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Objective:To investigate the incidence of thyroid dysfunction in patients with chronic kidney disease and analyze the influencing factors.Methods:One hundred and ninety-eight patients with chronic kidney disease who were treated in Chronic Disease Management Department of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from Apr. 2021 to Apr. 2022 were selected, including 71 patients with abnormal thyroid function and 127 patients with normal thyroid function. The differences in TT3, FT3, TT4, FT4, and TSH between patients with abnormal thyroid function and those with normal thyroid function were analyzed. At the same time, the abnormal thyroid function of patients with different clinical characteristics and the influencing factors were analyzed. The intergroup differences were analyzed using t-test or χ2-test, and the influencing factors were analyzed using logistic regression analysis. Results:In one hundred and ninety-eight patients with chronic kidney disease, thyroid function abnormality occurred in 71 patients (35.86%), including two or more abnormal thyroid function indicators in 35 patients (49.30%). The total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4) and free thyroxine (FT4) in patients with abnormal thyroid function were (1.02 ± 0.29) nmol/mL, (3.03 ± 0.88) pmol/L, (77.93 ± 20.02) nmol/mL and (11.02 ± 1.95) pmol/L respectively, which was significantly lower in patients with normal thyroid function (1.32±0.25) nmol/mL, (4.20±0.92) pmol/L, (93.30±19.28) nmol/mL and (13.54±1.82) pmol/ ( P<0.05), while thyroid stimulating hormone (TSH) was (3.14 ± 0.96) mIU/L, which was significantly higher than that in patients with normal thyroid function (1.84±0.89) mIU/L ( P<0.05). The incidence of thyroid dysfunction in female patients was 50.59% (43/85), It was significantly higher than 24.78% (28/113) of male patients (P <0.05) ; The incidence of thyroid dysfunction in patients aged 60 years was 49.55% (55/111), It was significantly higher than 18.39% (16/87) of the patients aged <60 years ( P<0.05) ; The incidence of thyroid dysfunction in patients with 1-year duration of disease was 71.43% (30/42), It was significantly higher than 25.28% (41/156) of patients with a course of disease <1 year ( P<0.05) ; The incidence of thyroid dysfunction in patients with clinical stage G 4 to 5 was 50.62% (41/81), It was significantly higher than 25.64% (30/117) of patients in G1~3 stages ( P<0.05) ; The incidence of thyroid dysfunction in patients with diabetes was 74.36% (29/39), This was significantly higher than 26.42% (42/159) in patients without diabetes mellitus ( P<0.05). Logistic regression analysis showed that gender, age, course of disease and clinical stage were the influencing factors of thyroid dysfunction in patients with chronic kidney disease ( P<0.05) . Conclusion:A high proportion of patients with chronic kidney disease have abnormal thyroid function, which is affected by the patient's sex, age, course of disease and clinical stage,clinical attention should be paid to targeted intervention to prevent the incidence of thyroid dysfunction in chronic kidney disease population.
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BACKGROUND:Acupotomy is an effective method for the clinical treatment of osteoarthritis,with affirmed clinical outcomes,but the specific mechanisms remain unclear OBJECTIVE:To investigate the role of acupotomy in modulating chondrocyte autophagy to promote chondrocyte homeostasis in osteoarthritis. METHODS:Twenty-eight New Zealand rabbits were randomly divided into control group,osteoarthritis group,acupotomy group,and hyaluronic acid group,with seven rabbits in each group.The knee osteoarthritis rabbit model was prepared using the Videman method in the latter three groups.After modeling,the control group and osteoarthritis group received no interventions.The acupotomy group received acupotomy treatment 15 minutes per time,once a week,while the hyaluronic acid group received intra-articular injection of hyaluronic acid once a week,with a continuous treatment duration of 5 weeks.The day after the final intervention,knee joint macrostructure was observed using DR imaging,chondrocyte ultrastructure was examined through transmission electron microscopy,apoptosis of chondrocytes was assessed using Tunel staining,and western blot analysis was used to detect the expression of proteins related to the PI3K/Akt/mTOR pathway. RESULTS AND CONCLUSION:The DR imaging results revealed that the osteoarthritis group exhibited narrowed knee joint spaces and the formation of periarticular osteophytes,while the hyaluronic acid group and acupotomy group showed widened knee joint spaces with a reduction in periarticular osteophytes.Transmission electron microscopy results demonstrated a decreased number of autophagosomes in chondrocytes in the osteoarthritis group,along with nuclear shrinkage,nuclear membrane rupture,incomplete organelle morphology,and a clear tendency towards cell death.In contrast,both the hyaluronic acid group and acupotomy group exhibited a significant increase in autophagosomes,intact nuclear membranes,and a well-preserved cellular state.Tunel staining results indicated a considerable decrease in the number of apoptotic cells in the hyaluronic acid group and acupotomy group compared with the osteoarthritis group.Western blot results revealed that,compared with the control group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly decreased in the osteoarthritis group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly increased(P<0.05);compared with the osteoarthritis group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly increased in both the hyaluronic acid group and acupotomy group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly decreased(P<0.05).To conclude,acupotomy intervention can modulate the PI3K/Akt/mTOR signaling pathway to enhance the autophagic level in chondrocytes,thereby maintaining chondrocyte homeostasis.This ultimately leads to a slowdown in cartilage degeneration.
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【Objective】 To evaluate the clinical use of the baseline CT angiography (CTA) quantitative score (self-designed collateral circulation quantitative, SD-CCQ) in determining the collateral circulation compensation status in patients with acute ischemic stroke (AIS), as well as the reliability and accuracy of the SD-CCQ score and the Alberta Stroke Program Early CT Score (ASPECTS). 【Methods】 Retrospective analysis was made on the clinical and imaging data, including CT, CTA and DWI image data, of 84 patients who were admitted for acute ischemic stroke to the Department of Neurorehabilitation of Zhongshan Hospital of Traditional Chinese Medicine from January 2020 to December 2022.Their CTA source images were annotated using a multi-task deep learning method for vascular segmentation. The ASPECTS score and SD-CCQ score were then applied to the CTA images following vascular segmentation in order to assess the collateral circulation compensation of AIS patients. The Kappa test was used to assess the consistency of the two methods used to assess collateral circulation, and the multifactorial Logistic regression analysis was used to examine the relationship between the SD-CCQ and the prognosis of the AIS patients. 【Results】 ASPECTS score had good consistency with SD-CCQ score in evaluating collateral circulation in AIS patients (κ=0.65, P<0.001), and the diagnostic accuracy of the latter for benign collateral circulation in AIS was 96.15%. Logistic regression analysis showed that the new collateral circulation score, baseline NIHSS, and DWI infarct volume were the main factors affecting the long-term prognosis of AIS patients. 【Conclusion】 The new scoring system SD-CCQ can be used to evaluate the compensatory status of collateral circulation in AIS patients, which may help in clinical treatment decision-making and prognosis prediction.
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Three 2,3-diketoquinoxaline alkaloids were isolated from Heterosmilax yunnanensis Gagnep. Their structures were determined through 1D and 2D NMR, HR-ESI-MS, UV, and IR as 1-[5′-(3″-hydroxy-3″-methyl) glutaryl] ribityl-2,3-diketo-1,2,3,4-tetrahydro-6,7-dimethylquinoxaline (1), 1-[2′-(3″-hydroxy-3″-methyl) glutaryl]ribityl-2,3-diketo-1,2,3,4-tetrahydro-6,7-dimethylquinoxaline (2), and 1-ribityl-2,3-diketo-1,2,3,4-tetrahydro-6,7-dimethylquinoxaline (3). Compounds 1 and 2 are novel compounds, and 3 was isolated from H. yunnanensis for the first time. The hepatoprotective activity of these three compounds was evaluated, with compound 3 showing promising hepatoprotective activity.
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OBJECTIVE To investigate the improvement effect and potential mechanism of “Layers adjusting external application” paste on synovial fibrosis (SF) in rats with knee osteoarthritis (KOA). METHODS Male SD rats were randomly divided into sham operation group, KOA group and Layers adjusting external application group, with 8 rats in each group. KOA model was induced by the anterior cruciate ligament disruption method in KOA group and Layers adjusting external application group. Fourteen days after modeling, the Layers adjusting external application group was given “Layers adjusting external application” paste [Sanse powder (8 g for every 100 cm2), Compound sanhuang ointment (5 g for every 100 cm2)] on the knee joint, 8 h every day, for 28 d in total. After the last administration, the degree of synovitis and fibrosis in rats was observed, and Krenn scoring was performed in each group. The expressions of collagen Ⅰ, high mobility group protein B1 (HMGB1) and phosphorylated nuclear factor-κB p65 (p-NF-κB p65) were detected in the synovial membrane; the contents of interleukin-1β (IL- 1β), IL-6 and tumor necrosis factor-α (TNF-α) in serum as well as the expressions of fibrosis-related and HMGB1/Toll-like receptor 4 (TLR4)/NF-κB signaling pathway-related proteins and mRNA were detected in synovial tissue. RESULTS Compared with the sham operation group, the synovial lining cells in the KOA group showed significant proliferation and disordered arrangement, the inflammatory cell infiltration and collagen fiber deposition were obvious; the positive expressing cells of collagen Ⅰ, HMGB1 and p-NF-κB p65 were increased significantly; the contents of IL-1β, IL-6 and TNF-α in serum, the expressions of fibrosis-related protein (transforming growth factor-β, collagen Ⅰ, tissue inhibitor of metalloproteinase 1, α-smooth muscle actin) and their mRNA as well as theexpressions of HMGB1, TLR4 protein and their mRNA, the expressions of p-NF-κB p65 protein and NF-κB p65 mRNA were all increased significantly in synovial tissues of rats (P<0.01). Compared with the KOA group, the pathological changes in the synovial tissue of rats in Layers adjusting external application group were significantly improved, and the above quantitative indicators were significantly reversed (P<0.05 or P<0.01). CONCLUSIONS “Layers adjusting external application” paste could significantly improve SF in KOA rats, the mechanism of which may be associated with the inhibition of the activation of HMGB1/ TLR4/NF-κB signaling pathway.
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Dysthyroid optic neuropathy is an important secondary pathological condition of thyroid-associated ophthalmopathy, characterized clinically by several clinical manifestations, including reduced visual acuity, impairment of color vision, relative afferent pupillary defect, and optic disk edema or atrophy. Ophthalmological auxiliary examination shows abnormal vision field and visual evoked potential, etc., and imagining examination shows orbital apex crowding, which can assist diagnosis. The pathogenesis of this disease is still unclear. With previous studies proposing that it was related to optic nerve compression, stretch, and ischemia. Treatment methods include high-dose intravenous glucocorticoid, orbital decompression, orbital radiation therapy, and biological agent. This article systematically reviews the research progress on the epidemiological characteristics, pathogenesis, diagnosis, and treatment of this disease, with a view to providing useful reference for future in-depth clinical practice and scientific research.
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ObjectiveTo explore the effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia. MethodsFrom September, 2022 to February, 2023, 124 elderly people with sarcopenia were conveniently sampled from Lishuiwan Community and Shuxiangyuan Community in Shijiazhuang City, Hebei Province. According to the coin toss, 62 elderly people from Shuxiangyuan Community were designated as control group, and 62 elderly people from Lishuiwan Community were as intervention group. The intervention group implemented the intervention based on the theory of planned behavior, including behavior attitude, behavior, subjective norms, perceived behavior control and behavior awareness; the control group maintained their original lifestyle, for twelve weeks. Before and after intervention, the grip strength, time of Five-Times-Sit-to-Stand Test, relative appendicular skeletal muscle index (RASM), 6-minute walking speed and the score of Berg Balance Scale (BBS) were compared. ResultsAfter intervention, the grip strength, RASM, 6-minute walking speed, and the score of BBS significantly increased, and the time of Five-Times-Sit-to-Stand Test shortened in the intervention group (|Z| > 6.257, |t| > 28.643, P < 0.001), and they were better in the intervention group than in the control group (|Z| > 2.288, |t| > 3.177, P < 0.05). ConclusionThe intervention based on theory of planned behavior can effectively relieve the muscle attenuation of the elderly with sarcopenia, and improve their balance ability.
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OBJECTIVE To optimize the extraction technology for the raw drugs of Sanse powder gel paste. METHODS SD rats were divided into blank group, model group, traditional technology group, water extraction group and ethanol extraction group, with 5 rats in each group. Anterior cruciate ligament transection was used to construct knee osteoarthritis model, and the pharmacodynamic effects of different extraction methods on arthritic rats were investigated. Analgesic experiments were conducted using cold and hot pain thresholds and pain mediators calcitonin gene-related peptide (CGRP), cyclooxygenase-2 (COX-2), substance P (SP), and prostaglandin E2 (PGE2) contents as indicators. HE staining was performed on the synovial membrane of rats to observe the degree of synovial cell proliferation, inflammatory infiltration and vascular invasion, and anti-inflammatory experiments were conducted using protein and mRNA expressions of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and IL-6 as indicators. The analgesic and anti-inflammatory effects were compared among those groups. In the orthogonal test, ethanol dosage, extraction time and extraction times were used as evaluation factors, and the contents of casticin, strychnine and toxiferine were taken as evaluation indicators; comprehensive score was calculated. The validation experiments were carried out after optimizing the extraction technology of the raw drugs of Sanse powder gel paste. RESULTS Compared with the model group, the cold and heat pain thresholds of drug administration groups (except for the traditional technology group) were all increased significantly (P<0.05), while the contents of pain (No.Y2021rc02) mediators CGRP, COX-2, SP and PGE2 were all decreased significantly (P<0.05). HE staining showed that inflammatory cell infiltration, fibrosis and collagen deposition were 炎。E-mail:liuzixiu3221@126.com decreased in the administration groups; a small amount of capillary proliferation could be found; the protein and mRNA expressions of inflammatory factors such as IL-1β, IL-6 and TNF-α were decreased significantly in synovial tissue of rats in administration groups (P<0.05). Compared with the traditional technology group, most indicators of the ethanol extraction group were significantly reduced (P<0.05), and only heat pain threshold and mRNA expression of IL-6 in rats were decreased significantly in the water extraction group (P<0.05). The optimal extraction technology of the raw drugs of Sanse powder gel paste included suitable dose of Sanse powder, 8-fold 55% ethanol, heating reflux extraction for 90 minutes, extracting twice. The results of 3 times of verification experiments showed that the average contents of casticin, strychnine and toxiferine were 0.007%, 0.092%, and 0.214%, respectively; RSD were all less than 5%. CONCLUSIONS The optimized extraction technology for the raw drugs of Sanse powder gel paste is stable and feasible, which can improve the efficacy of the preparation.
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Objective:To analyze the clinical characteristics, diagnosis and treatment of 3 children with severe COVID-19 encephalopathy, targeted to improve the clinicians′ understanding of the disease.Methods:The clinical features, laboratory examinations, imaging data and diagnosis and treatment process of 3 cases of severe COVID-19 encephalopathy admitted to the Pediatric Intensive Care Unit of Shengjing Hospital of China Medical University from December 1, 2022 to December 31, 2022 were retrospectively analyzed.Results:Among the 3 patients, 2 were female, age was 2-11 years old, all of them had 2-3 days of medical history, all of them had clinical manifestations of high fever(≥40 ℃), convulsions and consciousness disorders, nucleic acid and antigen tests of SARS-CoV-2 were positive, and mycoplasma pneumonia IgM antibody was positive in 1 case.Within 24 hours after admission, the levels of white blood cells were basically normal, neutrophil fraction was dominant, and procalcitonin was significantly increased.Total T cells and NK cells in the blood of the three patients were significantly decreased, and the levels of blood ammonia, blood glucose and bilirubin were basically normal.In the early stage of the disease, the cell counts of the cerebrospinal fluid was normal in all the three patients, the protein level was significantly increased, there were new symmetrical lesions on head magnetic resonance imaging in 3 patients.After symptomatic treatment and immunotherapy including early use of hormone, human gamma globulin and plasma exchange, all the patients were survived, but had different degrees of new dysfunction of the nervous system.Conclusion:Severe COVID-19 encephalopathy can occur in the acute phase of SARS-CoV-2 infection, mostly manifested as high fever, convulsions and severe disturbance of consciousness, combined with multiple organ dysfunction and irreversible nervous system damage.Early supportive treatment, brain protective treatment and immunotherapy are helpful to improve the prognosis of patients.
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Objective:To analyze the clinical characteristics, diagnosis and treatment of 3 children with severe COVID-19 encephalopathy, aiming to improve the clinicians′ understanding of the disease.Methods:The clinical features, laboratory examinations, imaging data and diagnosis as well as treatment process of 3 cases of severe COVID-19 encephalopathy admitted to the Pediatric Intensive Care Unit of Shengjing Hospital of China Medical University from December 1, 2022 to December 31, 2022 were retrospectively analyzed.Results:Among the 3 patients, 2 were female, age was 2-11 years old, all of them had 2-3 days of medical history.All of them had clinical manifestations of high fever(≥40 ℃), convulsions and consciousness disorders, nucleic acid and antigen tests of SARS-CoV-2 were positive, and mycoplasma pneumonia IgM antibody was positive in 1 case.Within 24 hours after admission, the levels of white blood cells were basically normal, neutrophil fraction was dominant, and procalcitonin was significantly increased.Total T cells and NK cells in the blood of the three patients were significantly decreased, and the levels of blood ammonia, blood glucose and bilirubin were basically normal.During the early stage of the disease, the cell counts of the cerebrospinal fluid was normal in all three patients, the protein level was significantly increased, and there were new symmetrical lesions on head magnetic resonance imaging in 3 patients.After symptomatic treatment and immunotherapy including early use of hormone, human gamma globulin and plasma exchange, all patients were survived, but had different degrees of new dysfunction of the nervous system.Conclusion:Severe COVID-19 encephalopathy can occur in the acute phase of SARS-CoV-2 infection, mostly manifested as high fever, convulsions and severe disturbance of consciousness, combining with multiple organ dysfunction and irreversible nervous system damage.Early supportive treatment, brain protective treatment and immunotherapy are helpful to improve the prognosis of the patients.
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Objective:To investigate the characteristics of congenital hypothyroidism (CH) in premature infants and analyze the predictors of transient congenital hypothyroidism(TCH) and permanent CH (PCH).Methods:A retrospective study was conducted on the preterm infants with CH born in Beijing from January 2008 to June 2018. They were screened, diagnosed and treated by the Beijing Neonatal Disease Screening Center. They were assigned into TCH and PCH groups according to the clinical prognosis. Univariate analysis and Logistic regression analyses were used to determine the predictors of PCH, and the receiver operating characteristic curve (ROC) was drawn to determine the best cut-off point.Results:A total of 2 216 892 newborns were screened, 15 382 were initially screened positive, the median time of screening was 4(4,10) d after birth, and the median time of postnatal reexamination was 30(22,42) d after birth, 14 576 newborns were reexamined, the reexamination rate was 94.8%. A total of 92 preterm infants were diagnosed with CH, of which 60 were TCH, accounting for 65.2%; 28 were PCH, accounting for 30.4%; and 4 were lost to follow-up, accounting for 4.3%. Univariate analysis showed that in the PCH group, the abnormal rate of thyroid B-ultrasound, levothyroxine (LT4) dose at 1-year old, thyrotropin (TSH) level at 2 years old, LT4 dose at 2 years old, LT4 dose and free thyroxine (FT4) level at 3 years old were higher than those in the TCH group. Logistic regression analysis revealed that abnormal B-ultrasound ( OR=12.184,95% CI 2.270~65.403), and elevated TSH level at 2 years old ( OR=2.033,95% CI 1.280~3.228),increased LT4 dose at 3 year old ( OR=21.435,95% CI 3.439~133.584) are the risk factors for PCH. The maximum area under ROC curve was 0.798 at 3 years old (95% CI 0.680~0.916), the best cut-off point was 1.3 μg/(kg·d) for the 3-year-old drug dose; followed by 2-year-old TSH level, which was 0.683 (95% CI 0.548~0.817), the best cut-off point was 4.51 μIU/ml. Conclusions:TCH accounted for a large proportion of preterm infants with CH. During the follow-up, the increased LT4 dose at 3 years old and the elevated TSH level at 2 years old were the early predictors of PCH.
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OBJECTIVE To compare the clinical comprehensive value of 15 Chinese patent medicines for the treatment of chronic hepatitis B, in order to provide reference for clinical rational drug use. METHODS According to the Management Guidelines for Clinical Comprehensive Evaluation of Pharmaceuticals (2021 Version for Trial Implementation), systematic literature review, meta-analysis and other related data analysis methods were used to perform qualitative and quantitative analysis for the safety, efficacy, economy, suitability, accessibility and innovation of 15 Chinese patent medicines. RESULTS In terms of safety, most of the adverse drug reactions of chronic hepatitis B Chinese patent medicines before the market were unobserved or unclear; post-marketing safety took nucleoside analogs as the intermediate bridge for meta-analysis, there was no significant difference in the incidence of adverse drug reactions among the combined regimens of Chinese patent medicines (P>0.05), except that the combination regimen of Fuzheng huayu capsule, Compound yiganling capsules versus combination regimen of Jiuwei gantai capsules showed statistically significant differences (P<0.05). In terms of effectiveness, the results of network meta-analysis showed that most Chinese patent medicines, such as Fuzheng huayu capsules combined regimens, had no significant differences in effective rate, HBeAg negative conversion rate and HBV-DNA negative conversion rate (P>0.05); however, in reducing the liver elastic hardness value, the combined regimen of Dangfei liganning tablet (capsule) was better than the other combined regimens (P<0.05). In terms of economy, the highest cost was the Shuganning injection, and the lowest was Hepatitis B qingre jiedu granules. In terms of suitability, most of the medicines were capsules, tablets and granules, which only needed to be sealed to store and taken orally or taken with boiling water. Compared with injections and some similar products that required strict control of storage temperature, its suitability was better. In terms of accessibility, from the perspective of drug price and affordability, Shuganning injection had the highest average daily cost, the number of days that needed to be borne by the average daily wage was the highest; the average daily cost of Compound yiganling tablets was the lowest, and the number of days required to be borne by the average daily wage was the lowest. From the perspective of availability, Compound biejia ruangan tablets, Dangfei liganning capsules and Wuzhi granules were easier to obtain. In terms of innovation, the 15 Chinese patent medicines included in the study were all domestically produced medicines with a relatively long-term theoretical basis of traditional Chinese medicine and experience in human medicine, and had good industrial innovation. Among them, Compound huayu tablets (capsules) and Anluo huaxian pills were protected varieties of traditional Chinese medicine; Fuzheng huayu tablets (capsules) with more patents had 6 valid patents, all of which were patents for invention. CONCLUSIONS Wuzhi capsule, Sedum sarmentosum granules, Compound yiganling tablets, Rhubarb buchong pills and Dangfei liganning capsules have high clinical comprehensive value.
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BACKGROUND@#This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability.@*METHODS@#This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability.@*RESULTS@#STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min.@*CONCLUSION@#The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
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Humans , Reproducibility of Results , Surveys and Questionnaires , Practice Guidelines as TopicABSTRACT
OBJECTIVE To investigate the improvement effect mechanism of Xibining prescription (XBN) on knee osteoarthritis (KOA) model rats based on AMP-activated protein kinase(AMPK)/mammalian target of rapamycin (mTOR) signaling pathway. METHODS Totally 36 rats were randomly divided into blank group, model group, XBN group (12.56 g/kg), XBN+metformin (AMPK agonist) group (12.56 g/kg XBN+100 mg/kg metformin), with 9 rats in each group. Except for blank group, KOA model was induced by anterior cruciate ligament transection in other groups. After modeling, each group was given relevant medicine/normal saline, XBN and normal saline intragastrically, once a day, and metformin intraperitoneally, every other day, for 4 consecutive weeks. The pathomorphological changes of cartilage tissue in rats were observed and Mankin scoring was conducted. The expression level of Aggrecan in rat cartilage, mRNA and protein expressions of platelet reactive protein disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4), ADAMTS-5, matrix metalloproteinase 3 (MMP-3) and MMP- 13, and the phosphorylation level of AMPK and mTOR proteins were detected. RESULTS Compared with blank group, the structure of cartilage tissue in the model group was disordered, the matrix of cartilage layer was lightly stained,the tide line was distorted or interrupted, and Mankin score was significantly increased (P<0.05). The protein expression of Aggrecan in cartilage tissue and the phosphorylation level of AMPK protein were all decreased significantly (P<0.05); mRNA and protein expressions of ADAMTS-4, ADAMTS-5, MMP-3 and MMP-13 and the phosphorylation levels of mTOR protein were significantly increased in cartilage tissues (P<0.05). Compared with model group, the pathological morphology of cartilage was improved significantly in each administration group, and above score or indexes were reversed significantly (P<0.05). Compared with XBN group, the degree of cartilage lesions in rats was further alleviated in XBN+ metformin group, and the levels of above score or indicators were further improved (P<0.05). CONCLUSIONS XBN can ameliorate cartilage injury in KOA model rats, promote cartilage synthesis and reduce cartilage degradation, the mechanism of which may be associated with activating AMPK/mTOR signaling pathway.
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This article reviews the relevant studies on the efficacy and safety of influenza, pneumococcal and COVID-19 vaccination among tumor patients worldwide in recent years. By combing and analyzing the retrieved literature, the results show that influenza and pneumococcal vaccination can significantly reduce the morbidity and hospitalization rate of infectious diseases in tumor patients, reduce the risk of cardiovascular events and death, and significantly improve survival prognosis. COVID-19 vaccination can also protect tumor patients, especially those who have completed full dose vaccination. Authoritative guidelines and consensuses worldwide all recommend that tumor patients receive influenza, pneumococcal and COVID-19 vaccines. We should carry out relevant researches, as well as take effective measures to strengthen patient education, so that tumor patients can fully experience the health protection brought by the vaccine to this specific group.
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Humans , Influenza, Human/prevention & control , COVID-19 Vaccines , COVID-19/prevention & control , Influenza Vaccines/therapeutic use , Vaccination , Pneumococcal Vaccines/therapeutic use , Streptococcus pneumoniae , NeoplasmsABSTRACT
@#As one of the most attention-attracting immunotherapy, immune checkpoint inhibitors (ICIs) have been approved as the first-line drugs for the therapy of various types of cancers.Nevertheless, the single application of ICIs exhibited limited efficacy, and it is easy to develop drug resistance.Therefore, the development of combination therapies become a hot topic in this field to improve the efficacy of ICIs therapy.This article describes some new ICIs targets, reveals the mechanisms of resistance, and introduces the current status of combination other therapies with ICIs therapy systematically including chemotherapy, radiotherapy, hyperthermia, antiangiogenic therapy, tumor vaccines, cytokine therapy and adoptive cellular therapy.Furthermore, the synergistic mechanism of combination therapy to enhance antitumor effect.Thus, this article provides solid references for personalized combination therapy according to the pathological characteristics of patients.
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Lacunar stroke (LS) is one of the subtypes of small cerebral vascular disease. Recent studies have shown that LS has a high risk of cognitive impairment, which imposes a heavy burden on patients, their families and society. However, at present, there is a lack of comprehensive discussion on the related factors, pathogenic mechanism, clinical features, prevention and treatment of cognitive impairment in LS patients. Therefore, this article reviews the relationship between LS and cognitive impairment, in order to provide clinical basis for early prevention and rehabilitation plan, and improve long-term follow-up awareness and comprehensive management ability of cognitive function in LS patients.
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Objective:To investigate the safety and effectiveness of Solitaire FR with intracranial support catheter for mechanical thrombectomy (SWIM) in the treatment of cerebral venous sinus thrombosis (CVST).Methods:Patients with progressive CVST treated with SWIM technology in the Neurology Department, Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from June 2019 to March 2022 (including 4 patients with intracranial hemorrhage) were retrospectively included. The venous sinus recanalization after procedure and during follow-up was observed. The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after procedure.Results:A total of 9 patients with progressive CVST were treated with SWIM technology, including 6 males with a median age of 37.0 years (range, 15-78). Immediately post-procedural angiography showed complete recanalization of the venous sinuses in 6 cases and partial recanalization in 3 cases. At 3 months after procedure, the mRS score showed that 3 cases was 0, 3 cases was 1, 2 cases was 2, and 1 case was 4.Conclusion:SWIM technology may be a safe and effective method in the treatment of progressive CVST.
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Rabies is a zoonosis caused by rabies virus for which no effective treatment is available.The main preventive measure is vaccination with human rabies vaccine before or after rabies exposure.With progress in science and technology,the production process of human rabies vaccine has continually advanced,thereby increasing vaccine quality,and providing a safer,more effective means of rabies prevention and control through increasing human resistance to rabies.New human rabies vac-cines have made breakthroughs in basic research and clinical research.However,the problems of poor vaccine compliance and low vaccination rates must urgently be addressed.China must actively explore effective coping strategies,accelerate the upda-ting of existing immunization procedures,effectively increase the rabies vaccination rate,and achieve the goal of eliminating ra-bies by 2030 as soon as possible.
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@#Objective To establish a nomogram model based on cystatin C (Cys-C) to predict the risk of large-artery atherosclerosis (LAA) by analyzing the risk factors of LAA and to evaluate its effectiveness. Methods A retrospective observational study performed on clinical data of 800 patients with acute ischemic stroke (AIS) in the Department of Neurology,Affiliated Hospital of Xuzhou Medical University,from January 2019 to January 2022.Patients were randomly assigned (2∶1 ratio) to the training set (n=546) and the validation set (n=254). The independent risk factors of LAA were determined by logistic regression analysis. A nomogram model of the risk of LAA was established and the model was verified internally and externally. The nomogram was evaluated based on discrimination,calibration,and clinical efficacy using the concordance statistic (C-statistic),calibration plot and decision curve analysis (DCA),respectively. Results Univariate and multifactor logistic regression analysis screening showed hypertension,diabetes,cystatin c,low-density lipoprotein (LDL),homocysteine (HCY),and hypersensitive C-reactive protein (hs-CRP) as independent correlated predictors of LAA,and the prediction model constructed from this,and the ROC curve was plotted with an area under the training set curve of 0.800 (0.762-0.838),with a diagnostic threshold of 0.6224,corresponding to a sensitivity of 68.3% and a specificity of 79.2%,and a validation set curve with an area under the curve of 0.838 (0.786-0.890) and a diagnostic threshold of 0.5901,corresponding to a sensitivity of 79.5% and a specificity of 78.5%,with a well-fitted calibration curve. Conclusion The nomogram model established has a good degree of differentiation and accuracy. It has a good performance in predictive ability,which is simple,intuitive and individualized to screen high-risk groups and has a certain predictive value for the occurrence of LAA patients,and can improve their prognosis through various preventive measures at an early stage.