumor volumes were (0±1.5) cm 3 and (1.00±10.63) cm 3( P=0.022) and the CR rates were 70% and 50%( P=0.009) in the study and control groups before afterloading treatment. The median follow-up was 24.6(9.3-101.7) months. The 1-and 2-year overall survival rates were 96%, 96% and 90%, 71%( P=0.110), the recurrence-free survival rates was 96%, 96% and 97%, 89%( P=0.512), and the distant metastasis-free survival rates were 96%, 88% and 83%, 80%( P=0.297) in the study and control groups, respectively. Adverse reactions were acceptable in both groups. Conclusion:Bevacizumab combined with neoadjuvant chemotherapy can significantly reduce the tumor volume, improve the tumor CR rate and yield tolerable adverse reactions.
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Based on the clinical characteristics of atopic dermatitis( AD) in traditional Chinese medicine( TCM) and Western medicine,the existing animal models were analyzed,and the coincidence degree,advantages and disadvantages between the models and the clinical manifestations of AD were evaluated,so as to provide reference for establishing a rational animal model. After consulting relevant literatures in recent years and summarizing the existing modeling methods,it is found that spontaneous,transgenic/gene knockout models were highly consistent,but with high breeding conditions and expensive prices. The hapten-induced model was low in cost and fast in modeling. It revealed the corresponding mechanism of AD to a certain extent,but did not fully reflect the state of the entire process of AD. The modeling method was guided by Western medicine,but with a lack of pathogenic factors of traditional Chinese medicine,and so has certain limitations in TCM research. Therefore,it is necessary to combine the etiology,pathogenesis and clinical mani-festations of AD with traditional Chinese and Western medicine,so as to improve the coincidence degree between the model and the characteristics of clinical symptoms and lay the foundation for in-depth studies on AD.
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Animals , China , Dermatitis, Atopic/genetics , Drugs, Chinese Herbal , Eczema , Medicine , Medicine, Chinese TraditionalABSTRACT
As an important branch of medicine,Traditional Chinese Medicine(TCM)has been applied for the treatment of diseases for thousands of years in China and other countries in East Asia.The Chinese Pharmacopoeia(ChP)is a drug code formulated by the Chinese government,and it includes a special volume for the monographs of TCM,which plays an important role in ensuring the quality of drugs.The use of quality control technology has always been a complex and important factor in TCM.Owing to the chemical diversity of TCM,chromatography technology has been proven to be a comprehensive strategy for the assessment of the overall quality of TCM and has become the main analytical method in the ChP.This article provides an overview of the classical and modern chromatographic technologies applied in the ChP,and summarizes the advantages and disadvantages of each technique in the TCM monographs.In 2020,the new edition of the ChP(the 2020 edition)has been implemented at the end of 2020.This paper also contains a brief introduction about the application of chromatographic technologies in the new edition of the ChP.
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This study was to investigate the protective effect of paeoniflorin (PF) on hydrogen peroxide-induced injury. Firstly, "SMILES" of PF was searched in Pubchem and further was used for reverse molecular docking in Swiss Target Prediction database to obtain potential targets. Injury-related molecules were obtained from GeenCards database, and the predicted targets of PF for injury treatment were selected by Wayne diagram. For mechanism analysis, the protein-protein interactions were constructed by String, and the KEGG analysis was conducted in Webgestalt. Then, cell viability and cytotoxicity assay were established by CCK8 assay. Also, the experimental cells were allocated to control, model (200 μmol·L
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OBJECTIVE@#To investigate the application value of serum 25-hydroxy vitamin D [25(OH)D] in systemic lupus erythematosus (SLE).@*METHODS@#Data of 158 patients with SLE in Department of Rheumatology and Immunology in the People's Hospital of Xinjiang Uygur Autonomous Region from July 2016 to July 2019. All the SLE patients were divided into two groups by SLE scores of the disease activity index (SLEADI): 59 cases of active group (SLEADI > 4), 99 cases of non-active group (SLEDAI ≤4). Fifty healthy people were selected as healthy control group. The patients' general information and their laboratory data including serum 25(OH)D levels were collected. Statistical methods used were t-test, Spearman's correalation analysis and Logistic regression analysis.@*RESULTS@#(1) A total of 208 cases were included in this study. The level of 25(OH)D in SLE group [10.4(5.6, 15.8) μg/L] was significantly lower than that in healthy control group [25.5(22.8, 32.3) μg/L, P < 0.01]. 25(OH)D level in active SLE patients [6.2(3.7, 13.8) μg/L] was significantly lower than that in remission SLE patients [12.3(7.2, 16.7) μg/L, P < 0.01]. The serum 25(OH)D level in lupus nephritis [6.7 (4.4, 12.9) μg/L] was significantly lower than that in SLE without renal involvement [13.3 (7.4, 18.7) μg/L, P < 0.01]. (2) A significant negative correlation was demonstrated between the serum level of 25(OH)D and SLEDAI (r=-0.35, P < 0.01), and the 24h urinary protein excretion (r=-0.39, P < 0.01).Positive correlation was demonstrated between the serum level of 25(OH)D and C3 that decreased (r=0.249, P < 0.05). (3) Univariate analysis showed anti- dsDNA antibodies(ds-DNA), anti-Sm antibodies(Sm), IgG, C3, C4, erythrocyte sedimentation rate (ESR), 24h urinary protein quantification(24h-pro) and 25(OH)D were associated with disease activity in the SLE patients; Multivariate Logistic regression analysis showed that 25(OH)D was associated with the disease activity of the lupus patients.@*CONCLUSION@#The decrease of vitamin D level is related to the disease activity of SLE patients, and may be related to lupus nephritis, which plays an important role in the occurrence and development of SLE.
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Antibodies, Antinuclear , Humans , Lupus Erythematosus, Systemic , Lupus Nephritis , Vitamin D/analogs & derivativesABSTRACT
OBJECTIVE@#To investigate the clinical and serological features of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) overlap syndrome (Rhupus syndrome).@*METHODS@#We retrospectively reviewed the medical records of 21 patients with Rhupus syndrome who were hospitalized at Department of Rheumatology and Immunology, People's Hospital of Xinjiang Uygur Autonomous Region between January 2010 and January 2018. We compared the joint involvement, autoantibodies and clinical manifestations of Rhupus syndrome with 81 cases of RA-alone and 51 cases of SLE-alone.@*RESULTS@#In 21 patients with Rhupus syndrome, there are 3 males and 18 females. Compared with the SLE-alone group, the patients with Rhupus syndrome were older [(49.43±11.66) vs. (40.59±12.73), P=0.008]. The median age of the patients with Rhupus syndrome at RA onset was significantly younger than that of the RA-alone patients [(32.58±11.14) vs. (43.11±11.83), P=0.010]. Of the 21 patients with Rhupus syndrome, the initial diagnosis was RA in 57% (12/21), except 2 male patients, the other 10 patients with SLE manifestations were menopause, the mean age of amenorrhea or menopause was (44.30±5.33) (36-50) years. The mean interval between the onset of SLE and RA was 10.83 years. Two patients started with SLE manifestations. Moreover, both diseases simultaneously developed in 33.3% of the patients. Except one male patient, 3 patients were in menopause stage when RA and SLE appeared. The positive rate of specific antibody Rhupus syndrome was similar to that of RA. Renal damage was relatively rare in SLE related manifestations, but the incidence of interstitial lung disease was higher. There were no significant differences in the prevalence of complements C3 and C4, antinuclear antibody (ANA), anti-double-stranded DNA (anti-dsDNA), anti-SSA or anti-SSB antibody between the Rhupus syndrome and SLE-alone group.@*CONCLUSION@#Rhupus syndrome is an overlapping syndrome in which RA and SLE coexist. Most of the diseases occur in RA and the related manifestations of RA are more serious than those of SLE. The incidence of Rhupus syndrome may be related to the change of sex hormone levels.
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Adult , Antibodies, Antinuclear , Arthritis, Rheumatoid/epidemiology , Autoantibodies , Female , Humans , Lupus Erythematosus, Systemic/epidemiology , Male , Middle Aged , Retrospective StudiesABSTRACT
Objective@#To retrospectively analyze the characteristics of nasopharyngeal carcinoma, long-term efficacy, adverse reactions of intensity-modulated radiotherapy (IMRT) in non-endemic northwest China and summarize the experience of IMRT in the treatment of nasopharyngeal carcinoma in the past decade.@*Methods@#Clinical data of 658 patients newly diagnosed with nasopharyngeal carcinoma without distant metastasis admitted to First affiliated hospital from January 2006 to December 2016 were retrospectively analyzed. All patients were treated with IMRT. The survival analysis was performed by Kaplan-Meier method. The multivariate analysis was conducted with Cox’s regression model.@*Results@#In non-endemic northwest China, a large proportion of patients were newly diagnosed with locally advanced nasopharyngeal carcinoma, and a majority of them were pathologically characterized as differentiated subtypes. The 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) rates were 75.7%, 70.1%, 91.2%, 97.0% and 81.0%, respectively. Multivariate analysis showed that age, pathological type, nasopharyngeal tumor volume>23 cm3 and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DFS (all P<0.05). Age, pathological type, neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of OS (all P<0.05). N stage and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DMFS (both P<0.05).@*Conclusions@#Similar clinical efficacy has been achieved in terms of IMRT for nasopharyngeal carcinoma in non-endemic northwest China compared with that in endemic area. Induction chemotherapy combined with concurrent radiochemotherapy can provide clinical benefits for patients with locally advanced nasopharyngeal carcinoma in non-endemic area.
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Objective To retrospectively analyze the characteristics of nasopharyngeal carcinoma,long-term efficacy,adverse reactions of intensity-modulated radiotherapy (IMRT) in non-endemic northwest China and summarize the experience of IMRT in the treatment of nasopharyngeal carcinoma in the past decade.Methods Clinical data of 658 patients newly diagnosed with nasopharyngeal carcinoma without distant metastasis admitted to First affiliated hospital from January 2006 to December 2016 were retrospectively analyzed.All patients were treated with IMRT.The survival analysis was performed by Kaplan-Meier method.The multivariate analysis was conducted with Cox's regression model.Results In non-endemic northwest China,a large proportion of patients were newly diagnosed with locally advanced nasopharyngeal carcinoma,and a majority of them were pathologically characterized as differentiated subtypes.The 5-year overall survival (OS),disease-free survival (DFS),local recurrence-free survival (LRFS),regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) rates were 75.7％,70.1％,91.2％,97.0％ and 81.0％,respectively.Multivariate analysis showed that age,pathological type,nasopharyngeal tumor volume＞23 cm3 and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DFS (all P＜0.05).Age,pathological type,neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of OS (all P＜0.05).N stage and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DMFS (both P＜0.05).Conclusions Similar clinical efficacy has been achieved in terms of IMRT for nasopharyngeal carcinoma in non-endemic northwest China compared with that in endemic area.Induction chemotherapy combined with concurrent radiochemotherapy can provide clinical benefits for patients with locally advanced nasopharyngeal carcinoma in non-endemic area.
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G protein-coupled receptor 119 (GPR119) has been a promising target for the treatment of type 2 diabetes. It can not only directly promote insulin secretion, but also indirectly increase insulin secretion by stimulating the release of glucose-dependent GIP/CLP-1 without causing hypoglycemia. The remarkable advantages of small molecule GPR119 agonists make it one of the research hotspots for the development of type 2 diabetes drugs. This article reviews the anti-diabetic small molecules based on the GPR119 target in the past five years.
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To establish the HPLC-ELSD specific chromatogram analysis method of Rehmanniae Radix and Rehmanniae Radix Prae-parata, and analyze and compare their chemical compositions, so as to reveal the change regularity of compositions during the proces-sing. By HPLC-ELSD method, the chromatographic column for Prevail Carbohydrate ES(4.6 mm ×250 mm, 5 μm) was adopted, with acetonitrile(A)-water(B) as mobile phase for gradient elution, and the evaporative light-scattering detector was used. A total of 23 batches of Rehmannia Radix samples, and 25 batches of Rehmanniae Radix Praeparata samples and processing dynamic samples were compared. The established method had a great repeatability, precision and stability. Eight common chromatographic peaks were extracted from 23 batches of Rehmanniae Radix samples, 8 common peaks were extracted from 25 Rehmanniae Radix Praeparata, and 7 chromatographic peaks were identified. The composition ratio of Rehmannia Radix was changed greatly during the processing. When the simila-rity≥0.95 and the fructose peak area was more than 2 times of stachyose tetrahydrate or more than 20 times of raffinose, the processing degree conformed to the requirements of empirical identification. The three main oligosaccharides of Rehmanniae Radix were sucrose that was heated to generate fructose and glucose, stachyose tetrahydrate that was heated to generate melibiose, sucrose and fructose, and stachyose tetrahydrate that was heated to generate manninotriose. The change in the index of proportion between monosaccharides and oligosaccharides can be used as the quantitative criterion for the processing quality of Rehmanniae Radix Praeparata.
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Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Monosaccharides , Plant Roots , RehmanniaABSTRACT
Objective: To explore the utility and safety of leadless intracardiac transcatheter pacing system. Methods: The study was a prospective observational study. Patients underwent Micra transcatheter pacing system in Beijing Anzhen hospital from December 2019 to January 2020 were enrolled. The baseline characteristics, platelet count, hemoglobin, anticoagulation and/or antiplatelet therapy, mean procedural time, average fluoroscopy time, number of deployment and electrical parameters (threshold, R-wave amplitude, impedance) were recorded. Ultrasonography of bilateral femoral and iliac veins was performed in all patients. Patients were followed including access site complication, adverse event and device evaluation at implant, hospital discharge, 1 and 3 months post-implant. R-wave≥5 mV, impedance between 400 and 1 500 Ω and threshold increase≤1.5 V than implant is considered a stable parameter. Femoral access site complications included hematoma, hemorrhage, pseudoaneurysm, and arteriovenous fistula. Adverse events included dislodgement, cardiac effusion/perforation and infection. Left ventricular end diastolic diameter and ejection fraction before and at 1 month after implant were reported. Results: Five patients were enrolled and pacemaker implantation was successful in all 5 patients. Patients were all males and the average age was (78.4±8.4) years. 2 patients received aspirin and clopidogrel therapy, 1 patient suffered from anemia and thrombocytopenia occurred in 1 patient. No stenosis, occlusion and vascular malformation of bilateral femoral and iliac veins was observed. The mean implant time was (39.6±1.7) minutes. The average fluoroscopy time was (9.2±1.3) minutes and the number of deployment was (1.40±0.55). Electrical parameters(threshold, R-Wave amplitude and impedance) were as follows: (0.40±0.10) V/0.24 ms, (10.80±3.72) mV and (822.00±162.23) Ω at implant; (0.45±0.07) V/0.24 ms, (13.04±2.41) mV, and (748.0±91.5) Ω at discharge, (0.40±0.06) V/0.24 ms, (14.26±4.11) mV, and (700.0±91.7) Ω at 1 month post-implant and (0.39±0.05) V/0.24 ms, 14.40±3.97 mV, and (682.0±96.0) Ω at 3 months post-implant, respectively. Threshold increase was ≤1.5 V compared to that during implantation, electrical parameters were acceptable and stable. There was no difference in LVEDD [(44.00±5.24) mm vs. (44.00±5.34) mm,P=1.000] and EF [(62.00±3.39)% vs. (62.20±3.56)%, P=0.861] before and 1 month post-implant. No incidence of access site complications, cardiac effusion/perforation, dislodgment or infections occurred during the 3 months. Conclusions: The leadless transcatheter pacemaker implantation performed in our study archived a high implant success rate and favorable safety profile as well as associated with low and stable pacing thresholds. The long-term safety and benefit of leadless pacemaker need to be evaluated in future clinical studies.
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Aged , Aged, 80 and over , Equipment Design , Follow-Up Studies , Humans , Male , Pacemaker, Artificial , Prospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE@#To observe the effect of Bruton's tyrosine kinase (BTK) on the proliferation and differentiation of osteoclasts and to explore the mechanism of BTK on bone destruction in periapical periodontitis.@*METHODS@#After RAW264.7 cells induced with 100 ng·L⁻¹ receptor activator for nuclear factor-κB ligand (RANKL) for 5 days, osteoclast induction was confirmed by light microscopy, tartrate-resistant acid phosphatase (TRAP) staining, and quantitative real-time PCR (RT-qPCR). Then, BTK-small interfering RNA (BTK-siRNA) was transfected into cells induced for 5 days. After 24 h, the expression of TRAP mRNA was measured using RT-qPCR, and the proliferation and differentiation of osteoclasts were detected using CCK-8 and TRAP activity assay. Statistical analysis was performed.@*RESULTS@#After RAW264.7 was induced with RANKL for 5 days, a large number of round, ellipse, irregularly protuberant, and TRAP-positive macrophages were observed under light microscopy. The expression of TRAP mRNA significantly reduced after 24 h of BTK-siRNA transfection (P<0.05). The detection of CCK-8 and TRAP activities showed that the proliferation and differentiation of osteoclasts significantly decreased (P<0.05).@*CONCLUSIONS@#Silencing of BTK can inhibit the proliferation and differentiation of osteoclasts. BTK can be used as a new target for the inhibition of osteoclasts.
Subject(s)
Agammaglobulinaemia Tyrosine Kinase , Cell Differentiation , Cell Proliferation , Macrophages , Osteoclasts , RANK LigandABSTRACT
Conventional imaging techniques and gastrointestinal endoscopy cannot accurately predict the early clinical efficacy of chemoradiotherapy in the treatment of esophageal cancer,whereas the functional imaging of PET-CT,MRI-DWI and radiomics can reflect the functional metabolism of the tumors prior to the morphological changes,which can compensate for the limitations of conventional diagnostic methods.In this article,the current application of imaging techniques in predicting the early response of chemoradiotherapy for esoohageal cancer was reviewed.
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Objective To evaluate the effect of surgery-radiotherapy interval (SRI) on clinical prognosis of locally advanced stage c Ⅱ-Ⅲ breast cancer patients treated with neoadjuvant chemtherapy and modified radical mastectomy.Methods Clinical data of 1 087 breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy from 11 hospitals in China were retrospectively analyzed.The optimal threshold value of SRI upon clinical prognosis was determined by maxstat method.The effect of SRI on clinical prognosis was evaluated by using multivariate Cox regression analysis and propensity score matching (PSM).Results The median follow-up time was 72.9 months.The 5-year disease-free survival (DFS) and overall survival (OS) rates were 68.1％ and 81.8％.All patients were divided into SRI ≤18 weeks (n=917) and SRI＞ 18 weeks groups (n=170).Multivariate Cox regression analysis demonstrated that hormone receptor status (P＜0.001),pathological T stage (P＜0.001),pathological N stage (P＜0.001) and SRI (P=0.023) were independent influencing factors of DFS.Hormone receptor status (P=0.013),pathological T stage (P=0.006),pathological N stage (P＜0.001),endocrine therapy (P=0.013) and SRI (P=0.001) were significantly associated with OS.After balancing the clinical and pathological factors with PSM,patients with SRI＜ 18 weeks had superior DFS and OS to those with SRI＞ 18 weeks.Conclusions SRI affects the clinical prognosis of locally advanced breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy.Radiotherapy should be performed within 18 weeks after mastectomy.
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For resectable elderly esophageal cancer,neoadjuvant chemoradiotherapy combined with surgery is still the preferred treatment under the condition of fully measuring the patient's physical function.Definitive chemoradiation is the first choice for patients with inoperable esophageal cancer,and may be a good alternative for elderly operable patients with good response to tumor regression.For older patients (＞80 years old),radiotherapy alone may be mild and conservative enough to be the preferred option.At the same time,compared with conventional radiation dose (50.4 Gy),selective regional lymph node irradiation,standard PF regimen (cisplatin + 5-fluorouracil),radiotherapy of high dose (≥60 Gy),involving field irradiation combined with single-drug chemotherapy (such as tegio) can bring better prognosis.