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Percutaneous coronary intervention and acute coronary syndrome are both closely tied to the frequently occurring complication of coronary microembolization (CME). Resveratrol (RES) has been shown to have a substantial cardioprotective influence in a variety of cardiac diseases, though its function and potential mechanistic involvement in CME are still unclear. The forty Sprague–Dawley rats were divided into four groups randomly: CME, CME + RES (25 mg/kg), CME + RES (50 mg/kg), and sham (10 rats per group). The CME model was developed. Echocardiography, levels of myocardial injury markers in the serum, and histopathology of the myocardium were used to assess the function of the cardiac muscle. For the detection of the signaling of TLR4/MyD88/NF-κB along with the expression of pyroptosisrelated molecules, ELISA, qRT-PCR, immunofluorescence, and Western blotting were used, among other techniques. The findings revealed that myocardial injury and pyroptosis occurred in the myocardium following CME, with a decreased function of cardiac, increased levels of serum myocardial injury markers, increased area of microinfarct, as well as a rise in the expression levels of pyroptosis-related molecules. In addition to this, pretreatment with resveratrol reduced the severity of myocardial injury after CME by improving cardiac dysfunction, decreasing serum myocardial injury markers, decreasing microinfarct area, and decreasing cardiomyocyte pyroptosis, primarily by blocking the signaling of TLR4/MyD88/NF-κB and also reducing the NLRP3 inflammasome activation. Resveratrol may be able to alleviate CME-induced myocardial pyroptosis and cardiac dysfunction by impeding the activation of NLRP3 inflammasome and the signaling pathway of TLR4/MyD88/NF-κB.
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OBJECTIVE To investigate the protective effects and mechanism of ziyuglycoside Ⅰ on acute lung injury in sepsis rats based on network pharmacology， and conduct experimental verification. METHODS The network pharmacology was used to predict the potential target of ziyuglycoside Ⅰ in the treatment of acute lung injury following sepsis. The rat model of sepsis was reproduced by cecum ligation and puncture for experimental verification. Totally 192 SD rats were randomly divided into the sham operation group （Sham group）， sepsis group （Sep group）， conventional therapy group （CT group） and ziyuglycoside Ⅰ group （Zg Ⅰ group）， respectively. Sham group and Sep group were given sterile normal saline， and CT group and ZgⅠ group were given relevant volume of Ringer’s solution and ziyuglycoside Ⅰ. The arterial blood gas， serum inflammatory factors， lung wet/dry mass ratio， pathological changes of lung tissue， pulmonary vascular permeability， the expressions of pulmonary vein tight junction protein 1 （ZO-1） and vascular endothelial cadherin （VE-cadherin） protein and 72-hour survival were observed in each group. RESULTS Results of network pharmacology showed that there were 47 potential targets of ziyuglycoside Ⅰ in the treatment of sepsis. The results of gene ontology function enrichment analysis and Kyoto encyclopedia of genes and genomes pathway enrichment analysis showed that the mechanism could 598486924@qq.com be correlated with biological processes such as positive regulation of reactive oxygen species metabolism， wound healing， regulation of endothelial cell proliferation， cell activation， blood vessel development， response to oxidative stress， etc.， and with signaling pathway such as apoptosis， tight junction， HIF-1 signaling pathway， etc. The results of experimental verification showed that compared with Sham group， pH value and the level of partial arterial oxygen pressure were decreased significantly in Sep group （P＜0.05）， while the level of partial pressure of carbon dioxide， serum levels of tumor necrosis factor α， interleukin 6 were increased significantly （P＜0.05）； the ratio of lung wet/dry mass was increased significantly （P＜0.05）； the protein expressions of ZO-1 and VE-cadherin were decreased significantly （P＜0.05）； 72 h survival rate decreased，the survival time was significantly shortened （P＜0.05）； the results of pathological observation of lung tissue showed that the rats’ alveoli were extensively ruptured， the alveolar wall was thickened and accompanied with edema， and there was obvious inflammatory cell infiltration； the results of pulmonary vascular permeability observation showed that the lung surface of rats was dark， with a large amount of Evans blue exudation， and the left lower lung was obviously dark blue. Compared with Sep group， the levels of above indexes almost were reversed significantly in CT group and ZgⅠ group （P＜0.05）； the lung histopathology and pulmonary vascular permeability were significantly improved， and the recovery degree of ZgⅠ group was greater than that of CT group， which was close to the results of Sham group. CONCLUSIONS Ziyuglycoside Ⅰ can significantly reduce inflammatory reaction and acute lung injury in septic rats， which is related to vascular function and tight junction signal pathway.
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At present， major depressive disorder （MDD） is highly prevalent with advanced neurological disorders as the main pathological manifestations. As the physiological function bearer of higher neural activity， gray matter has become the focus of MDD treatment. However， recent research has shown that white matter and gray matter are independent of each other in the central nervous system （CNS）， and their functions are integrated and linked. In addition to gray matter damage， white matter damage is also the core driving event of disease progression and determines the outcome of MDD. At the treatment level， the current drug treatment of MDD mainly focuses on gray matter repair， while ignoring the importance of white matter integrity for the treatment of the disease， which has become the weakness of the current treatment of MDD. Traditional Chinese medicine （TCM） has good application potential in white matter repair. This paper elaborated on the following three aspects. ① The roles of white matter damage in the occurrence and development of MDD were summarized. ② The key link of white matter repair in MDD was elaborated with microglia microenvironment regulation as the entry point. ③ The application value of TCM in white matter repair in MDD was analyzed. This review aims to highlight the importance of white matter integrity in the treatment of MDD and is expected to expand the understanding dimension of the activity of related Chinese medicines in MDD from the perspective of white matter repair and analyze its potential application value.
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Sarcopenia etiology is diverse and the pathogenesis is complex.It is closely related to limited activity, malnutrition and a variety of clinical diseases, which seriously affects the quality of life in the elderly and has become a global common health problem.This review focuses on the literature of non-drug interventions for sarcopenia in the past five years, focusing on the relationship of multimodal exercise, intestinal flora, parenteral nutrition and comprehensive intervention with sarcopenia, in order to provide a new basis for formulating scientific and effective non-drug intervention for sarcopenia.
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Objective:To investigate the clinical effect assistant with pelvic unlocking reduction frame for the treatment of old Denis I or II sacral fractures combined with sacral plexus nerve injury.Methods:From January 2013 to October 2020, 37 patients diagnosed with old sacral fractures with sacral plexus nerve injury which Gibbons classification was grade III were divided into the use group and the non-use group according to whether assisted with pelvic unlocking reduction frame. Eighteen patients (11 males, 7 females, mean age 38±6.4, range from 13-56) were selected into the use group and nineteen patients (14 males, 5 females, mean age 42±10.7, range 19-59) were selected into the non-use group. The three-dimensional (3D) pelvic model (1∶1) was printed before operation. The operation time, intraoperative bleeding, Matta score, visual analogue scale (VAS), Majeed score and gibbons sacral nerve injury grade of the two groups were compared. The healing time and complications of each group was recorded.Results:The average operation time of the use group and the non-use group was 121.0±16.2 min and 182.6±16.2 min, respectively, with significant difference ( t=11.54, P<0.001). The mean operative bleeding was 686±382 ml of the use group and 963±348 ml of the non-use group ( t=2.38, P=0.003). The quality of fracture reduction was evaluated according to Matta scoring standard: the excellent and good rate of the use group was 94% (17/18), and that of the non-use group was 68% (13/19) ( P=0.039). The curative effect was evaluated according to the Majeed score: the use group was 88.72±7.03 points, and that of the non-use group was 72.00±9.75 points ( t=5.96, P<0.001) at 1 year post-operative. One year after operation, the VAS scale of the use group was 0.83±0.71 points, and that of the non-use group was 1.00±0.82 points ( t=0.66, P=0.512). According to Gibbons classification, 15 patients were grade I, 1 patient was grade II and 2 patients were grade III in the use group and 11 patients were grade I, 3 patients were grade II and 5 patients were grade III in the non-use group one year after operation ( Z=-1.04, P=0.401). One patient in the use group presented rupture of plate without symptoms. In the non-use group, 1 case with internal iliac vein rupture which treated with gelatin sponge and no obvious bleeding after operation. 4 cases with unequal length of lower limbs, walking claudication. The complication rate of the use group was 6% (1/18), and that of the non-use group was 26% (5/19) ( P=0.042) . Conclusion:The lateral rectus abdominis approach combined with pelvic unlocking reduction frame can reduce the operation time and bleeding, improve the fracture reduction in the treatment of old Denis type I and II sacral fractures with sacral plexus injury.
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Objective:To investigate the application of three-dimensional (3D) image fusion technique of pelvic enhanced CT and magnetic resonance neurography (MRN) on the patients of pelvic fractures with lumbosacral plexus injury.Methods:From January 2019 to December 2020, 15 patients (11 males, 4 females, mean age 26.67±11.34 of pelvic fracture (AO classification C1.3 of 11 cases, C2 of 2 cases, C3 of 2 cases) with lumbosacral plexus injury underwent 3D image fusion of pelvic enhanced CT and MRN. All patients exhibited lower limb nerve dysfunction after injury. The preoperative muscle strength were evaluated by British Medical Research Council (BMRC) criteria: grade 0 in 2 cases, grade 1 in 5, grade 2 in 7 and grade 3 in 1. Physical examination and enhanced CT combined with MRN 3D image fusion technology were used to accurately determine the injury site of lumbosacral plexus nerve, fracture displacement, and the direction of blood vessels and ureters, and develop corresponding surgical plans. The neurological functions were measured in post-operation follow-up.Results:All 15 operations were successfully completed and the site of lumbosacral plexus injury during operation was consistent with preoperative fusion image, and inconsistency of injury characteristic in 4 patients (4/15, 27%). Among the 6 cases of laparoscopic surgery, 2 cases were changed to open surgery because of the difficulty of nerve decompression. The average time of 4 cases of laparoscopic surgery was 116.27±26.46 min and intraoperative blood loss was 102.50±79.32 ml. The average time of 11 cases of open operation was 123.64±38.28 min, and intraoperative blood loss was 713.64±393.12 ml. For the opening operations, 9 cases were successfully decompressed, and nerve disruption was observed in 2 patients. All 15 patients were followed up. The average follow-up time was 9.33±2.19 months. The radial bony healing was observed in each case at the end of follow-up, mean healing time was 5.03±1.04 months (range, 3-6 months). In addition, patients' muscle strength recovered, 8 cases of grade 5, 3 cases of grade 4, 1 case of grade 3, 1 case of grade 2, and 2 cases of grade 0 after surgery. The difference was statistically significant ( Z=3.27, P<0.001). On the other hand, in sensory function assessment, there were 8 cases of grade S5, 1 case of grade S4, 3 cases of grade S3, 1 case of grade S2 and 2 cases of grade S0 after surgery. Conclusion:3D image fusion of enhanced CT and MRN can accurately locate and characterize pelvic fractures combined with lumbosacral plexus injury before surgery, accurately guide the formulation of surgical plan, and reduce surgical trauma and related complications.
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Objective:To explore the expression and clinical significance of Janus protein tyrosine kinase/signal transducer and activator of transcription (JAK3/STAT5) signaling pathway in peripheral blood mononuclear cells (PBMCs) of patients with primary gouty arthritis (GA).Methods:Peripheral blood, clinical data and laboratory tests were collected from 50 patients with acute gout (AG), 50 patients with intermittent gout (IG) and 50 healthy controls (HC). Quantitative real-time-polymerase chain reaction (RT-qPCR) was used to detect mRNA expression level of JAK3/STAT5 related genes (JAK3, STAT5a, STAT5b). Enzyme linked immune sorbent assay (ELISA) was used to detect interleukin-2 (IL-2) concentration in subject′s plasma. Measurement data among the three groups that was in accordance with normal distribution was analyzed by one-way analysis of variance, pairwise comparisons using LSD, non-normal distribution data was analyzed by Mann-Whitney test or Kruskal-Wallis H test, and correlation analysis between variables was analyzed using Spearman correlation analysis. Results:① The mRNA expression levels of JAK3, STAT5a and STAT5b were significantly different among the three groups ( F=50.13, P<0.01; F=7.573, P=0.000 7; F=12.14, P<0.01), of which the JAK3 mRNA expression level in the HC group [(606±65)×10 -4] was significantly higher than that in the AG group [(103±13)×10 -4] and IG group [(114±24)×10 -4], and the difference was statistically significant (both P<0.01), while the STAT5a mRNA expression level in the AG group [(89±9)×10 -4] was significantly higher than that in the IG group [(59±4)×10 -4] and HC group [(61±4)×10 -4], and the difference was statistically significant ( P=0.002, P=0.003 9), and the expression level of STAT5b mRNA in HC group [(60±5)×10 -4] was significantly lower than that in AG group [(95±7)×10 -4] and IG group [(98±7)×10 -4], and the difference was statistically significant ( P=0.000 2, P<0.000 1). ② The difference of IL-2 concentration in plasma among the three groups was statistically significant ( F=22.87, P<0.01), and the serum IL-2 concentration in the AG group [(87.9±8.4) pg/ml] was significantly higher than that in the IG group [(32±4) pg/ml] and HC group [(44±4) pg/ml], and the difference was statistically significant (both P<0.01). ③ Spearman correlation analysis showed that the mRNA expression of STAT5a and STAT5b was positively correlated with the absolute value of neutrophils in patients with gout ( r=0.282, P<0.05; r=0.257, P<0.05). Conclusion:The IL-2/JAK3/STAT5 signaling pathway is involved in the occurrence and development of gout, suggesting that this pathway may play a key role in the pathogenesis of gout.
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Objective:To explore the surgical techniques and clinical effects of minimally invasive adjustable plate (MIAP) together with distraction reduction by minimally invasive anterior pelvic ring internal fixator (INFIX) in the treatment of fresh Denis type ⅡB sacral fracture with sacral nerve injury.Methods:From June 2017 to June 2020, 12 fresh Denis type ⅡB sacral fractures were treated by anterior-posterior distraction reduction and fixation with MIAP and INFIX. There were 8 males and 4 females, with an average age of 30 years (from 16 to 44 years). Preoperatively, imaging found Denis ⅡB fracture of the sacrum and magnetic resonance neurography of the lumbosacral plexus showed injury to the sacral nerve root at the sacral foramen. All patients had symptoms of S 1 nerve root injury on the affected side after injury, with 9 cases of grade M0 and 3 cases of grade M1. The time from injury to operation averaged 11 days (from 5 to 19 days). INFIX combined with MIAP was used to distract and fixate the compressed sacral fracture. The quality of fracture reduction and recovery of sacral nerve function were evaluated postoperatively. Results:According to the criteria proposed by Lindahl et al., the quality of fracture reduction was excellent in 8 cases, good in 2 and fair in 2. The 12 cases were followed up for an average of 20 months (from 12 to 36 months). All sacral fractures got united after an average of 6 weeks (from 5 to 8 months). At one-year follow-up, according to the criteria proposed by the Nerve Injuries Committee of the British Medical Research Council, the postoperative muscle strength recovery was evaluated as complete recovery in 10 cases and as partial recovery in 2 cases.Conclusion:In the treatment of fresh Denis type ⅡB sacral fracture, MIAP combined with INFIX can obtain satisfactory clinical effects because the compressed sacrum can be effectively distracted, the sacral foramen be expanded and the sacral nerve be decompressed indirectly.
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Objective:To compare the clinical efficacy of lateral-rectus approach and ilioinguinal approach in the treatment of Torode-Zieg type IV pelvic fracture in toddlers.Methods:A retrospective cohort study was used to analyze the clinical data of 12 toddlers with Torode-Zieg type IV pelvic fracture admitted to Affiliated Hospital of Youjiang Medical College for Nationalities and Third Affiliated Hospital of Southern Medical University from June 2012 to June 2019. There were 6 males and 6 females, aged 13-36 months [(23.9±7.4)months]. Treatment via ilioinguinal approach was performed for 5 patients (ilioinguinal group), and via lateral-rectus approach for 7 patients (lateral-rectus group). Operation duration, intraoperative blood loss and postoperative complications were compared between the two groups. At the last follow-up, pelvic function was evaluated by Majeed function score, and fracture reduction was evaluated according to Mears-Velyvis radiological evaluation criterion.Results:All patients were followed for 24-72 months [(46.0±18.5)months]. In ilioinguinal group and lateral-rectus group, the operation time was (295.0±95.3)minutes and (165.1±52.2)minutes, respectively ( P<0.05), and the intraoperative blood loss was (190.0±65.2)ml and (225.7±92.0)ml, respectively ( P>0.05). In ilioinguinal group, the development of bilateral iliac wings was asymmetric in 3 patients. In lateral-rectus group, fracture-dislocation of epiphyseal plate together with abnormal development of iliac wing occurred in 1 patient, but had no effects on the function of lower limbs. According to Majeed function score at the last follow-up, the pelvic function in ilioinguinal approach group was rated as excellent in 1 patient, good in 2, fair in 1 and poor in 1, with the excellent and good rate of 60%, while the pelvic function in lateral-rectus group was excellent in 4 patients, good in 1, fair in 2 and poor in none, with the excellent and good rate of 71% ( P>0.05). According to Mears-Velyvis radiological evaluation criterion at the last follow-up, the fracture reduction in ilioinguinal group was rated as satisfied in 3 patients and dissatisfied in 2 patients, with the satisfaction rate of 60%, while the fracture reduction in lateral-rectus group was satisfied in 7 patients and dissatisfied in none, with the satisfaction rate of 100% ( P>0.05). Conclusions:For Torode-Zieg type IV pelvic fracture in toddles, both surgical approaches can complete the reduction and fixation. However, the lateral-rectus approach has shorter operation time and less damage to the epiphyseal structure around the pelvis than the ilioinguinal approach.
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Objective:To investigate the clinical efficacy of integrated acetabular wing-plate in the management of both column fractures with posterior wall involvement via the lateral-rectus approach.Methods:A retrospective case series analysis was performed on 43 patients with both column fractures involved with posterior wall admitted to Third Affiliated Hospital of Southern Medical University from March 2016 to June 2020. There were 35 males and 8 females, aged 19-78 years [(47.3±13.3)years]. The single lateral-rectus approach was used to expose, reduce and fix the fracture using the integrated acetabular wing-plate. Operation time, incision length, intraoperative blood loss and bone healing time were recorded. Quality of fracture reduction was assessed according to the Matta reduction criteria at postoperative 2 days, and hip function by the modified Merle d′Aubigné-Postel score at postoperative 3 months and 12 months. Postoperative complications were observed.Results:All patients were followed up for 12-48 months [(28.1±13.1)months]. Operation duration was 35-150 minutes [(84.6±26.3)minutes], with incision length of 8-12 cm [(9.4±1.0)cm] and intraoperative blood loss of 100-1 200 ml [(200(300, 500) ml]. Bone healing time was 3-6 months [(3.9±0.9)months]. According to Matta reduction criteria,the results were excellent in 32 patients, good in 7 and poor in 4 at postoperative 2 days, with the excellent and good rate of 91%. The modified Merle d′Aubigné-Postel score was 12-18 points [(16.1±1.5)points] at postoperative 3 months, and 13-18 points [(17.3±1.2)points] at postoperative 12 months ( P<0.01). According to modified Merle d′Aubigné-Postel score, the results were excellent in 3 patients, good in 34 and fair in 6 at postoperative 3 months, with the excellent and good rate of 86%; and the results were excellent in 32 patients, good in 9 and fair in 2 at postoperative 12 months, with the excellent and good rate of 95% ( P<0.01). Postoperative complications were incision fat liquefaction and infection in 1 patient, weakness of hip adduction in 5 and screw loosening with traumatic arthritis in 1. There was no sciatic nerve injury or heterotopic ossification. Conclusion:For both column fractures with posterior wall involvement, single lateral-rectus approach combined with integrated acetabular wing-plate has advantages of short operation time, minor trauma, low rate of bleeding and complications, and good hip function recovery, indicating satisfactory clinical effect.
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Objective:To understand the epidemiological and clinical characteristics of patients with tsutsugamushi disease in Zaozhuang City, Shandong Province, and to provide a basis for formulating effective diagnosis and treatment plan of tsutsugamushi disease. Methods:Retrospective analysis was carried out to collect clinical data of 38 patients with tsutsugamushi disease admitted to Zaozhuang Municipal Hospital of Shandong Province from 2018 to 2020. The epidemiological characteristics, clinical manifestations, laboratory examination results and drug treatment of patients with tsutsugamushi disease were analyzed. Results:Among the 38 patients with tsutsugamushi disease, 15 were males and 23 were females, aged (58.58 ± 14.47) years old; the occupation distribution was mainly farmers, accounting for 92.11% (35/38); the onset time was concentrated in October and November, accounting for 100.00% (38/38); the regional distribution was mainly in Yicheng District, accounting for 34.21% (13/38); 38 patients had a history of grassland/forest contact. All patients had fever, and other main symptoms were eschar (97.37%, 37/38), headache (68.42%, 26/38), fatigue (42.11%, 16/38), and whole body aches (36.84%, 14/38), etc. The results of laboratory examination mainly showed that C-reactive protein increased (89.47%, 34/38), procalcitonin increased (81.58%, 31/38), abnormal liver function (78.95%, 30/38), D-dimer increased (71.05%, 27/38), eosinophils decreased (60.53%, 23/38), and erythrocyte sedimentation rate increased (57.89%, 22/38). All 38 patients were cured after treated with doxycycline or azithromycin. Conclusions:The high incidence time of tsutsugamushi disease in Zaozhuang City is autumn. The clinical symptoms are mainly fever, eschar and headache. Doxycycline and azithromycin are the first choices for treatment of the disease.
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Objective:To analyze the epidemiological characteristics and clinical manifestations of patients with acute brucellosis in Zaozhuang City of Shandong Province, and to improve the understanding of brucellosis.Methods:The demographic characteristics, epidemiological characteristics, clinical manifestations and laboratory examination results of patients with acute brucellosis diagnosed in Zaozhuang Municipal Hospital from January 2019 to December 2020 were retrospectively analyzed.Results:Most of the 71 patients with acute brucellosis were male, with a male-to-female ratio of 2.2 ∶ 1.0 (49 ∶ 22) and an average age of (53.23 ± 14.12) years old, mainly in Yicheng District (32.39%, 23/71); 80.28% (57/71) of patients had a history of epidemiological contact; the disease occurred throughout the year, mainly from April to October (76.06%, 54/71); the main symptoms were fever (100.00%, 71/71), muscle and joint pain (80.28%, 57/71), fatigue (54.93%, 39/71), hyperhidrosis (39.44%, 28/71), hepatosplenomegaly (18.31%, 13/71) and orchitis (4.23%, 3/71), etc. Laboratory examination results showed that decreased white blood cells accounted for 12.68% (9/71), decreased red blood cells accounted for 21.13% (15/71), thrombocytopenia accounted for 8.45% (6/71), decreased lymphocyte percentage accounted for 12.68% (9/71), increased C-reactive protein accounted for 67.61% (48/71), and accelerated erythrocyte sedimentation rate accounted for 50.70% (36/71). Some patients were accompanied by elevated alanine aminotransferase (50.70%, 36/71) and aspartate aminotransferase (42.25%, 30/71), 57 patients (80.28%) with positive blood culture.Conclusions:The clinical manifestations of acute brucellosis are atypical in Zaozhuang City. Brucellosis screening should be carried out for patients with long-term unexplained fever and an epidemiological exposure history, especially those with muscle joint pain, hepatosplenomegaly and orchitis.
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OBJECTIVE@#To observe the effect of needle knife on chondrocyte autophagy and expressions of autophagy-related protein and mammalian target of rapamycin (mTOR) in rats with knee osteoarthritis (KOA), and to explore the possible mechanism of needle knife for KOA.@*METHODS@#A total of 42 SD rats were randomly divided into a normal group, a model group and a needle knife group, 14 rats in each group. Except for the normal group, the other two groups were injected with the mixture of papain and L-cysteine into the left hind knee joint to establish the KOA model. After modeling, the rats in the needle knife group were treated with needle knife at strip or nodule around the quadriceps femoris and medial and lateral collateral ligament on the affected side, once a week for 3 times (3 weeks). The changes of left knee circumference in each group were observed; the chondrocytes and ultrastructure of left knee joint were observed by HE staining and electron microscope; the mRNA and protein expressions of autophagy-related genes (Atg5, Atg12, Atg4a), Unc-51 like autophagy activated kinase 1 (ULK1), autophagy gene Beclin-1 and mTOR in left knee cartilage were detected by real-time fluorescence quantitative PCR and Western blot.@*RESULTS@#After modeling, the left knee circumferences in the model group and the needle knife group were increased compared with those before modeling and in the normal group (P<0.05); after intervention, the left knee circumference in the needle knife group was smaller than that in the model group and after modeling (P<0.05). Compared with the normal group, the number of chondrocytes was decreased, and a few cells swelled, nuclei shrank, mitochondria swelled and autophagosomes decreased in the model group; compared with the model group, the number of chondrocytes was increased , and most cell structures returned to normal, and autophagosomes was increased. Compared with the normal group, the mRNA and protein expressions of Atg5, Atg12, Atg4a, Beclin-1 and ULK1 in the knee cartilage in the model group were decreased (P<0.05); compared with the model group, the expressions of the above indexes in the needle knife group were increased (P<0.05). Compared with the normal group, the mRNA and protein expressions of mTOR in the knee cartilage in the model group were increased (P<0.05); compared with the model group, the expressions of the above indexes in the needle knife group were decreased (P<0.05).@*CONCLUSION@#The needle knife intervention could improve knee cartilage injury in rats with KOA, and its mechanism may be related to reducing the expression of mTOR and up-regulating the expressions of Atg5, Atg12, Atg4a, ULK1 and Beclin-1, so as to promote chondrocyte autophagy and delay the aging and degeneration of chondrocytes.
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Animals , Rats , Autophagy , Autophagy-Related Protein-1 Homolog/genetics , Beclin-1/genetics , Chondrocytes , Osteoarthritis, Knee/therapy , Rats, Sprague-Dawley , TOR Serine-Threonine Kinases/geneticsABSTRACT
@#Objective To investigate the occurrence and characteristics of dysphagia and aspiration in the elderly in nursing home in Weifang, Shandong, China.Methods From January to June, 2021, 837 elderly people from 10 nursing homes in Weifang were randomly selected and investigated with general situation questionnaire, Fried Frailty Phenotype, Ohkuma questionnaire and Volume-Viscosity Swallowing Test.Results The prevalence of dysphagia and aspiration was 44.2% and 12.3% respectively. There were significant differences in the prevalence of dysphagia among ages and health condition (χ2 > 8.437, P<0.05). The prevalence of dysphagia and aspiration was higher in men than in women (χ2 > 4.060, P < 0.05). The incidence of oral dysphagia was higher in men than in women, and the incidence of esophageal dysphagia was lower (χ2 > 20.830, P<0.001). Oral dysphagia was predominant in the elderly with stroke, Alzheimer's disease, and Parkinson's disease (χ2=27.579, P<0.001), and esophageal dysphagia and airway protection dysfunction were predominant in the elderly with chronic respiratory disease (χ2 > 20.241, P<0.01).Conclusion The dysphagia and aspiration are prevalent in the elderly in nursing homes, and varies with different genders and basic diseases.
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@#Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. The existing treatment of postoperative AF mainly focuses on preoperative prevention, intraoperative protection and postoperative treatment for factors prone to AF before, during and after surgery, but the postoperative treatment in various areas and hospitals is different. This article combines the latest literature published in Europace about the practice guidance of cardioversion of AF and atrial flutter, and summarizes the treatment of electrical cardioversion, in order to provide clinical guidance for electrical cardioversion of AF after cardiac surgery.
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Three sesquiterpenoids and nine iridoids were isolated from the roots and rhizomes of Valeriana jatamansi by various chromatographic methods. Their structures were identified by physicochemical properties, NMR and MS data. Among them, valeriananoid G (1) was a new patchoulol-type sesquiterpenoid, and compound 3 was isolated from the genus Valeriana for the first time. Compounds 3 and 10 exhibited significant inhibitory effects on nitric oxide production induced by lipopolysaccharide in RAW 264.7 macrophages, with IC50 values of 19.00 and 3.66 μmol·L-1, respectively. In addition, compounds 4, 6 and 12 showed anti-influenza virus activity with IC50 values of 51.75, 51.40 and 102.08 μmol·L-1, respectively.
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The key factors for producing the best quality Chinese herbal medicines are high-quality germplasm, suitable cultivation area and the proper processing methods for herbal raw materials. Gentiana crassicaulis in Gentiana (Sect. Cruciata), Gentianaceae is one of the original plants of the Chinese herb Qinjiao (Gentianae Macrophyllae Radix), and its type specimen was collected in Lijiang, Yunnan. There is a long planting history of the herb in this area. In this study a sampling plot was designated in these traditional planting areas. G. crassicaulis was planted and herbal raw materials were harvested from the plot. The raw materials were prepared locally and at a pharmaceutical factory in Shanghai using processing methods such as "sweating" or "no sweating", "slicing" or "no slicing" (whole root), and "stoving" or "no stoving" (air drying). The quality of all processed samples was evaluated. In addition, molecular markers were determined for identifying cultivated and wild samples from Lijiang, Yunnan. The results are as follows: ① Samples from the sampling plot and the field are taxonomically identified as Gentiana crassicaulis. ② A total of 270 sequences of trnC-GCA-petN, atpB-rbcL, psbN, ndhB-rps7 and ycf1 were obtained, and three genotypes were determined from the cultivated samples; the type III was shared by both cultivated and wild plants. Based on the molecular markers, a DNA barcoding method to identify cultivated and wild samples of G. crassicaulis from Lijiang, Yunnan was established. ③ Total content of loganic acid and gentiopicroside in all samples was ≥ 2.5%, and above the Chinese Pharmacopoeia (2020) limit. ④ In HPLC fingerprinting, 9 common peaks were assigned and similarity between all samples was > 0.999; and ⑤ In a PCA score plot all slice samples were clustered, while whole root samples were scattered. Therefore, our studies could provide basic data for optimizing the processing method, producing best quality Gentianae Macrophyllae Radix, and evaluating the quality of different ecotype varieties and the multiple origin of herbal medicines.
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Objective:To analyze the clinical characteristics of PHPT in elderly patients, as well as the safety and effectiveness of surgical treatment.Methods:179 patients with PHPT treated from Jan. 2000 to Dec. 2020 were analyzed retrospectively. They were divided into elderly group ( n=51) and non-elderly group ( n=128) according to whether they were over 60 years old at the time of operation. The clinical data of symptoms, complications, preoperative and postoperative blood calcium, phosphorus, ALP, PTH, surgical cure rate and complication rate of the two groups were analyzed retrospectively. T-test was used for measurement data comparison. χ2 test was used for enumeration data comparison and single factor analysis. Logistic regression analysis (forward method) was used for multivariate analysis. Results:The proportion of non-specific symptoms in the elderly group, including fatigue, dizziness, loss of appetite, memory decline, was higher than that in the non-elderly group (21.6% vs 8.6%, P=0.019) . Elderly patients had lower blood ALP level[ (163.4±229.8) U/L vs (325.9±449.2) U/L, P=0.016], higher proportion of preoperative hypertension (47.1% vs 21.1%, P=0.001) , diabetes (31.4% vs 10.9%, P=0.001) , coronary heart disease (13.7% vs 3.1%, P=0.013) and tumor (13.7% vs 3.9%, P=0.025) . High proportion of non-specific symptoms was related to higher blood calcium [ OR=4.936 (95% CI 1.126-21.637) , P=0.034] and lower blood phosphorus[ OR=0.011 (95% CI 0.000-0.650) , P=0.030]. Between the two groups there was no significant difference in cure rate (94.1% vs 96.1%, P=0.564) or complication rate (27.5% vs 44.5%, P=0.127) . Conclusions:The surgical treatment of elderly patients with PHPT also has high effectiveness and safety. More attention should be paid to surgical diagnosis and treatment of elderly patients.
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Objective:To investigate the clinical value of intraoperative intravenous injection of indocyanine green in differentiating extrahepatic bile duct structure in chronic atrophic cholecystitis.Methods:A retrospective analysis was performed on the data of 110 patients diagnosed with chronic AC who underwent laparoscopic cholecystectomy (LC) admitted to the Department of Hepatobiliary and pancreatic Surgery of Changzhou Second People′s Hospital from January 2020 to July 2021. All patients were confirmed by abdominal B-ultrasound before surgery. The patients in the experimental group were divided into experimental group ( n=55) and control group ( n=55) according to whether indocyanine green was intravenously injected during the operation. The experimental group was intravenously injected with 5 mg indocyanine green during the operation, and LC was navigated by indocyanine green fluorescence imaging technique during the operation. The control group received routine LC. The imaging rate and imaging time of the cystic duct, common bile duct, and common hepatic duct in the experimental group were compared. The clinical data, identify three tube time, operation time, intraoperative blood loss, abdominal cavity drainage placement and extubation time, transfer laparotomy and bile duct injury, postoperative hospital stay, postoperative first review of alanine aminotransferase (ALT), glutamine transferase (GGT) of leveling and follow-up were compared between the two groups. The measurement data subject to normal distribution were expressed by Mean±standard deviation ( ± s), and the two groups were compared by independent sample t test. The measurement data of skewness distribution were described by M( Q1, Q3)and the manhui method in nonparametric test was used Mann-whitney U test.The chi-square test or Fisher′s exact probability method was used for comparison between groups of count data. Results:Operation was performed successfully in both groups. In the experimental group, the common hepatic duct, common bile duct and gallbladder duct were developed successfully in all patients, 54 cases and 52 cases respectively, and the developing time of the three tubes was (15.8±1.2) min. In the experimental group, the time of three tubes, operation time, intraoperative blood loss and abdominal drainage tube placement were (18.5±1.3) min, (64.0±6.8) min, (16.3±6.7) mL, 43 cases, respectively. In the control group, there were (46.3±8.1) min, (98.7±10.5) min, (53.6±14.9) mL and 55 cases, respectively. The experimental group was significantly lower than the control group, and the difference between the two groups was statistically significant ( P< 0.05). There was no case of conversion to laparotomy and bile duct injury in the experimental group, and 1 case of conversion to laparotomy and 1 case of bile duct injury in the control group, and there was no statistical significance between the two groups ( P>0.05). There were significant differences in postoperative extubation time and postoperative hospital stay between the two groups ( P<0.05). ALT and GGT levels were 47(31, 75) U/L and 38(19, 114) U/L in the experimental group and 62(53, 92) U/L and 76(63, 96) U/L in the control group at the first postoperative review, with statistically significant differences between the two groups ( P<0.05). Patients in both groups were followed up for 3 months after discharge. There were no obvious complications in the experimental group, and 1 case had a small amount of peritoneal effusion 7 days after discharge in the control group. Conclusion:In the face of LC with chronic AC, intraoperative intravenous injection of indocyanine green to develop extrahepatic bile duct can help to distinguish its anatomical structure and avoid bile duct injury, improve the safety and progress of surgery, and maximize training and improve the level of the surgeon.
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Recent advances in genome editing, especially CRISPR-Cas nucleases, have revolutionized both laboratory research and clinical therapeutics. CRISPR-Cas nucleases, together with the DNA damage repair pathway in cells, enable both genetic diversification by classical non-homologous end joining (c-NHEJ) and precise genome modification by homology-based repair (HBR). Genome editing in zygotes is a convenient way to edit the germline, paving the way for animal disease model generation, as well as human embryo genome editing therapy for some life-threatening and incurable diseases. HBR efficiency is highly dependent on the DNA donor that is utilized as a repair template. Here, we review recent progress in improving CRISPR-Cas nuclease-induced HBR in mammalian embryos by designing a suitable DNA donor. Moreover, we want to provide a guide for producing animal disease models and correcting genetic mutations through CRISPR-Cas nuclease-induced HBR in mammalian embryos. Finally, we discuss recent developments in precise genome-modification technology based on the CRISPR-Cas system.