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1.
Arq. neuropsiquiatr ; 79(11): 943-949, Nov. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350129

ABSTRACT

ABSTRACT Background: Among patients with acute ischemic stroke with a mismatch between deficit severity and infarct volume, thrombectomy performed within a 6-24 hours time window has efficacy and safety similar to treatment within 6 hours. However, whether magnetic resonance imaging with T2 diffusion-weighted imaging (DWI) is feasible remains to be validated. Objective: To investigate prognosis among stroke patients receiving endovascular treatment (EVT) within 6 hours and 6-24 hours using non-contrasted computed tomography (NCCT) and DWI. Methods: Overall, 209 anterior-circulation ischemic stroke patients with large-vessel occlusion who underwent EVT were divided into ≤ 6 hours and 6-24 hours groups. Patients presenting symptoms within 6 hours were treated if their NIHSS score was ≥ 7 and ASPECTS score was ≥ 5, whereas those with wake-up stroke (WUS) or presenting symptoms 6-24 hours after last seen well (WUS/late-presenting stroke, LPS) were managed if their NIHSS score was ≥ 7 and ASPECTS score was ≥ 5. Results: The percentages of patients undergoing intracranial stenting and intracranial ballooning without stenting significantly differed between two groups (p < 0.001). Grades 0, 1, 2a and 2b recanalization rates did not differ between the 6 hours and 6-24 hours groups (all p > 0.05). Grade 3 recanalization rate in the 6 hours group was significantly lower than in the 6-24 hours group (p = 0.043). The 3-month Rankin Scale score did not significantly differ between the two groups (p = 0.629). Conclusions: EVT is a safe and effective treatment for patients with WUS and LPS selected through NCCT and DWI-based simple imaging.


RESUMO Antecedentes: Entre pacientes com acidente vascular cerebral isquêmico (AVCI) agudo com divergência entre gravidade do déficit e volume do infarto, a trombectomia em 6 a 24 horas tem eficácia e segurança semelhantes ao tratamento em até 6 horas. Entretanto, a viabilidade da imagem ponderada em T2 com difusão (DWI) da ressonância magnética necessita validação. Objetivo: Investigar o prognóstico de pacientes com AVCI que recebem tratamento endovascular (EVT) em até 6 horas e de 6-24 horas usando tomografia computadorizada sem contraste (NCCT) e DWI. Métodos: Duzentos e nove pacientes com AVCI de circulação anterior submetidos a EVT foram divididos em ≤ 6 horas e 6-24 horas. Pacientes com sintomas até 6 horas foram tratados se NIHSS ≥ 7 e ASPECTS ≥ 5; aqueles com AVCI ao despertar (WUS) ou com sintomas entre 6-24 horas da última vez em que foram vistos bem (WUS/AVC de fase tardia, LPS) foram tratados se NIHSS ≥ 7 e ASPECTS ≥ 5. Resultados: As porcentagens de pacientes submetidos a implante de stent intracraniano e angioplastia intracraniana sem stent diferiram entre os dois grupos (p <0,001). As taxas de recanalização 0, 1, 2a e 2b não diferiram entre 6 horas e 6-24 horas (p> 0,05). A taxa de recanalização de grau 3 no grupo 6 horas foi menor do que 6-24 horas (p = 0,043). Pontuação na Escala Rankin (3 meses) não foi diferente (p = 0,629). Conclusões: EVT é um tratamento seguro e eficaz para pacientes com WUS e LPS selecionados por meio de imagens baseadas em NCCT e DWI.


Subject(s)
Brain Ischemia , Brain Ischemia/diagnostic imaging , Stroke/therapy , Stroke/diagnostic imaging , Endovascular Procedures , Ischemic Stroke , Treatment Outcome , Thrombectomy , Diffusion Magnetic Resonance Imaging
2.
Article in Chinese | WPRIM | ID: wpr-907318

ABSTRACT

McCune-Albright syndrome is a clinical syndrome characterized by the triad of polyostotic fibrous dysplasia, precocious puberty, and café-au-lait skin macules.McCune-Albright syndrome is a rare guanine nucleotide-binding protein disease(G-protein disease), and was firstly described by Donovan McCune and Fuller Albright in 1936 and 1937.With the deepening of the understanding of this disease, more and more children have been clearly diagnosed.Early diagnosis and appropriate treatment are especially important in improving the final adult height and the quality of life.The application of bisphosphonates in the treatment of polyostotic fibrous dysplasia is currently advocated, but the long-term safety and effectiveness are not clear.There are some therapeutic strategies for precocious puberty, but the optimal one is not clear.This review elaborates on the pathogenesis, clinical manifestations, diagnosis and treatment of McCune-Albright syndrome, especially the treatment of polyostotic fibrous dysplasia and precocious puberty.

3.
Article in Chinese | WPRIM | ID: wpr-906050

ABSTRACT

Objective:To explore the effects of Xintongtai (XTT) on traditional Chinese medicine (TCM) syndrome score and collagen fibers in vascular smooth muscle cells(VSMCs) of rabbits with atherosclerosis in the regulation of p38 mitogen-activated protein kinase (p38 MAPK)/activator protien-1 (AP-1)signaling pathway. Method:A total of 120 rabbits of SPF grade were randomly divided into the sham operation group, combined phlegm and blood stasis model group, rosuvastatin group, and low-, middle-, and high-dose XTT groups. The rabbit model of atherosclerosis due to combined phlegm and blood stasis was established by exposing them to high-fat diet and balloon injury. Following modeling, the corresponding drugs were administered by gavage for eight weeks (2.3, 4.6, 9.2 g·kg<sup>-1</sup> for low-, middle-, and high-dose XTT groups and 0.55 mg·kg<sup>-1 </sup>for rosuvastatin group). At the end of medication, the abdominal aorta was isolated and stained with htoxylin-eosin (HE) for observing the vulnerable plaque. Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were detected by immunohistochemistry (IHC). The collagen fiber decomposition in VSMCs was observed after Masson staining. The protein expression levels of p38 MAPK and AP-1 in aorta was assayed by Western blotting. The combined phlegm and blood stasis syndrome was scored based on TCM syndrome scoring scale. Result:Compared with the model group, XTT at each dose and rosuvastatin significantly decreased MMP-9 content, increased TIMP-1, down-regulated p38 MAPK protein expression, and weakened the nuclear translocation of AP-1 (<italic>P</italic><0.01). Compared with the low-dose XTT group, the middle- and high-dose XTT groups and rosuvastatin group exhibited obviously lowered MMP-9,elevated TIMP-1, down-regulated p38 MAPK protein expression, and diminished AP-1 nuclear translocation (<italic>P</italic><0.05,<italic>P</italic><0.01). The TCM syndrome scores of the middle- and high-dose XTT groups and rosuvastatin group were significantly improved as compared with that in the model group (<italic>P</italic><0.05,<italic>P</italic><0.01). The comparison with the low-dose XTT group revealed a remarkable improvement in TCM syndrome score of the middle- and high-dose XTT groups and rosuvastatin group (<italic>P</italic><0.01). As demonstrated by Masson staining, the smooth muscle fibers in the model group were arranged in disorder, accompanied by enhanced collagen decomposition, thinned fibrous cap, and increased plaque vulnerability. Compared with the model group, the VSMCs in each XTT group and rosuvastatin group were orderly arranged, manifested as decreased collagen fiber decomposition and increased plaque stability. Conclusion:XTT down-regulates the expression of p38 MAPK and MMP-9, increases the level of TIMP-1, reduces the nuclear translocation of AP-1, diminishes the decomposition of collagen fibers in VSMCs, and improves the score of combined phlegm and blood stasis syndrome. XTT alleviates arteriosclerosis due to combined phlegm and blood stasis by regulating p38 MAPK/AP-1 signaling pathway and downstream cytokines and stabilizing vulnerable plaques.

4.
Article in Chinese | WPRIM | ID: wpr-905913

ABSTRACT

Objective:To explore the effective components, targets, and possible mechanisms of Wenshen Yangxue prescription in improving endometrial receptivity of aged female mice based on network pharmacology and experimental verification. Method:Based on Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine (BATMAN-TCM) and Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine, the components and targets of Wenshen Yangxue prescription were retrieved, and the targets of ovulatory dysfunctional infertility were collected from the Online Mendelian Inheritance in Man (OMIM) and GeneCards with "anovulatory sterility" and "anovulatory infertility" as keywords. The protein-protein interaction (PPI) network was constructed based on STRING and the core targets of Wenshen Yangxue prescription against ovulatory dysfunctional infertility were screened by Cytoscape, followed by Gene Ontology (GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment of the core targets in DAVID database. Then, the "medicinal-component-target-pathway" network was established and the core targets were verified by animal experiment. Result:A total of 253 components and 326 targets of Wenshen Yangxue prescription, 819 disease targets, and 74 common targets were screened out. The common targets were mainly involved in the biological processes such as positive regulation of nitric oxide biosynthetic process, positive regulation of cell proliferation, response to estradiol, aging, response to oxidative stress, and angiogenesis. The GO term of response to oxidative stress and five of the top 20 KEGG pathways were analyzed. According to the "medicinal-component-target-biological process/pathway" network, 41 chemical components in 20 medicinals participated in hypoxia inducible factor-1 (HIF-1) signaling pathway, tumor necrosis factor (TNF) signaling pathway, forkhead box O (FOXO) signaling pathway, Toll-like receptor (TLR) signal pathway, and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway by affecting 35 targets. The results of animal experiment showed that the prescription could increase the expression of PI3K, phosphorylated PI3K (p-PI3K), Akt, phosphorylated Akt (p-Akt), forkhead box O3A (FoxO3A), and phosphorylated FoxO3A (p-FoxO3A) in uterus of aged female ICR mice. Conclusion:Wenshen Yangxue prescription interferes with oxidative stress and PI3K/Akt/FoxO3A signaling pathway by influencing Akt1, dual oxidase 2 (DUOX2), epidermal growth factor receptor (EGFR), heme oxygenase-1 (HMOX1), myeloperoxidase (MPO), and other targets, thereby improving endometrial receptivity of aged female mice.

5.
Article in English | WPRIM | ID: wpr-922407

ABSTRACT

OBJECTIVES@#To study the effect of high-fat diet for maternal Sprague-Dawley rats at different stages on glucose and lipid metabolism in offspring and related mechanisms.@*METHODS@#According to the diet before pregnancy and during pregnancy and lactation, maternal rats were randomly divided into four groups (@*RESULTS@#Compared with the control diet groups (CC and CH groups), the groups with high-fat diet before pregnancy (HC and HH groups) had a significant increase in body weight (@*CONCLUSIONS@#High-fat diet for rats at different stages before and after pregnancy has different effects on glucose and lipid metabolism of offspring rats, and high-fat diet before pregnancy and during pregnancy and lactation has the greatest effect. The effect of high-fat diet on glucose and lipid metabolism of offspring rats is considered associated with the changes in the expression of genes involved in glucose and lipid metabolism.


Subject(s)
Animals , Body Weight , Diet, High-Fat/adverse effects , Female , Glucose/metabolism , Insulin , Insulin Resistance , Lipid Metabolism , Liver/metabolism , Male , Pregnancy , Rats , Rats, Sprague-Dawley
6.
Article in Chinese | WPRIM | ID: wpr-921553

ABSTRACT

Objective To investigate the suitable services of telemedicine at present and the future from the perspective of medical service supplier,clarify the challenges in the development of telemedicine services at present,and provide evidence-based suggestions for improving the quality of telemedicine services. Methods A questionnaire was developed through literature review for the survey of telemedicine services from the perspective of service providers.From January to June in 2020,electronic questionnaires were collected from volunteers.The data were collated and analyzed by Excel 2010 and SPSS 21.0. Results A total of 614 questionnaires were distributed,and 582 effective questionnaires were collected,which showed an effective rate of 94.79%.The participants of this study were mainly young healthcare workers,including doctors,nurses,technicians,and medical students.Among them,68.73% expressed concern to telemedicine services-related work,and more than 50% only had a basic understanding of the related work.The top five developable telemedicine/healthcare services were health management,online consultation,disease re-examination,disease screening,and difficult disease consultation,which were basically consistent with the services suitable for future development. Conclusions Healthcare workers have a high degree of recognition to the development of telemedicine services,while their understanding of the related technologies remains to be improved.The available telemedicine services focus on online consultation,difficult disease consultation,and disease re-examination,while the complicated medical services need to be improved.In the future,efforts should be made to continuously improve the information construction level and narrow the regional gap of medical services,so as to promote the continuous improvement and the coordinated development of medical services between regions.


Subject(s)
Hospitals , Humans , Internet , Referral and Consultation , Surveys and Questionnaires , Telemedicine
7.
Singapore medical journal ; : 642-646, 2021.
Article in English | WPRIM | ID: wpr-920933

ABSTRACT

INTRODUCTION@#This study aimed to investigate the trend and seasonality of infection due to respiratory syncytial virus (RSV) at KK Women's and Children's Hospital (KKH) in Singapore and to examine the risk factors for mortality among children with RSV infection requiring admission to the paediatric intensive care unit (PICU).@*METHODS@#A retrospective study was conducted at KKH on children with RSV infections who were admitted to the PICU between January 2004 and December 2010. The medical records of children who died from RSV infections were reviewed. Linear regression was performed to determine the risk factors for RSV mortality.@*RESULTS@#RSV infection was documented in 5,785 children during the study period; the infection was noted to be occurring throughout the year, with a small increase in prevalence between the months of June and August every year. Among 85 (1.5%) out of 5,785 children who were admitted to the PICU for RSV infection, 74 (1.3%) survived and 11 (0.2%) died. Multivariate logistic regression analysis showed that haemodynamically significant cardiac disease (odds ratio [OR] 12.2, 95% confidence interval [CI] 0.9-16.7, p = 0.05), immunodeficiency (OR 71.4, 95% CI 8.2-500, p < 0.001) and metabolic disease (OR 71.4, 95% CI 4.3-1,000, p = 0.003) were independent risk factors for mortality in RSV infections. Prematurity increased the risk of admission to the PICU but was not significantly associated with mortality.@*CONCLUSION@#Children with haemodynamically significant cardiac disease, immunodeficiency and metabolic disease were at higher risk of death after hospitalisation for RSV-related illnesses. These children should be considered for palivizumab prophylaxis.

8.
Article in Chinese | WPRIM | ID: wpr-886756

ABSTRACT

Objective To establish a multiplex nucleic acid assay for rapid detection of Echinococcus multilocularis, E. granulosus and E. shiquicus based on the recombinase-aided isothermal amplification assay (RAA) and to preliminarily assess its diagnostic efficiency. Methods The mitochondrial genomic sequences of E. multilocularis (GenBank accession number: NC_000928), E. granulosus (GenBank accession number: NC_044548) and E. shiquicus (GenBank accession number: NC_009460) were used as target sequences, and three pairs of primers were designed based on the RAA primer design principle and synthesized for the subsequent multiple RAA amplification. The genomic DNA of E. multilocularis, E. granulosus and E. shiquicus at different concentrations and the recombinant plasmids containing the target gene at various concentrations were amplified to evaluate the diagnostic sensitivity of the multiplex RAA assay, and the genomic DNA of E. multilocularis, E. granulosus, E. shiquicus, Taenia multiceps, T. saginata, T. asiatica, Dipylidium caninum, T. hydatigena, Toxocara canis, Fasciola hepatica, T. pisiformis, Mesocestoides lineatus and Cryptosporidiumn canis was detected using the multiplex RAA assay to evaluate its specificity. In addition, the reaction condition of the multiplex RAA assay was optimized, and was then employed to detect the tissues with echinococcosis lesions, simulated canine fecal samples and field captured fox fecal samples to examine its application values. Results The multiplex RAA assay was effective to specifically amplify the mitochondrial gene fragments of E. multilocularis, E. granulosus and E. shiquicus within 40 min at 39 °C, with sequence lengths of 540, 430 bp and 200 bp, respectively. This multiplex RAA assay showed the minimum detection limits of 2.0, 2.5 pg/μL and 3.1 pg/μL for detection of the genomic DNA of E. multilocularis, E. granulosus and E. shiquicus, and presented the minimum detection limit of 200 copies/μL for detection of the recombinant plasmids containing E. multilocularis, E. granulosus and E. shiquicus target genes. This multiplex RAA assay was effective to simultaneously detect single and multiple infections with E. multilocularis, E. granulosus and E. shiquicus, but failed to amplify the genomic DNA of T. multiceps, T. saginata, T. asiatica, D. caninum, T. hydatigena, T. canis, F. hepatica, T. pisiformis, M. lineatus and C. canis. In addition, the optimized multiplex RAA assay was effective to detect all positive samples from the tissue samples with echinococcosis lesions, simulated canine fecal samples and field captured fox fecal samples, which was fully consistent with the detection of the single PCR assay. Conclusion A sensitive and specific multiplex nucleic acid assay for rapid detection of E. multilocularis, E. granulosus and E. shiquicus has been successfully established.

9.
Article in Chinese | WPRIM | ID: wpr-880152

ABSTRACT

OBJECTIVE@#To summarize and compare the clinical baseline characteristics of patients with monoclonal gammopathy of undetermined significance (MGUS), primary light chain amyloidosis (pAL), multiple myeloma (MM), or MM with concurrent amyloidosis, especially the differences in cytogenetic abnormalities.@*METHODS@#The clinical data of 15 cases of MGUS, 34 cases of pAL, 842 cases of MM and 23 cases of MM with concurrent amyloidosis were analyzed and compared retrospectively.@*RESULTS@#Cytogenetic statistics showed that the incidence of t (11; 14) in the four groups (MGUS vs pAL vs MM vs MM with concurrent amyloidosis) was 0%, 33.3%, 16.4%, and 15.8%, respectively (P=0.037); that of 13q deletion was 20.0%, 14.7%, 45.8% and 56.5%, respectively (P<0.001); gain of 1q21 was 50.0%, 12.5%, 47.4% and 40.9%, respectively (P=0.001). Proportion of pAL patients with 0, 1 and≥2 cytogenetic abnormalities (including 13q deletion, 17p deletion, 1q21 amplification and IgH translocation) accounted for 41.9%, 41.9% and 16.1%, respectively; while the proportion of the same category in MM was 17.6%, 27.3%, and 55.2% respectively; this ratio of MM with concurrent amyloidosis was more similar to MM. Subgroup analysis showed that genetic abnormalities (including 13q deletion, 17p deletion and 1q21 amplification) were comparable within t (11; 14) negative and positive groups. Compared with positive cases, t(11; 14) negative patients with MM or MGUS were more likely to have 13q deletions and multiple genetic abnormalities.@*CONCLUSION@#Clinical characteristics of pAL, especially cytogenetic abnormalities, are significantly different from MM with concurrent amyloidosis. It suggests that although the onset characteristics are similar, actually the two diseases belong to different disease subtypes which should be carefully predicted and identified.


Subject(s)
Amyloidosis , Humans , In Situ Hybridization, Fluorescence , Monoclonal Gammopathy of Undetermined Significance/complications , Multiple Myeloma , Retrospective Studies
10.
China Pharmacy ; (12): 284-288, 2021.
Article in Chinese | WPRIM | ID: wpr-872678

ABSTRACT

OBJECTIVE:To ex plore the improvement effects of small-molecule glucagon-like peptide- 1 receptor(GLP-1R) agonists(6,7-dichloro-2-methylsulfonyl-3-N-tert-butylaminoquinoxaline,DMB)on osteoporosis model mice. METHODS :C57BL/ 6J mice were randomly divided into sham operation group ,model group ,positive control group (17β-estradiol,10 μg/kg)and DMB group (1 mg/kg),with 10 mice in each group. The sham operation group received bilateral laparotomy without ovariectomy , and the other groups received bilateral ovariectomy to reproduce the osteoporosis model. At 4th week after operation ,sham operation group and model group were given constant volume of florence oil intragastrically ;administration groups were given relevant medicine intragastrically ,once a day ,for consecutive 8 weeks. After last medication ,Micro-CT was used to detect the femur microstructure ,bone mineral density (BMD),bone mineral content (BMC)and bone morphometric parameters [bone tissue volume fraction (BV/TV),trabecular thickness (Tb.Th),trabecular number (TB.N)and trabecular spacing (Tb.Sp)]. ELISA assay was used to detect the expression of bone formation indexes [bone specific alkaline phosphatase (BALP),osteoprotegerin(OPG)] and bone resorption indexes [tartrate resistant acid phosphatase (TRAP)and C-terminal cross-linked peptide of type Ⅰ collagen (CTX-Ⅰ)]. Three-point bending test was used to detect biomechanical parameters (maximum load ,stiffness,stress and Young ’s modulus)of femur of mice in each group. RESULTS :In sham operation group ,trabeculae were numerous ,thick,complete in morphological structure ,well-organized and reticular ;bone Δ 基金项目:国家自然科学基金资助项目(No.81402931);陕西省 重点研发计划项目(No.2017SF-261);西安医学院 2016年博士科研启 microstructure and bone mass were normal. Compared with 动基金项目(No.2016DOC27) sham operation group , the number of trabecular bone *讲师,博士。研究方向 :分子药理学 。E-mail:zhouying209@ decreased,the thickness became thinner ,twisted or broken , 163.com and the trabecular space increased ;the bone microstructure ·284· China Pharmacy 2021Vol. 32 No. 3 中国药房 2021年第32卷第3期 deteriorated and the bone m ass decreased ;BMD,BMC,BV/TV,Tb.Th,Tb.N and biomechanical parameters of femur were decreased significantly ,while Tb.Sp and serum levels of BLAP ,OPG,TRAP and CTX- Ⅰ were increased significantly (P<0.05 or P<0.01). Compared with model group ,the bone mass of positive control group and DMB group were increased ,while the number,thickness and shape of trabecular bone partially recovered ;BMD,BMC,BV/TV,Tb.Th,Tb.N and biomechanical parameters of femur were increased significantly (P<0.05 or P<0.01);Tb.Sp,serum levels of BLAP and OPG were increased significantly (P<0.01), while the levels of TRAP and CTX- Ⅰ were decreased significantly (P<0.05 or P<0.01). CONCLUSIONS:DMB can improve osteoporosis by increasing bone mass ,improving bone microstructure ,increasing the expression of bone formation related indexes and biomechanical parameters and decreasing bone resorption related indexes.

11.
Article in English | WPRIM | ID: wpr-888656

ABSTRACT

OBJECTIVE@#To study the effect and mechanism of Huayu Wan (, HYW) in combination of chemotherapy of tumor treatment.@*METHODS@#HYW serum was added in Lewis cells to assess its impact on fluorescent doxorubicin delivery in vitro. Then, Lewis tumor cells was implanted in C57BL/6 mice via xenograft transplantation. Tumor growth was measured and signal intensity corresponding to blood flow was assessed by laser doppler perfusion imaging (LDPI). Finally, the effect of HYW on the effificacy of doxorubicin was studied.@*RESULTS@#HYW can improve the transfer of fluorescent doxorubicin into cells. The blood flow signal in the tumor tissues of the HYW group was higher than that of the control group (P<0.01). Furthermore, HYW improved drug delivery of doxorubicin to tumor tissues, and this activity was associated with HYW-induced microvascular proliferation (P<0.01).@*CONCLUSIONS@#HYW can promote microangiogenesis and increase blood supply in tumor tissues, which in turn may increase the risk of metastasis. At the same time, HYW increases drug delivery and improves the effificacy of chemotherapy drugs through vascular proliferation. Therefore, rational judgment must be exercised when considering applying HYW to an antitumor regimen.

12.
Article in Chinese | WPRIM | ID: wpr-828254

ABSTRACT

OBJECTIVE@#To explore the clinical effects of convolution method in treating displaced midshaft clavicle fracture.@*METHODS@#From January 2018 to July 2019, 32 patients (21 males and 11 females) with displaced midshaft clavicle fracture were treated, ranging in age from 18 to 65 years old, with a median age of 41.5 years old. Nineteen patients had fractures on the left side and 13 patients had fractures on the right side. The duration from injury to treatment ranged from 30 minutes to 5 days. The patients were treated with convolution method and repeated push and rotation of the affected upper limb, followed by external fixation of clavicle band. The reduction and healing of the fracture and the functional recovery of shoulder joint were observed.@*RESULTS@#After operation, fracture reduction was evaluated by X ray film. Seven patients had an excellent result, 20 good and 5 fair. All the patients were followed up, and the duration ranged from 14 to 18 weeks. The mean Neer score was 89.75±6.88, which included pain score of 32.66±2.54, functional score of 26.44±2.91, range of motion score of 22.38±2.06, and anatomy score of 8.43±0.84;17 patients receive an excellent result, 14 good and 1 fair.@*CONCLUSION@#The rotation method combined with the repeated pushing and rotating of the upper limb of the affected side can well reduce the displaced fracture of the middle clavicle. Bandage and clavicle band can be performed after reduction. Functional exercise runs through the whole course of treatment. Functional recovery of shoulder joint is good and satisfactory therapeutic effect is achieved.


Subject(s)
Adolescent , Adult , Aged , Bone Plates , Clavicle , Female , Fracture Fixation , Fracture Fixation, Internal , Fracture Healing , Fractures, Bone , Humans , Male , Middle Aged , Shoulder Joint , Treatment Outcome , Young Adult
13.
Article in Chinese | WPRIM | ID: wpr-827959

ABSTRACT

In this paper, we analyzed medical records of 40 patients with coronavirus disease 2019(COVID-19), in order to explore the clinical efficacy of Matrine and Sodium Chloride Injection in the treatment of COVID-19. The investigation was based on the results of a previous animal test, which was aimed to investigate and confirme the clinical efficacy of Matrine and Sodium Chloride Injection in the treatment of COVID-19. The animal test demonstrated that Matrine and Sodium Chloride Injection has a significant therapeutic effect on the human coronavirus pneumonia for the model mice. The lung inhibition index reached up to 86.86%. The evaluation was conducted on 40 confirmed cases of COVID-19 treated at Jingzhou Hospital of Infectious Disease(Chest Hospital) of Hubei Pro-vince from January 30~(th) to March 21~(th), 2020. In these cases, patients were treated with other integrated Chinese and Western medicines regimens in the recommended Matrine and Sodium Chloride Injection diagnosis and treatment regimen. The clinical manifestations, laboratory data, nucleic acid clearance time, and imaging data were compared and analyzed before and after treatment. After administration with Matrine and Sodium Chloride Injection, the clinical symptoms of 40 cases were alleviated markedly, and their blood analysis and biochemical indexes returned to normal. The lung CT showed more than 50% of lesion absorption rate, and the viral nucleic acid test showed the average clearance time of patients was 16.6 days, and the average length of hospital stay was 25.9 days. After administration with Matrine and Sodium Chloride Injection, the symptoms of cough and fatigue were alleviated significantly, and the appetite was significantly improved compared with before, especially for patients with gastrointestinal symptoms. Additionally, laboratory indicators, especially absolute value and ratio of lymphocytes and CRP were significantly alleviated. According to the chest CT for short-term review, the absorption of lung lesions was faster than before, especially for grid-like and fibrotic lesions. Compared with antiviral drugs, such as Abidol and Kriging, the nucleic acid clearance time was significantly shorter than the cases treated with Matrine and Sodium Chloride Injection. The clinical effective rate of 40 cases was 100.0%. We believed that Matrine and Sodium Chloride Injection have a good clinical effect in the treatment of COVID-19, and suggested increasing the clinical application and further conducting large-sample-size cli-nical verification.


Subject(s)
Alkaloids , Animals , Betacoronavirus , Coronavirus Infections , Disease Models, Animal , Mice , Pandemics , Pneumonia, Viral , Quinolizines , Sodium Chloride , Treatment Outcome
14.
Article in Chinese | WPRIM | ID: wpr-827177

ABSTRACT

OBJECTIVE@#To study the clinical effects of preoperative autologous blood donation (PABD) in selective general surgery.@*METHODS@#Paired study was performed in PABD group with 70 PABD cases screened from selective general surgery during the period from November 2017 to August 2018 in our hospital, and the control group included 70 cases without preoperative autologous blood donation, the baseline data before surgery were not significantly different. The transfusion quantities of allogeneic RBC and plasma, the levels of perioperative hemoglobin and platelets, the time and expense of hospitalization were compared between two groups.@*RESULTS@#The levels of Hb and Plt in PABD group before and after blood collection were determined as follows: 138.26±14.73 g/L vs 127.52±13.36 g/L (P<0.05) and (221.67±52.86)×10/L vs (198.35±52.65)×10/L (P>0.05) respectively. The analysis of allo-RBC and allo-plasma transfusion in PABD group and control group showed that: the quantity of allogeneic RBC transfusion was 0.20±0.71 U and 0.89±0.97 U, and the quantity of allogeneic plasma transfusion was 30.43±100.81 ml and 106.52±152.61 ml (P<0.05) respectirdy during perioperation. The comparison results of preoperative Hb and plt in PABD group and control group were 135.65±14.16 g/L vs 134.15±11.98 g/L and (270.36±58.28)×10/L vs (271.67±65.02) ×10/L respectively. The levels of postoperative Hb and plt in PABD group and control group were 120.24±14.40 g/L vs 121.20±14.30 g/L at 1 d after operation, and (241.80±63.58)×10/L vs (241.30±69.11)×10/L at 1 d after operation respectively; 123.15±13.80 g/L vs 121.65±14.33 g/L at 3 d after operation and (251.26±72.94)×10/L vs (255.54±73.85)×10/L at 3 d after operation; 122.78±13.92 g/L and 122.00±13.82 g/L (before discharge) and (262.50±80.96)×10/L and (264.56±71.08)×10/L (before discharge, platelet). These data were not statistically different (P>0.05). The hospitalization time was 14.84±3.37 days and 14.84±2.24 days, respectively, without statistical difference (P>0.05) in two groups. The expenses of hospitalization and the blood transfusion in two groups were 50627.27±9889.45 RMB and 50979.43±8195.00 RMB; 354.39±362.57 RMB and 684.02±425.53 RMB (P<0.05).@*CONCLUSION@#The application of PABD reduces the use of allogeneic blood and costs for patients undergoing selective surgery with blood losts of 1000 ml.


Subject(s)
Blood Component Transfusion , Blood Donors , Blood Transfusion , Blood Transfusion, Autologous , Humans , Plasma
15.
Article in Chinese | WPRIM | ID: wpr-826330

ABSTRACT

Telemedicine is one of the five key components of the "Internet Plus Healthcare".Due to its high speed,real-timeness,low cost,and wide spread,telemedicine is highly feasible in the prevention and control of major infectious diseases.This article introduces the practiceof telemedicine in Peking Union Medical College Hospital during the cornavirus disease 2019(COVID-19)epidemic,during which the network resources were applied to break geographical restrictions and resolve communication barriers between hospitals and departments.This article summarizes the telemedicine application before,during and after COVID-19 control and elucidates how to build a telemedicine prevention and control system for infectious diseases,with an attempt to further improve telemedicine and is application in the public health emergency system in China.


Subject(s)
Betacoronavirus , Coronavirus Infections , Drug Therapy , Humans , Pandemics , Pneumonia, Viral , Drug Therapy , Telemedicine
16.
Article in Chinese | WPRIM | ID: wpr-873196

ABSTRACT

Objective:To observe the effect of Zikun decoction (ZKD) in treatment of Yin deficiency and blood dryness in delayed menorrhea due to decreasing ovarian reservation.Method:A total of 60 cases were randomly divided into two groups.The observation group was given ZKD orally,and the control group was treated with complex packing estradiol tablets/estradiol and dydrogestero for three months.The control group began to take medicine on the first day of menstruation for 28 days, while the observation group began to take medicine on the fifth day of menstruation, and stopped taking medicine on the first day of the next menstruation. Three menstrual cycles were followed up. The clinical syndrome scores, follicle-stimulating hormone (FSH), luteinizing hormone (LH), inhibin B (INHB), FSH/LH, Estradiol (E2), anti-müllerian hormone (AMH), and antral follicle count (AFC) scores of the patients before and after treatment were compared.Result:After treatment, there was no significant difference in clinical efficiency between observation group and control group, but the traditional Chinese medicine syndrome score of observation group was significantly reduced (P<0.05), observation group and control group had the same curative effect in improvement of FSH, FSH/LH, AMH and AFC (P<0.05), but ZKD was better than complex packing estradiol tablets/estradiol and dydrogestero in improvement of INHB.Conclusion:ZKD has a good treatment effect in the treatment of DOR. It can effectively improve patients' sex hormone levels, increase antral follicle count, improve the ovarian reserve function and promote menstruation.

17.
Asian Journal of Andrology ; (6): 602-607, 2020.
Article in English | WPRIM | ID: wpr-879693

ABSTRACT

The aims of this study were to determine the prognostic value of primary tumor surgery and identify optimal candidates for such surgery among patients with seminoma and distant metastasis at diagnosis. We identified 521 patients with seminoma and distant metastasis at diagnosis between 2004 and 2014 from the Surveillance, Epidemiology, and End Results database. Among these patients, 434 had undergone surgery, whereas 87 had not. The prognostic value of primary tumor surgery was assessed by Kaplan-Meier methods, log-rank analyses, and multivariate Cox's proportional hazards model. Survival curves and forest plots were also plotted. Survival analysis indicated that patients who underwent surgery had a better 5-year overall survival and cancer-specific survival than those who did not. Multivariate analyses demonstrated that primary tumor surgery is an independent prognostic factor for overall survival and cancer-specific survival, along with age at diagnosis, M stage, and marital status. In addition, primary tumor surgery still had considerable prognostic value in the subgroup of patients with lymph node metastasis. Further, forest plots demonstrated that patients with M1a stage, N1 or N2-3 stage, and a younger age at diagnosis (<60 years) may benefit from primary tumor surgery. In conclusion, our findings indicate that primary tumor surgery is correlated with improved survival in patients with seminoma and distant metastasis. Furthermore, primary tumor surgery is an independent prognostic indicator for patients with seminoma and distant metastasis.

18.
Article in Chinese | WPRIM | ID: wpr-771861

ABSTRACT

OBJECTIVE@#To explore the the effects of 2-Me, DTT, papain, pineapple protease and ZZAP on the antigenicity of JMH antigen of human red blood cells (RBC) surface.@*METHODS@#Firstly, human RBC were treated with 2-Me, DTT, pineapple protease, papain and ZZAP reagents, respectively. The antigenicity of JMH antigen on human RBC surface was detected and analyzed by flow cytometry.@*RESULTS@#Flow cytometric analysis found that compared with level before treatment, the antigenicity of JMH antigen on RBC surface was significantly reduced after 2-Me treatment, the positive rate of JMH antigen: 69.5%±4.5% vs 56.5%±3.4% (t=12.44, P<0.01); fluorescence intensity: 4906±317 vs 3003±165 (t=11.84, P<0.01). The antigenicity of JMH antigen on RBC surface significantly increased after DTT treatment, showing the positive rate of JMH antigen: 61.7%±3.8% vs 75.5±4.9% (t=16.57, P<0.01), fluorescence intensity: 4044±294 vs 4854±319 (t=15.46, P<0.01). However, both bromelain and papain could significantly reduce the antigenicity of JMH antigen on the RBC surface, Bromelain: the positive rate of JMH antigen: 62.2%±3.8% vs 8.8%±1.2% (t=26.44, P<0.01), fluorescence intensity: 4263±273 vs 1444±212 (t=19.27, P<0.01); Papain: the positive rate of JMH antigen: 62.8%±3.6% vs 8.8%±1.5% (t=21.38, P<0.01), fluorescence intensity: 4389±284 vs 1458±230 (t=17.49, P<0.01). The flow cytometric analysis revealed that ZZAP treatment significantly reduced the antigenicity of JMH antigen on the RBC surface, the positive rate of JMH antigen: 62.2%±4.4% vs 48.2%±4.1% (t=14.87, P<0.01), fluorescence intensity: 4106±263 vs 2063±175 (t=17.49, P<0.01).@*CONCLUSION@#The treatment with 2-Me can reduce the antigenicity of JMH antigen on human RBC surface. The antigenicity of JMH antigen on human RBC surface increased after DTT treatment. The antigenicity of JMH antigen on human RBC surface significantly reduces after the treatment with pineapple protease or papain. ZZAP treatment can reduce the antigenicity of JMH antigen on the RBC surface.


Subject(s)
Blood Group Antigens , Erythrocytes , Flow Cytometry , Humans , Rh-Hr Blood-Group System
19.
Chinese Medical Journal ; (24): 2698-2704, 2019.
Article in English | WPRIM | ID: wpr-803228

ABSTRACT

Background@#Organ preservation has long been a consideration in the treatment of supraglottic and hypopharyngeal carcinoma to improve the quality of life (QOL). Definitive radiotherapy (DRT) with or without systematic treatment, such as chemotherapy, is always the first choice to achieve improved QOL. This retrospective study focused on the survival differences between DRT and surgery followed by adjuvant radiotherapy (S + RT) in supraglottic and hypopharyngeal carcinoma.@*Methods@#This study included adult patients with supraglottic or hypopharyngeal carcinoma undergoing single-modality treatment with either DRT or S + RT between January 2012 and August 2016. A total of 59 patients were identified, of whom 31 were treated with DRT, and 28 were treated with S + RT. In the 31 cases of DRT, 23 cases were treated with concurrent chemoradiotherapy (CRT), one case was treated with DRT plus cetuximab, and seven cases were treated with DRT alone. Of the other 28 cases of S + RT, 15 cases were treated with adjuvant concurrent CRT. Survival analysis was used to compare the overall survival (OS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) between DRT and S + RT groups.@*Results@#The median follow-up was 20 months (range, 4-67 months). The patients of the two groups were similar with respect to mean age, original sites, and tumor stages. The 1-, 2-, and 5-year OS rates were 80.6%, 53.4%, and 24.7% for the DRT group and 85.7%, 67.1%, and 24.7% for the S + RT group, respectively. There was no significant difference between the two groups (χ2 = 3.183, P = 0.074). The 1-, 2-, and 5-year LRFS and DMFS were 90.4%, 61.7%, and 18.0% and 87.4%, 49.2%, and 9.9%, respectively, and no statistical difference was observed between the two groups (LRFS: χ2 = 0.028, P = 0.868; DMFS: χ2 = 3.347, P = 0.067). No significant difference was found between the two groups in acute radiotoxicity.@*Conclusions@#Without loss of laryngeal function, the survival of DRT is comparable to that of S + RT in supraglottic and hypopharyngeal carcinoma.

20.
Article in Chinese | WPRIM | ID: wpr-802233

ABSTRACT

Objective: To explore the protective effect of formula of Gougancai decoction (FGD) on acute liver injury induced by carbon tetrachloride (CCl4) in rats, in order to provide basis for the development of pharmaceutical preparations or healthcare products. Method: Sixty rats were randomly divided into normal group, Silymarin group (120 mg·kg-1) and FGD groups (475, 950, 1 900 mg·kg-1). The normal group and the model group were given equal volume of saline by gavage, while the other groups were administered with the corresponding dose of drugs according to the body weight. After 10 days, the acute liver injury model was established with 12% carbon tetrachloride peanut oil solution (5 mL·kg-1), except the normal group. All of the rats were put to death to collect serum and liver tissues. The contents of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bilirubin (TBIL), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were detected by biochemical methods, the levels of tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in liver tissues were determined by enzyme-linked immunosorbnent assay(ELISA). Nuclear factor-κB (NF-κB) and peroxisome proliferator-activated receptor-γ (PPAR-γ) protein expression in liver tissues were detected by Western blot, and htoxylin eosin (HE) staining was used to observe the variation of liver histopathological. Result: Compared with the normal group, the serum activities of AST, ALT, ALP and the content of TBIL, MDA in the model group were significantly increased (Pα, IL-1β, IL-6 in liver tissue were remarkably increased (PPκB was enhanced in liver tissue (Pγ was down-regulated (PPPα, IL-1β, IL-6 (PPκB (PPγ (PPConclusion: FGD has a protective effect on CCl4-induced acute liver injury in rats, and its mechanism may be related to the activation of PPAR-γ and the inhibition of NF-κB signaling pathway, with anti-inflammatory and anti-oxidative effects.

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