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OBJECTIVE To comprehensively screen the optimal steaming time of salt-steaming Morinda officinalis (SSMO) based on Q-markers and anti-oxidative activities, and to establish characteristic quality standard of the decoction pieces. METHODS The contents of six Q-markers (1-kestose, nystose, 1F-fructofuranosylnystose, inulotriose, inulotetraose and inulopentaose) in SSMO at different steaming time were determined by HPLC-ELSD method simultaneously. The activity of sample extracts to scavenge 4 kinds of oxidative free radical and their iron reduction abilities were determined by visible UV spectrophotometer. The optimal steaming time of SSMO was screened by gray relevance degree and entropy weight technique for order preference by similarity to an ideal solution (TOPSIS)-fusion model method. The contents of six Q-markers in 10 batches of SSMO prepared at the optimal steaming time were determined. HPLC-ELSD fingerprints of SSMO decoction pieces were established. RESULTS The results showed that the contents of six Q-markers were the highest when SSMO was steamed for 3-5 h; and the ability of scavenging DPPH·, ABTS·, PTIO·, ·OH and iron reduction ability was the best at 5 h. There were 20 common peaks in the fingerprints for 10 batches of samples, and the similarities were higher than 0.990. A total of 9 chromatographic peaks were identified, which were D-fructose (peak 1), D(+)-glucose (peak 2), sucrose (peak 3), 1-kestose (peak 4), nystose (peak 5), 1F-fructofuranosylnystose (peak 6), inulotriose (peak X2), inulotetraose (peak X3) and inulopentaose (peak X4). Average contents of six Q-markers were 4.17%, 5.54%, 6.60%, 2.89%, 2.62% and 2.13%, respectively. CONCLUSIONS The optimal steaming time of SSMO is 5 h; the contents of six Q-markers are primarily determined on the basis of dry product, which are no less than 3.03%, 4.11%, 4.87%, 2.15%, 1.96% and 1.58%, respectively. The ratio of Inulin-/Inulo oligosaccharides content is no more than 2.5.
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Objective: To construct and verify a light-weighted convolutional neural network (CNN), and explore its application value for screening the early stage (subcategory 0/1 and stage Ⅰ of pneumoconiosis) of coal workers' pneumoconiosis (CWP) from digital chest radiography (DR) . Methods: A total of 1225 DR images of coal workers who were examined at an Occupational Disease Prevention and Control Institute in Anhui Province from October 2018 to March 2021 were retrospectively collected. All DR images were collectively diagnosed by 3 radiologists with diagnostic qualifications and gave diagnostic results. There were 692 DR images with small opacity profusion 0/- or 0/0 and 533 DR images with small opacity profusion 0/1 to stage Ⅲ of pneumoconiosis. The original chest radiographs were preprocessed differently to generate four datasets, namely 16-bit grayscale original image set (Origin16), 8-bit grayscale original image set (Origin 8), 16-bit grayscale histogram equalized image set (HE16) and 8-bit grayscale histogram equalized image set (HE8). The light-weighted CNN, ShuffleNet, was applied to train the generated prediction model on the four datasets separately. The performance of the four models for pneumoconiosis prediction was evaluated on a test set containing 130 DR images using measures such as the receiver operating characteristic (ROC) curve, accuracy, sensitivity, specificity, and Youden index. The Kappa consistency test was used to compare the agreement between the model predictions and the physician diagnosed pneumoconiosis results. Results: Origin16 model achieved the highest ROC area under the curve (AUC=0.958), accuracy (92.3%), specificity (92.9%), and Youden index (0.8452) for predicting pneumoconiosis, with a sensitivity of 91.7%. And the highest consistency between identification and physician diagnosis was observed for Origin16 model (Kappa value was 0.845, 95%CI: 0.753-0.937, P<0.001). HE16 model had the highest sensitivity (98.3%) . Conclusion: The light-weighted CNN ShuffleNet model can efficiently identify the early stages of CWP, and its application in the early screening of CWP can effectively improve physicians' work efficiency.
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Humans , Retrospective Studies , Anthracosis/diagnostic imaging , Pneumoconiosis/diagnostic imaging , Coal Mining , Neural Networks, Computer , CoalABSTRACT
Objective: To evaluate the safety and efficacy of distal rectal transection by using transanterior obturator nerve gateway (TANG) in laparoscopic radical resection for lower rectal cancers. Methods: A descriptive case series study was performed. Inclusion criteria: (1) patients with primary rectal adenocarcinoma, with the distance of 3-5 cm from tumor to anal verge, with normal anal function before surgery and a desire to preserve anus; (2) laparoscopic radical resection of rectal cancer was performed and the distal rectum was transected using TANG approach. Exclusion criteria: (1) patients with distant metastasis or receiving palliative surgery; (2) the distal rectum was transected using non-TANG approach; (3) patients receiving combined multiple organs resection; (4) patients complicated with other tumors requiring additional treatment during the study. Clinicopathological data of 50 patients with low rectal cancer undergoing laparoscopic resection using TANG approach between January 2019 and December 2020 in Peking University First Hospital were retrospectively collected. Perioperative conditions, length of specific pelvic lines, additional angle and postoperative short-term outcomes were observed and described. Additional angle was defined as the angle between the simulated stapling line with the traditional approach and the real stapling line with the TANG approach. Data following normal distribution were presented as Mean±SD, or M [quartile range (Q(R))] otherwise. Results: All the patients successfully completed laparoscopic surgery without transferring to open or transanal surgery. The median operative time was 193 (80) min and blood loss was 50 (58) ml. All tumors received R0 resection with the distance from the tumor to distal resection margin of 1.7 (0.4) cm and the anastomotic height of 2.0 (0.1) cm. Rectal transection was completed by one cartridge in 52.0% of the cases (26/50) and two cartridges in 48.0% (24/50). Length of the stapling line was 6.6 (1.5) cm. The time to construct the gateway was 8.0 (6.0) min. The vessel damage occurred in 4.0% of the cases (2/50) and none of the cases encountered obturator nerve damage. Inlets of the pelvis in TANG and traditional approach were (9.9±1.3) cm vs. (7.2±1.1) cm (t=24.781, P<0.001). Additional angle of TANG was (15±2) °. The transecting positions on the midline and right edge of the rectum specimen by TANG were 0.6 (0.2) cm and 1.0 (0.2) cm lower than those by the traditional approach. One case (2.0%) died of pulmonary infection on the 17th day after surgery, 2 cases (4.0%) received re-operation and 14 cases (28.0%) had postoperative complications, including anastomotic leakage (7/50, 14.0%), urinary retention (6/50, 12.0%), pelvic infection (2/50, 4.0%) and ileus (2/50, 4.0%). The median postoperative hospital stay was 12 (6) days. Conclusions: Laparoscopic distal rectal transection by using TANG approach is safe and effective in the treatment of low rectal cancer. As an alternative rectal transecting method, TANG has advantages especially for the obese and those with a contracted pelvis and ultralow rectal cancers.
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Humans , Laparoscopy , Obturator Nerve , Rectal Neoplasms/surgery , Rectum/surgery , Retrospective Studies , Treatment OutcomeABSTRACT
Objective:To explore the method and experience of augmentation mammoplasty with autologous fat transplantation assisted by external expander.Methods:From January 2013 to December 2020, 352 female patients (698 breasts, 346 bilateral and 6 unilateral), aged from 18 to 55 years, with an average age of 41.5 years, were admitted to the Department of Cosmetic Surgery, Beijing Jingmei Medical Cosmetology Clinic. From 1-28 days before surgery, autologous fat transplantation was performed after wearing the dilator, and postoperative wearing of the dilator lasted from 1 to 24 months, with an average of 3.5 months.Results:The volume of fat transplantation per breast ranged from 150 ml to 460 ml, with an average of 320 ml. No obvious postoperative complications such as fat liquefaction, infection, intramammary induration and fat embolism were observed, and the postoperative appearance was lasting. The postoperative follow-up was conducted from 6 months to 7 years, and patient postoperative satisfaction rate reached 84.9% and doctors' satisfaction after surgery reached 82.1%.Conclusions:Augmentation mammoplasty with autologous fat transplantation assisted by external expander can effectively improve the appearance of breast morphology and contour defects and increase the survival rate of fat transplantation, which is worthy of clinical application.
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OBJECTIVE@#To investigate the application value of apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) of MR diffusion-weighted imaging (DWI) in quantitative evaluation of lumbar spine osteoporosis.@*METHODS@#A total of 175 patients with lumbar spine diseases who received dualenergy X-ray absorption (DXA) bone mineral density (BMD), routine MRI and DWI of the lumbar spine from May 2017 to October 2019 were selected. According to the T-value of DXA, the patients were divided into osteoporosis group (64 cases), osteopenia group (53 cases) and normal bone mass group (58 cases). The ADC and SIR values of L@*RESULTS@#There were statistically significant differences in ADC and SIR values among three groups (@*CONCLUSION@#ADC and SIR can better reflect the BMD of patients with lumbar diseases, and can quantitatively evaluate the vertebral body of osteoporosis, which play an important role in the diagnosis of lumbar osteoporosis.
Subject(s)
Humans , Diffusion Magnetic Resonance Imaging , Lumbar Vertebrae/diagnostic imaging , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Osteoporosis/diagnostic imagingABSTRACT
Objective To analyze the CT characteristics of consolidation type of pulmonary cryptococcosis in immunocompetent patients,and thus improve the diagnosis of this disease. Methods A total of 20 cases with consolidation-type pulmonary cryptococcosis confirmed by pathological examinations were studied.Each patient underwent breath-hold multislice spiral CT,and 10 patients underwent contrast enhanced CT.The data including lesion number,lesion distribution,lesion density,performance of enhanced CT scan,accompanying signs,and prognosis were analyzed. Results The occurrence rates of single and multiple lesions were 80.0%(n=16)and 20.0%(n=4),respectively.In all the 16 multiple-lesion patients,the occurrence rate of unilateral lobar distribution was 56.0%(n=9).The 76 measurable lesions mainly presented subpleural distribution(71.1%,n=54)and lower pulmonary distribution(75.0%,n=57).A total of 39 lesions were detected in the 10 patients received contrast enhanced CT,in which 31 lesions(79.5%)showed homogeneous enhancement,34 lesions(87.2%)showed moderate enhancement,and all the lesions manifested angiogram sign.Consolidation lesions were accompanied by many CT signs,of which air bronchogram sign had the occurrence rate of 63.2%(n=48),including types Ⅲ(n =37)and Ⅳ(n=11).Other signs included halo signs(43/76,56.6%),vacuoles or cavities(9/76,11.8%),pleural thickening(14/20,70.0%),and pleural effusion(2/20,10.0%).After treatment,the lesions of 7 patients were basically absorbed and eventually existed in the form of fibrosis. Conclusions The lesions in the immunocompetent patients with consolidation type of pulmonary cryptococcosis usually occur in the lower lobe and close to the pleura,mainly presenting unilateral distribution.The CT angiogram signs,proximal air bronchogram signs,and halo signs are the main features of this disease,which contribute to the diagnosis.
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Humans , COVID-19 , Cryptococcosis/diagnostic imaging , Lung , Lung Diseases, Fungal/diagnostic imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
In this study, we intended to describe a human case of lumbosacral canal sparganosis in People’s Republic of China (China). A 56-year-old man was admitted to Xiangya Hospital Central South University in Changsha, Hunan province, China after having an experience of perianal pain for a week. An enhancing mass, a tumor clinically suggested, was showed at the S1-S2 level of the lumbosacral spine by the examination of magnetic resonance imaging (MRI) with gadolinium contrast. The patient was received the laminectomy from S1 to S2, and an ivory-white living worm was detected in inferior margin of L5. In ELISA-test with cerebrospinal fluid (CSF) and serum samples, anti-sparganum antibodies were detected. He had a ingesting history of undercooked frog meat in his youth. By the present study, a human case of spinal sparganosis invaded in lumbosacral canal at the S1-S2 level was diagnosed in China. Although the surgical removal of larvae is known to be the best way of treatment for sparganosis, we administered the high-dosage of praziquantel, albendazole and dexamethasone to prevent the occurrence of another remain worms in this study.
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When this paper was first published the following ethical statement was omitted in error: All animal experimental protocols were approved by the Animal Ethics Committee of Guangdong Provincial Engineering Technology Institute of Traditional Chinese Medicine (Guangzhou, Guangdong, China, Approval NO: 048483). Further, all methods were performed in accordance with the relevant guidelines and regulations. NIH mice were purchased from the Guangdong Medical Laboratory Animal Center (Guangzhou, Guangdong, China, Certificate NO.44007200031795). The authors would like to apologise for any inconvenience caused.
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Objective To explore whether astragaloside IV (AS-IV) can protect radiation-induced kidney injury through toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB)-mediated signaling pathway. Methods The mice were randomly divided into normal control group, DMSO solvent group, irradiation group (IR), IR + AS-IV 20 mg/kg group and IR + AS-IV 40 mg/kg group. One month after intraperitoneal injection of AS-IV, the mice were irradiated with 8 Gy 60Coγ and to the content of serum creatinine (Cr) and uric acid (BUA) in serum were determined, HE and immunohistochemical staining, and expression of TLR4/NF-κB signaling pathway related protein in kidney were performed. Results Compared with the control group, the levels of Cr and BUA in the serum of the radiation group increased significantly (P<0.001), glomerular atrophy and tubular expansion, TLR4 and myeloid differentiation factor 88(MyD88) positive expression increased significantly (P< 0.001), and the expression of TLR4/NF-κB signaling pathway-related proteins[ TLR4, MyD88, NF-κB, interleukin-1 β (IL-Iβ), tumor necrosis factor α (TNF-α)] increased significantly (P< 0.01); AS-IV pretreatment can reduce the content of Cr and BUA in serum (P<0.05, P<0.01 or P<0.001), significantly improve the pathological response caused by radiation, and reduce the expression of TLR4/NF-κB signaling pathway-related proteins (P<0.05 or P<0.01). Conclusion AS-IV may down-regulate the release of inflammatory factors through the TLR4/NF-κB signaling pathway, thereby improving radiation-induced kidney injury in mice and playing a protective role.
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Objective:To understand the relationship between joint bleeding and joint disease in hemophilia children, and to provide a theoretical basis for clinical treatment and prognosis.Methods:The patients with severe hemophilia A between 1 and 7 years old and with relevant nodal bleeding records were selected.All the patients admitted in Beijing Children′s Hospital, Capital Medical University, and Chengdu New Century Women′s and Children′s Hospital since June 2016 to January 2017.All the joint bleeding of each child was taken as the study joint, and the joint bleeding was collected during the last 3 months.The joints were assessed by using ultrasound, X-ray, magnetic resonance imaging(MRI) and Hemophilia Joint Health Score (HJHS) scoring systems.The correlation analysis was conducted between the joint bleeding, ultrasound, X-ray, MRI and HJHS scores.The correlation analysis was conducted for baseline ultrasound, X-ray, MRI and HJHS scores.Results:(1) There were 18 patients enrolled.The mean age was (5.6±1.8) years old.There were 30 joints bleeding in the observation period in total, with the annul median joint bleeding times of 4 (4-16 times), and the annul median target joint bleeding times of 8 (4-16 times). (2) Joint bleeding times of was correlated with ultrasound and X-ray evaluation ( r=0.390, P=0.033; r=0.517, P=0.008), and not correlated with HJHS or MRI(all P>0.05). (3) There was significantly positive correlation among ultrasound, X-ray, HJHS and MRI [ r=0.815(ultrasound vs.X-ray), r=0.510(ultrasound vs.HJHS), r=0.812(ultrasound vs.MRI), r=0.666(X-ray vs.HJHS), r=0.911(X-ray vs.MRI), r=0.781(HJHS vs.MRI), all P<0.01]. (4) There was no correlation between times and assessment for joints whose ultrasound and /or MRI in joints with abnormal ultrasound and /or MRI evaluation( P>0.05). Conclusions:The results of joint bleeding and joint evaluation are inconsistent.Joint bleeding can not truly reflect the situation of joint diseases.The assessment of hemophilia should include comprehensive evaluation of joint structure, function, activity ability and other aspects to guide the treatment of haemophi-lia children.
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Traditional Chinese medicine(TCM) is the treasure of our culture, and TCM theory is the core of traditional Chinese medicine. Many of its concepts can be unified and balanced with modern functional food ideas. Even in ancient days, people had already found that medicine and food have the same source. Nowadays, homology between drug and food has been accepted widely. Astragali Radix and some other herbs have been used both as food and medicine, with a variety of bio-active substances, so such herbs can be used as characteristics resources to be developed into functional food. It's a combination of traditional medicine and modern ideas. Flavonoids, polysaccharides and saponins, the main compositions of Astragali Radix, can keep intestinal microenvironment homeostasis and human health by influencing the population structure, metabolism and intestinal cell function of intestinal flora. On the other hand, intestinal flora is also involved in the absorption, metabolism, transformation and other steps of these active ingredients in the body, which has an impact on their effectiveness and improves their bioavailability, playing an essential role in the relevant mechanism of their effectiveness. In this paper, we summarize the interaction between the above three functional ingredients in Astragali Radix and intestinal flora, sum up the interaction between these three functional ingredients of other homologous drugs and intestinal flora, provide a theoretical basis for the mechanism and application of functional food materials, and propose some suggestions and prospects for their future development.
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Humans , Astragalus Plant , Drugs, Chinese Herbal , Functional Food , Gastrointestinal Microbiome , Medicine, Chinese TraditionalABSTRACT
Alpinia officinarum is a medicinal plant and food. Its dried rhizome has been widely used for the relief of symptoms such as stomach aches, colds, ulcer and diarrhea for hundreds of years. Recent pharmacological studies showed it has anti-inflammatory, anti-oxidative, antidiabetic, anti-ulcer, anti-diarrhea, antiemetic, analgesia, anticoagulation, antitumor and antivitiligo effects. In this study, we summarized the current knowledge about its botanical resources, ethanopharmacological function, chemical constituents, pharmacologies and pharmacokinetics, safety and toxicity, and clinical application.
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Objective@#To explore the quality management of critical patients in the process of medical helicopter rescue and transshipment.@*Methods@#After receiving the rescue and transshipment task for 10 critically ill patients, the Emergency Department quickly established the rescue quality management team under the direction of the dean: with helicopter on-site rescue and transshipment team, in-hospital pick-up and transshipment team, logistic support team and coordination command group; full medical security assessment: to prepare all emergency supplies, drugs, instruments and equipment in a predictable manner, and all within the effective period, completed. The success rate is 100%. The formulation of rescue plan: formulating individualized emergency plan, pre-examination and triage evaluation plan, transporting and implementing process plan; unblocked green channel: setting up rescue room as rescue preparation area; radiology department, laboratory department, pharmacy, B-ultrasound room, electrocardiogram room, emergency transfer elevator, medical housekeeper and other departments ensure the green channel unblocked, safety logistic support team dedicated personnel management. To manage the area from apron to emergency hall and rescue room, smooth transit routes, and prepare for emergency treatment in emergency intensive care unit and specialized intensive care unit. Specialized organizations are responsible for: Department directors, head nurses and quality control team leaders to organize and coordinate quality management work.@*Results@#All 10 critically ill patients were safely and smoothly transported to hospital for emergency treatment without any adverse events. Six patients received emergency intensive care, three orthopaedic care, one hand-foot surgery care, and 10 critically ill patients were discharged from hospital in time and safely through various specialties.@*Conclusion@#The successful rescue and safe transshipment of 10 critically ill patients reflects the good beginning of the development of medical helicopter rescue in our province, and forms a complete, organized, targeted, planned and implemented team rescue system, which greatly improves the quality management level of medical helicopter rescue and transshipment.
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Objective To explore the quality management of critical patients in the process of medical helicopter rescue and transshipment. Methods After receiving the rescue and transshipment task for 10 critically ill patients, the Emergency Department quickly established the rescue quality management team under the direction of the dean: with helicopter on-site rescue and transshipment team, in-hospital pick-up and transshipment team, logistic support team and coordination command group; full medical security assessment: to prepare all emergency supplies, drugs, instruments and equipment in a predictable manner, and all within the effective period, completed. The success rate is 100% . The formulation of rescue plan: formulating individualized emergency plan, pre-examination and triage evaluation plan, transporting and implementing process plan; unblocked green channel: setting up rescue room as rescue preparation area; radiology department, laboratory department, pharmacy, B-ultrasound room, electrocardiogram room, emergency transfer elevator, medical housekeeper and other departments ensure the green channel unblocked, safety logistic support team dedicated personnel management. To manage the area from apron to emergency hall and rescue room, smooth transit routes, and prepare for emergency treatment in emergency intensive care unit and specialized intensive care unit. Specialized organizations are responsible for: Department directors, head nurses and quality control team leaders to organize and coordinate quality management work. Results All 10 critically ill patients were safely and smoothly transported to hospital for emergency treatment without any adverse events. Six patients received emergency intensive care, three orthopaedic care, one hand-foot surgery care, and 10 critically ill patients were discharged from hospital in time and safely through various specialties. Conclusion The successful rescue and safe transshipment of 10 critically ill patients reflects the good beginning of the development of medical helicopter rescue in our province, and forms a complete, organized, targeted, planned and implemented team rescue system, which greatly improves the quality management level of medical helicopter rescue and transshipment.
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Objective@#To analyze the differences of cardiovascular(CV) risk factors between middle school students with normal weight but high body fat and students with normal weight and normal body fat in urban area of Yinchuan,to provide a theoretical basis for early detection of their invisible obesity and controlling CV metabolism disease.@*Methods@#During 2017 to 2018, a total of 1 043 secondary school students in urban area of Yinchuan were selected through cluster sampling. Questionnaire survey, physical examination, body composition and blood lipid test were conducted among all the participants.745 middle school students with normal body mass index (BMI) were included in the analysis.@*Results@#Nearly 31.1% students with normal BMI had high body fat, with girls significantly higher than that in boys across different age groups(χ2=10.37,106.49,P<0.01). Total cholesterol (TC) in boys with normal-weight obesity was higher than that in the normal group, while diastolic blood pressure (DBP), triglyceride (TG), TC and lowdensity lipoprotein cholesterol (LDL-C) in girls with normal-weight obesity were significantly higher than that in the normal group, with statistically significant differences (t=-2.37,-3.82,-3.48,-4.46,-4.68,P<0.01). The detection rates of high blood pressure, high TC level and high LDL-C level in normalweight obese girls were all higher than those in normal group (χ2=4.17,8.77,5.91,P<0.05). The detection rate of CV risk factors ≥2 in normal-weight obesity group was higher than that in the normal group, and the difference was statistically significant(χ2=7.05,P<0.01).@*Conclusion@#Normal-weight obesity among middle school students in urban area of Yinchuan is prevalent, which is mainly concentrated in female students. Moreover, cardiovascular risk factors are more common among those normal-weight obese students compared with normal students. Interventions for preventing and controlling normal-weight obesity should be developed and implemented as early as possible.
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Objective@#To analyze the association between fat mass percentage (FMP) and waist circumference (WC) with cardiovascular risk factors in children and adolescents in Yinchuan City, and to provide a reference for preventing and contyolling the risk factors of cardiovascular diseases among children and adolescents.@*Methods@#A questionnaire survey, physical examination, body composition determination and biochemical tests were conducted among 1 043 children aged 12-18 years in Yinchuan selected through a convenient cluster sampling method.@*Results@#Among boys and girls, both FMP and WC were associated with high rate of high blood pressure and high TG in children and adolescents(P<0.01). The increased risk of metabolic abnormalities by FMP and WC were 1.14-2.36 times and 1.32-2.09 times, respectively. About 4.9%-22.1% of cardiovascular disease risk was explained by the combination of FMP and WC, which was significantly higher than separate interpretation of FMP or WC (3.5%-22.0%). Standardized regression coefficient for TC and LDL-C (0.25 and 0.22) was greater than WC (0.17 and 0.14) by FMP, and the absolute value of the standardized regression coefficient for SBP, DBP, TG, HDL-C was less than WC by FMP. The predictive risk for high blood pressure, high TG, high TC, low HDL-C and high LDL-C by combination of FMP and WC was 3.67(95%CI=2.42-556), 3.09(95%CI=2.04-4.69), 3.37(95%CI=1.38-8.28), 2.00(95%CI=1.35-2.98) and 4.73(95%CI=2.15-10.44) times higher than different combinations risk groups(P<0.01).@*Conclusion@#The ability of fat mass percentage and waist circumference to predict the risk of cardiovascular risk factors is similar. It might be used as a predictor of cardiovascular risk factors in children and adolescents. It is recommended to combine FMP with WC to predict the risk of cardiovascular disease among children and adolescents.
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Common bile duct (CBD) stones are a frequent problem in Chinese populations, and their incidence is particularly high in certain areas (Wang et al., 2013). In recent years, laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP) have been the main surgical procedures for CBD stones, although each has different advantages and disadvantages in the treatment of choledocholithiasis (Loor et al., 2017; Zhou et al., 2017). For patients with large stones, a dilated CBD, especially concurrent gallstones, LCBDE is the preferred and most economical minimally invasive procedure (Koc et al., 2013). However, a T-tube is often placed during LCBDE to prevent postoperative bile leakage; this is associated with problems such as bile loss, electrolyte disturbance, and decreased gastric intake (Martin et al., 1998). In addition, the T-tube usually must remain in place for more than a month, during which time the patient's quality of life is seriously compromised. Many skilled surgeons currently perform primary closure of the CBD following LCBDE, which effectively speeds up rehabilitation (Hua et al., 2015). However, even in sophisticated medical centers, the incidence of postoperative bile leakage still reaches ≥10% (Liu et al., 2017). Especially for a beginner, bile leakage remains a key problem (Kemp Bohan et al., 2017). Therefore, a safe and effective minimally invasive surgical approach to preventing bile leakage during primary closure of the CBD after LCBDE is still urgently needed.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Choledocholithiasis , Common Bile Duct Diseases , Drainage/methods , Gallstones , Gastroscopy , LaparoscopyABSTRACT
OBJECTIVE: To develop on-line high performance liquid chromatography-biochemical detection (HPLC-BCD) METHODS: to screen effective components in Ginkgo biloba extract for treatment of Alzheimer's disease.METHODS: Radical scavengers and AchE inhibitors in G.biloba leave extract were screened by HPLC-UV-DPPH/ABTS and HPLC-UV-AchE METHODS:, respectively. The stability and repeatability of the on-line HPLC-UV-AchE method were investigated using galanthamine as a positive reference. The main active ingredients in the extract were identified by ultra high performance liquid chromatography linear ion trap/orbitrap high resolution mass spectrometry (UPLC-LTQ/orbitrap MS) method. RESULTS: Fourteen antioxidants in G.biloba extract were detected by the HPLC-UV-DPPH/ABTS method, while three AchE inhibitors were found by the HPLC-UV-AchE method. The three AchE inhibitors were tentatively identified by UPLC-LTQ/orbitrap MS as 4-O-beta-glucopyranosyl-cis-coumaric acid ginkgolide A and 3-O-[2-O-(β-D-Glucosyl)-α-L-rhamnosyl]quercetin, respectively. CONCLUSION: The proposed on-line HPLC-BCD method shows high sensitivity, good repeatability and stability. It can be used to screen antioxidants and AchE inhibitors in G. biloba extract. This will provide an effective, quick and convenient analysis tool to quickly find bioactive ingredients of traditional Chinese medicines for treating related diseases.
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Objective:To investigate the effect of PKM2 on proliferation and apoptosis of nasopharyngeal carcinoma cells.Methods:Nasopharyngeal carcinoma cell CNE-1 was transfected with PKM2 small interfering RNA (PKM2 siRNA1 and PKM2 siRNA2) and negative controls (siRNA control),the levels of PKM2 in the cells were detected by fluorescent quantitative PCR and Western blot,screening interference PKM2 siRNA2 continued to study.Cell proliferation was detected by MTT,cell cloning test showed the ability of cell cloning,apoptosis was detected by flow cytometry,ROS level was detected by DCFH-DA,the levels of p38MAPK,p-p38MAPK,C-myc,β-catenin,Cleaved Caspase-3 protein were detected by Western blot.Results:After transfection of PKM2 siRNA1 and PKM2 siRNA2,the levels of PKM2 mRNA and protein were significantly decreased compared with those without transfection,and after transfection of PKM2 siRNA2,the level of PKM2 in cells decreased more,the levels of PKM2 in transfected siRNA control cells were not significantly different from those without transfection.The rate of apoptosis after down-regulation of PKM2 expression increased from (9.36 ± 1.04)% to (48.42 ± 5.28)%,and the rate of cell clone formation decreased from (75.48 ± 8.25)% to (46.15 ± 3.47)%,OD values from (0.86±0.11) down to (0.52±0.04),elevated levels of ROS in cells,the levels of p-p38MAPK,Cleaved Caspase-3 proteins in cells were also significantly increased, the levels of C-myc and β-catenin in cells were obviously decreased.Conclusion:Downregulation of PKM2 expression inhibits nasopharyngeal carcinoma cell growth,promoting apoptosis of naso-pharyngeal carcinoma cells,the mechanism of action may be related to p38MAPK and Wnt/β-catenin signaling pathway.
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Objective@#To detect the arthropathies on no bleeding history joints in pre-school hemophilia A children in order to provide evidence for further prevention and control of joint disease in children with hemophilia A.@*Methods@#This study was a cross-sectional study based on China Hemophilia Individualized prophylaxis study (CHIPS). The basic data of outpatients with hemophilia in Beijing Children's Hospital and Chengdu Women's and Children's Central Hospital between August 2016 and June 2017 were collected and a three-month follow-up was conducted. The target joints (six joints of bilateral elbows, knees and ankles) of thirty-four children aged 1-7 years old with severe hemophilia A were examined by ultrasound, X-ray and joint function examination (4-7 years old, hemophilia joint health score (HJHS)). To find out whether there are arthropathies in patient's joints with no bleeding history and analyze the relevant factors by chi-square test, rank sum test and other statistical methods.@*Results@#There were 32 analyzable cases with 112 no-bleeding history target joints, 42.9% (48/112) were elbow joints. Arthropathies were revealed in 34.8% (39/112) of them by joint structural and functional examination and 46.2% (18/39) were ankles (χ2=8.379, P=0.015) . Ultrasound showed abnormalities in 18.3% (20/109) joints, X-ray showed abnormalities in 3.8% (3/79) joints and HJHS showed abnormalities in 25.3% (20/79) joints. There was no correlation between ultrasound and HJHS (r=0.015, P=0.895), no correlation was found between X-ray and HJHS (r=-0.101, P=0.390) either, which suggested that joint structural and functional examination could not replace each other. The related risk factors of arthropathies in this group were >4.91 years old (OR=3.917, 95%CI:1.610-9.528) and combining with target joint (OR=3.530, 95%CI:1.316-9.465).@*Conclusions@#Detecting the joint structure and function on no bleeding history joints in pre-school hemophilia A children could reveal the arthropathies and majority of them were ankle arthropathies. Joint structural and functional examinations could not replace each other. For patients more than 5 years old and those with target joints, the joints with no complaint of bleeding should be examined regularly to reveal the arthropathies in time.