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1.
Chinese Journal of Geriatrics ; (12): 292-296, 2021.
Article in Chinese | WPRIM | ID: wpr-884882

ABSTRACT

Objective:To evaluate the efficacy and safety of conventional diuretic therapy versus Tolvaptan in elderly chronic heart failure patients combined with mild to moderate renal insufficiency with hyponatremia, in order to provide clinical evidence for the treatment of heart failure in the elderly.Methods:This was a randomized control trial.A total of 88 elderly chronic heart failure patients combined with mild to moderate renal insufficiency with hyponatremia were randomly divided into the control group(n=46)and the experimental group(n=42). Once enrolled both groups stopped taking oral loop diuretics.In addition to routine treatment, the control group was treated with furosemide 40 mg once a day, while the experimental group was treated with Tolvaptan 15 mg once a day.The rate of effectiveness in relieving heart failure, the diuretic effects and improvement in heart and kidney function were monitored, and changes in serum potassium and sodium levels and the incidences of thirst and other adverse events were compared between the two groups.Results:The effectiveness rate on heart failure was higher in the experimental group than in the control group(85.7% or 36/42 vs.65.2% or 30/46, χ2=17.855, P<0.001). After treatment, greater changes in average 24-hour urine volume from baseline(787.4±219.6 ml vs.388.6±179.6 ml, t=322.588, P<0.001), more weight loss(-2.4±2.1 kg vs.-1.7±1.6 kg, t=6.942, P=0.009), smaller changes in N-terminal pro-B-type natriuretic peptide(NT-proBNP)from baseline(-897.6±432.1 ng/L vs.-578.4±476.9 ng/L, t=539.400, P<0.001), greater changes in left ventricular ejection fraction(LVEF)from baseline(6.5±5.6 % vs.1.5±5.7 %, t=3.966, P=0.048), smaller changes in serum creatinine from baseline(-8.6±12.4 μmol/L vs.9.6±11.3 μmol/L, t=87.161, P<0.001), and greater changes in estimated glomerular filtration rate(eGFR)from baseline(1.4±1.8 ml·min -1·1.73m -2vs.-4.1±5.6 ml·min -1·1.73m -2, t=63.856, P<0.001)and in serum sodium from baseline(6.2±2.1 mmol/L vs.1.4±1.9 mmol/L, t=234.065, P<0.001)were observed in the experimental group than in the control group.There was no significant difference in the incidences of thirst, dry mouth and other adverse events between the two groups(16.7% or 7/42 vs.10.9% or 5/46, χ2=0.626, P=0.429). Conclusions:Tolvaptan can effectively improve the clinical symptoms and cardiac function and correct hyponatremia in elderly chronic heart failure patients combined with mild to moderate renal insufficiency, with a good safety profile.

2.
Article in Chinese | WPRIM | ID: wpr-884482

ABSTRACT

Objective:To understand and analyze the levels of individual dose to medical radiation workers from occupational external exposure in Inner Mongolia autonomous region from 2015 to 2019, with a view to provide basic scientific data for workers′ health protection and radiation protection management.Methods:By using National Individual Dose Registry, the individual dose monitoring result and other related data for medical workers were collected and analyzed.Results:The average annual individual doses to medical radiation workers in a time order from 2015 to 2019 were 0.72, 0.87, 0.88, 0.71 and 0.64 mSv, respectively. There were significant differences in the annual effective dose distribution in diagnostic radiology, dental radiology, nuclear medicine, radiotherapy, interventional radiology and other applications ( H=466.56, P<0.05). The average annual effective doses to workers in interventional radiology and nuclear medicine had not shown significant difference ( P>0.05), but significantly higher than those in other occupational categories ( Z=19.95, 9.87, 10.10, 12.76, P<0.05). Conclusions:The average annual effective dose to medical radiation workers is in accordance with the relevant national standards. The dose values for the radiation workers involved in interventional radiology and nuclear medicine are relatively high, especially for interventional radiology workers and radioactive drug operators. The protection measures should be further improved in radiation protection workplace.

3.
Article in Chinese | WPRIM | ID: wpr-879379

ABSTRACT

OBJECTIVE@#To compare therapeutic effects of internal fixation with volar locking plate in treating extension and flexion type of distal radius fracture (DRF).@*METHODS@#From January 2015 to June 2018, 103 patients with DRF were retrospectively analyzed. According to original fracture displacement direction, patients were divided into extension fracture(Colles) group and flexion fracture (Smith) group. In Colles fracture group, there were 24 males and 44 females aged from 20 to 79 years old with an average of (59.0±13.4) years old;according to AO classification, 9 patients of type A2, 13 patients of type A3, 16 patientsof type C1, 17 patients of type C2 and 13 patients of type C3;the time from injury to operation ranged from 2 to 9 days with an average of (3.9±0.8) days. In Smith fracture group, there were 15 males and 20 females, aged from 27 to 87 years old with an average of (60.1±15.3) years old;according to AO classification, 4 patienst of A2, 7 patients of A3, 14 patients of C1, 5 patients of C2 and 5 patients of C3;the time from injury to operation ranged from 2 to 6 days with an average of (4.1±0.9) days. Operation time, fracture healing time and postoperative complications were recorded between two groups. Disabilities of arm, shoulder and hand (DASH) score at 6 and 8 weeks, 6 and 8 months were used to evaluate functional recovery of affected limbs during each follow up. Volar tilt, radial inclination and radius height were measured at 8 months after operation. Mayo score was measured at 8 months after operation to evaluate recovery of limb function.@*RESULTS@#All patients were followed up for 8 to 30 months with an average of (14.8±4.3) months, and no difference in follow up between two groups (@*CONCLUSION@#Patients with Colles fracture and Smith fracture could receive good reduction and fixation through volar locking plate. The radiographic parameters of both groups recovered satisfactorily after operation. Recovery of volar tilt of Smith fracture group is better than that of Colles fracture group, and early recovery function of Colles fracture group is better than that of Smith group, but there is no significant difference in long-term wrist joint function and incidence of postoperative complications between two groups.


Subject(s)
Adult , Aged , Aged, 80 and over , Bone Plates , Female , Fracture Fixation, Internal , Humans , Male , Middle Aged , Radius Fractures/surgery , Range of Motion, Articular , Retrospective Studies , Treatment Outcome , Wrist Joint , Young Adult
4.
Article in Chinese | WPRIM | ID: wpr-879163

ABSTRACT

To systematically evaluate the clinical efficacy and safety of Compound Danshen Dripping Pills combined with conventional antihypertensive drugs in the treatment of hypertensive left ventricular hypertrophy. China National Knowledge Infrastructure(CNKI), Wanfang, VIP, PubMed, EMbase, Cochrane Library, Ovid and Web of Science databases were searched by computer to retrieve the randomized controlled trials(RCTs) of Compound Danshen Dripping Pills combined with conventional antihypertensive drugs in the treatment of hypertensive left ventricular hypertrophy from the establishment of databases to July 2020. After two researchers performed data retrieval, data extraction, and risk assessment of bias, they used RevMan 5.3 software for Meta-analysis. A total of 10 RCTs were included, with a total of 979 patients. Meta-analysis results showed that in terms of interventricular septal thickness(MD=-0.70, 95%CI[-1.15,-0.24], P=0.003), left ventricular posterior wall thickness(MD=-0.81, 95%CI[-1.41,-0.21], P=0.008), left ventricular mass index(MD=-8.75, 95%CI[-17.40,-0.10], P=0.05), systolic blood pressure(MD=-8.97, 95%CI[-13.46,-4.48], P<0.000 1), diastolic blood pressure(MD=-5.87, 95%CI[-8.39,-3.34], P<0.000 01) and left ventricular end-diastolic diameter(MD=-1.73, 95%CI[-2.38,-1.08], P<0.000 01), Compound Danshen Dripping Pills combined with conventional antihypertensive drugs was superior to conventional antihypertensive drugs. In terms of left ventricular ejection fraction(MD=0.41, 95%CI[-0.74, 1.55], P=0.49), there was no statistical difference in treatment between the two groups. Because of the small amount of literatures included in the safety aspect, it is impossible to give an accurate conclusion. The GRADE score showed that the level of evidence was low and extremely low. The results show that the Compound Danshen Dripping Pills combined with conventional antihypertensive drugs may effectively improve the clinical efficacy for hypertensive ventricular hypertrophy, and the safety needs to be further explored. Due to the low quality of the included literatures, more high-quality RCTs are needed for verification.


Subject(s)
Antihypertensive Agents/adverse effects , China , Drugs, Chinese Herbal/adverse effects , Humans , Hypertrophy, Left Ventricular/drug therapy , Stroke Volume , Treatment Outcome , Ventricular Function, Left
5.
Chinese Journal of Biotechnology ; (12): 361-377, 2021.
Article in Chinese | WPRIM | ID: wpr-878567

ABSTRACT

Exoelectrogenic microorganisms are the research basis of microbial electrochemical technologies such as microbial fuel cells, electrolytic cells and electrosynthesis. However, their applications are restricted in organic degradation, power generation, seawater desalination, bioremediation, and biosensors due to the weak ability of biofilm formation and the low extracellular electron transfer (EET) efficiency between exoelectrogenic microorganisms and electrode. Therefore, engineering optimization of interaction between exoelectrogenic microorganisms and electrode interface recently has been the research focus. In this article, we review the updated progress in strategies for enhancing microbe-electrode interactions based on microbial engineering modifications, with a focus on the applicability and limitations of these strategies. In addition, we also address research prospects of enhancing the interaction between electroactive cells and electrodes.


Subject(s)
Bioelectric Energy Sources , Biofilms , Electrodes , Electron Transport , Electrons
6.
Article in Chinese | WPRIM | ID: wpr-878424

ABSTRACT

OBJECTIVES@#This study was performed to clarify the effects of sitagliptin on @*METHODS@#Healthy gingival samples were collected from the donors. HGFs were isolated with enzymic digestion method and identified. The effects of LPS and sitagliptin on cell viability were detected by cell-counting kit-8 (CCK8). The mRNA levels of inflammatory cytokines, namely, interleukin (IL)-6, IL-8, C-C motif ligand 2 (CCL2), and superoxide dismutase 2 (SOD2), were evaluated by quantity real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immune sorbent assay (ELISA) was used to measure the secretion protein levels of IL-6, IL-8, and CCL2. Western blot analysis was used to further investigate the activation of nuclear factor (NF)-κB signaling pathway. The effect of NF-κB pathway inhibitor BAY11-7082 on LPS-induced HGF inflammatory cytokines at the gene level was verified by qRT-PCR.@*RESULTS@#Low concentrations of sitagliptin (0.1, 0.25, and 0.5 µmol·L@*CONCLUSIONS@#Sitagliptin could significantly inhibit LPS-induced HGF inflammatory response by blocking the NF-κB signaling pathway activation.


Subject(s)
Fibroblasts , Gingiva/metabolism , Humans , Lipopolysaccharides , NF-kappa B/metabolism , Signal Transduction , Sitagliptin Phosphate
7.
Asian Journal of Andrology ; (6): 69-73, 2021.
Article in English | WPRIM | ID: wpr-879738

ABSTRACT

46,XY disorders of sex development (DSD) is characterized by incomplete masculinization genitalia, with gonadal dysplasia and with/without the presence of Müllerian structures. At least 30 genes related to 46,XY DSD have been found. However, the clinical phenotypes of patients with different gene mutations overlap, and accurate diagnosis relies on gene sequencing technology. Therefore, this study aims to determine the prevalence of pathogenic mutations in a Chinese cohort with 46,XY DSD by the targeted next-generation sequencing (NGS) technology. Eighty-seven 46,XY DSD patients were enrolled from the Peking Union Medical College Hospital (Beijing, China). A total of fifty-four rare variants were identified in 60 patients with 46,XY DSD. The incidence of these rare variants was approximately 69.0% (60/87). Twenty-five novel variants and 29 reported variants were identified. Based on the American College of Medical Genetics and Genomics (ACMG) guidelines, thirty-three variants were classified as pathogenic or likely pathogenic variants and 21 variants were assessed as variants of uncertain significance. The overall diagnostic rate was about 42.5% based on the pathogenic and likely pathogenic variants. Androgen receptor (AR), steroid 5-alpha-reductase 2 (SRD5A2) and nuclear receptor subfamily 5 Group A member 1 (NR5A1) gene variants were identified in 21, 13 and 13 patients, respectively. The incidence of these three gene variants was about 78.3% (47/60) in patients with rare variants. It is concluded that targeted NGS is an effective method to detect pathogenic mutations in 46,XY DSD patients and AR, SRD5A2, and NR5A1 genes were the most common pathogenic genes in our cohort.

8.
Article in Chinese | WPRIM | ID: wpr-873218

ABSTRACT

Classical famous prescription Dihuang Yinzi is widely used in modern clinical practice,and can treat many kinds of diseases,especially the diseases of nervous system in internal medicine. Its clinical effect is accurate,but it has not been converted into Chinese patent medicine preparations. Therefore,the authors have collected ancient traditional Chinese medicine(TCM) literatures of Dihuang Yinzi by the methods of bibliometrics,and selected and sorted out 254 pieces of effective data, involving 144 ancient books of TCM,and systematically summarized and analyzed the historical development origin,main treatment syndrome,formula making principle,dosage,preparation method,decoction method and medicine taking method of Dihuang Yinzi,in order to provide the ancient literary evidence support for the development and clinical application of classic famous prescriptions. It is found that Dihuang Yinzi was from Xuanming Lunfang written by LIU He-jian,a doctor of Jin dynasty. It was composed of 12 kinds of herbs,namely Rehmanniae Radix Praeparata,Morindae Officinalis Radix,Corni Fructus,Cistanches Herba,Dendrobii Caulis,Aconm Lateralis Radix Praeparaia,Schisandrae Chinensis Fructus,Cinnamomi Ramulus,Poria,maimendong,Acori Calami Rhizoma and Polygalae Radix, and mainly used for the treatment of Yinfei. The later records of Dihuang Yinzi mostly followed the prescription composition and main treatment set forth in Xuanming Lunfang,and its clinical application was expanded. In the 199 articles with the indications for disease treatment,Yinfei was the most commonest indication, and took up about half of the total,which was followed by stroke,taking up about two fifths of the total. It was also used for the treatment of sudden aphonia,flaccidity syndrome,vertigo,enuresis. Dihuang Yinzi has a wide range of treatment,but the pathogenes is always belongs to "the deficiency of water and fire in the kidney". The recipe of Dihuang Yinzi was unique,and can be used to treat both the upper and lower parts of the body,as well as both the outward symptoms and root causes of an illness at the same time, in particular,it mainly focuses on the treatment of the lower and the root. Among the 56 literatures with drug dosage records,about one third of them inherited the records of Xuanming Lunfang: "Equal division,the top is the end,3 qian for each dose." The dosage was generally light. The preparations are mostly decoction and boiled powder. In the decocting and taking methods,it was suggested that "turbid medicine shall be boiled for a short time,and taken after several boilings,with no limit to time."

9.
Article in Chinese | WPRIM | ID: wpr-873215

ABSTRACT

Objective:To observe the effect of modified Tongqiao Huoxuetang on circulating blood flow and wall shear stress of vertebrobasilar dolichoectasia (VBD) due to blood stasis and channel blockage. Method:A total of 97 patients admitted in our department from October 2017 to August 2019 were collected. The traditional Chinese medicine (TCM) syndromes were consistent with blood stasis and channel blockage, and diagnosed as VBD by magnetic resonance angiography (MRA). The patients were divided into experimental group (48 cases) and control group (49 cases). Control group was given basic therapy and placebo of TCM, while treatment group was given basic therapy and modified Tongqiao Huoxuetang for 30 days. The degree of relief of vertigo symptoms, vertigo symptom scale (VSS), activity balance confidence (ABC), transcranial doppler (TCD) bilateral vertebral artery and basilar artery blood flow velocity [systolic blood flow velocity (Vs), mean blood flow velocity (Vm), diastolic blood flow velocity (Vd)], mean blood flow differences between (MFV), pulsatility index, resistance index (RI), and wall shear force (WSS) were observed before and after treatment. Result:Compared with control group before treatment, the score of ABC scale in control group after treatment was markedly higher, while the score of VSS was significantly lower (P<0.05). However, there was no statistical significance in the score of vertigo symptom. Compared with treatment group before treatment, the symptom grade of vertigo degree and the score of VSS in treatment group after treatment were substantially lower, while the score of ABC scale was significantly higher (P<0.05). Compared with control group, the score of vertigo degree symptoms and VSS in treatment group were markedly lower, while the score of ABC scale was significantly higher (P<0.05). Compared with control group before treatment, Vm, MFV and WSS of bilateral vertebral artery in control group after treatment were substantially higher, while RI was significantly lower (P<0.05). However, there were no statistical significances in Vs, Vd and PI in control group before and after treatment. Compared with treatment group, Vs, Vd, Vm, MFV and WSS of bilateral vertebral artery in treatment group after treatment were markedly higher, while RI was significantly lower (P<0.05). However, there was no statistical significance in PI of experimental group before and after treatment. Compared with control group after treatment, Vs, Vd, Vm, MFV and WSS of bilateral vertebral artery in treatment group after treatment were substantially higher, while there was no statistical significance in PI and RI. Before and after treatment, there were similar changes in blood flow parameters of the basilar artery and bilateral vertebral artery. Conclusion:Modified Tongqiao Huoxuetang could improve the clinical symptoms of dizziness or vertigo in patients of VBD due to blood stasis and channel blockage, and the mechanism might be related to the improvement of post-circulation hemodynamics by Tongqiao Huoxuetang.

10.
Article in Chinese | WPRIM | ID: wpr-873152

ABSTRACT

Objective:To investigate the mechanism of decomposed Zuoguiwan(ZGW) recipes in treating ovariectomized osteoporosis rats. Method:Forty Sprague-Dawley female rats were equally and randomly divided into Sham-operated group, ovariectomized model group, positive group, and low and high-dose ZGW groups. After 12 weeks of administration by gavage, the bone mineral density (BMD) of rats' distal femur was measured by micro-CT, the morphology of bone tissue were observed by hematoxylin-eosin staining (HE), β-cross-linked c-telopeptide of type Ι collagen (β-CTX) and bone-specific alkaline phosphatase (BALP) in serum were detected by enzyme-linked immunosorbent assay (ELISA), and the mRNA and protein expressions of β2AR, OPG and RANKL were evaluated by Western blot analysis and real-time quantitative polymerase chain reaction (PCR). Result:Compared with Sham-operated group, BMD of rats in ovariectomized model group was decreased (P<0.01), morphology of bone tissue was destroyed, serum BALP was reduced, while β-CTX was boosted (P<0.01),mRNA and protein expressions of OPG in tibia were reduced, while RANKL were increased, and mRNA and protein expressions of β2AR in the hypothalamus were decreased (P<0.05, P<0.01). Compared with ovariectomized model group, BMDs of rats in low and high-dose ZGW groups were increased (P<0.01), morphology of bone tissue was repaired, serum BALP and mRNA and protein expressions of OPG in tibia were up-regulated (P<0.05, P<0.01), whereas serum β-CTX and mRNA and protein expressions of β2AR in the hypothalamus and RANKL in tibia were down-regulated (P<0.05, P<0.01). Conclusion:Yang-nourishing components in decomposed Zuoguiwan recipes can improve BMD of ovariectomized rats by regulating OPG/RANKL pathway mediated by β2AR. "Seeking Yin in Yang" is a crucial mechanism of Zuoguiwan in treating ovariectomized osteoporosis in rats.

11.
Article in Chinese | WPRIM | ID: wpr-873023

ABSTRACT

Objective:To analyze the common active ingredients, potential target genes and pathways of Ginseng Radix et Rhizoma "Tonifying Qi" and Notoginseng Radix et Rhizoma "Enriching blood" in alleviating fatigue based on the network pharmacology technology. And the compound ingredients of total Ginsenoside Ginseng Root and Notoginseng total Saponins were selected to verify the core target genes in vitro. Method:The main active ingredients and related targets of Ginseng Radix et Rhizoma and Notoginseng Radix et Rhizoma were screened by traditional Chinese medicine systems pharmacology (TCMSP). The data of fatigue genes were established by GeneCards comprehensive database and Human Mendelian Genetic Integrated Database(OMIM). Depending, The data sets of fatigue-related genes are established based on the data bank of GeneCards and OMIM. The intersecting genes of drugs and disease were obtained by R software. Cytoscape software was used to establish the regulatory network among the active ingredients, drug targets and fatigue-related genes. PPI network of intersecting genes was constructed by STRING 11.0 software, and the core genes were screened by CytoHubba software and Matthews correlation coefficient (MCC) algorithm. Based on the results of network analysis, 24 male SPF ACR mice were randomly divided into control group, total Ginsenoside Ginseng Root group (0.08 g·kg-1) and Notoginseng total Saponins group (0.08 g·kg-1). The corresponding drugs were given for 3 weeks. The expressions of core genes in muscle tissue were detected by real-time fluorescence quantitative PCR. Result:The 20 active components and 181 drug targets were screened from TCMSP. 33 intersecting genes of diseases and drugs were obtained when compared with GeneCards and OMIM comprehensive database using R software. 10 core genes including aryl hydrocarbon receptor (AHR), androgen receptor (AR), glutathione S-transferase P1 (GSTP1), cysteine proteinase-3(Caspase-3), cytochrome p450 enzyme 3A4 (CYP3A4), intercellular adhesion molecule 1 (ICAM1) and nuclear factor kappa B inhibitor alpha (NFKBIA) were screened out by the algorithm of MCC. Total Ginsenoside Ginseng Root and Notoginseng total Saponins had no significant effect on GSTP1 and ICAM1 genes, but they could significantly inhibit the expressions of AHR, CYP3A4, Caspase-3, NFKBIA and AR (P<0.05,P<0.01), and there were no significant difference in anti-fatigue effect between total Ginsenoside Ginseng Root and Notoginseng total Saponins groups. Conclusion:The mechanism of anti-fatigue of Ginseng Radix et Rhizoma and Notoginseng Radix et Rhizoma may be related to the regulation of AHR, CYP3A4 and Caspase-3 genes, and there is no significant difference in their anti-fatigue effects, through the analysis of network and experimental verification.

12.
Article in Chinese | WPRIM | ID: wpr-872840

ABSTRACT

Objective:To explore the mechanism of modified Guipitang in the treatment of Yin-Fire insomnia with anxiety with the help of network pharmacological analysis technology. Method:Traditional Chinese Medicine Systems Pharmacology (TCMSP) was used to screen the main components and target genes of modified Guipitang. GeneCards and Online Mendelian Inheritance in Man (OMIM) were used to establish the target gene sets of insomnia and anxiety. STRING 11.0 software was used to analyze the interaction between the overlapping genes, and Cytoscape_3.6.1 software analysis and Matthews correlation coefficient (MCC) algorithm were used to screen the core genes. Based on the results of network analysis, 48 SD female rats were randomly divided into blank control group, model group, eszopiclone tablets group (0.2 mg·kg-1·d-1), modified Guipitang low,medium,and high-dose groups (0.31,1.25,5 g·kg-1·d-1). The model of insomnia with anxiety was established by intraperitoneal injection of Para-chlorophenylalanine (PCPA) and these rats were treated with corresponding drugs for 7 days. Then the frequency, time and distance of the activities were observed in the experiment of autonomic activity. Real-time quantitative polymerase chain reaction (PCR) was used to detect the mRNA expressions of proactivated protein kinase 8 (MAPK8), RAC-alpha serine/threonine protein kinase (Akt1), mitogen-activated protein kinase 3 (MAPK3) and interleukin-6 (IL-6) in rat hippocampus. Result:A total of 228 active compounds were screened from TCMSP database and 181 intersecting genes of diseases and drugs were obtained by comparing with GeneCards and OMIM comprehensive database. 9 core genes, including MAPK3, MAPK8, Akt1 and IL-6 were identified by STRING software and MCC algorithm. Animal experiments showed that the number of activity times, time and distance of modified Guipitang in high and medium dose groups were significantly lower than those in the model group. The high and middle dose groups of modified Guipitang could significantly inhibit the mRNA expression of MAPK3, MAPK8, Akt1 and IL-6 in hippocampus(P<0.01), while the low dose group had no significant effect. Conclusion:The mechanism of modified Guipitang in treating Yin-fire insomnia with anxiety may be related to the regulation of MAPK3, MAPK8, Akt1 and IL-6 genes.

13.
Article in Chinese | WPRIM | ID: wpr-870220

ABSTRACT

Objective To investigate clinical characteristics and treatment of phytophotodermatitis due to ingesting Chenopodium album.Methods This study included 11 patients with phytophotodermatitis caused by ingesting Chenopodium album collected from Department of Dermatology,Affiliated Hospital of Jining Medical University from 2013 to 2017.The patients' general information,clinical manifestations,laboratory test results,treatment and prognosis were retrospectively analyzed.Results All the 11 patients were female,and their age ranged from 45 to 62 years.They all had a history of ingesting Chenopodium album and exposing to sunlight within 1-2 days prior to the disease onset.Clinical manifestations included symmetrically distributed,painful and pruritic,nonpitting,swelling erythema on the face and back of both hands and at sunexposed sites of forearms,with a tense and bright surface.Increased white blood cell counts were observed in 6 patients,and increased eosinophil counts in 1.All of the 11 patients were treated with systemic methylprednisolone,loratadine,ebastine,spironolactone,furosemide and omeprazole as well as topical agents,2 also received human immunoglobulin treatment,and 3 were also treated with oral ibuprofen and codeine for painful lesions.Ten patients received obvious improvement and were discharged after 7-10 days of treatment,and no pigmentation or scars were observed after 1-year follow-up.Skin necrosis occurred on the back of both hands in 1 patient after 7-day treatment,and scars remained in the patient after follow-up of half a year.Conclusions Chenopodium album-induced phytophotodermatitis commonly manifests as swelling erythema on the exposed body sites.After confirmed diagnosis,Chenopodium album ingestation and sunlight exposure should be avoided,and timely antianaphylactic treatment should be considered to effectively control the disease.

14.
Chinese Journal of Geriatrics ; (12): 1038-1041, 2020.
Article in Chinese | WPRIM | ID: wpr-869522

ABSTRACT

Objective:To evaluate the therapeutic effects of Tolvaptan on refractory heart failure in patients aged 75 years and older.Methods:This was a randomized controlled trial.A total of 68 patients with refractory heart failure aged 75 years and older were divided into the control group(n=38)and the experimental group(n=30)by randomly generated numbers.Patients in the control group were given levosimendan and recombinant human brain natriuretic peptide intravenously plus routine treatments such as diuresis and electrolyte correction.In the experimental group, 30 patients were given a single dose of 15 mg Tolvaptan per day in addition to what was received by the control group.The effects on heart failure were compared between the two groups 1 week after treatment.Changes in rehospitalization rate, emergency intervention frequency and mortality rate were recorded after a 3-month follow-up.Results:Clinical symptoms of heart failure were alleviated in both the experimental and control groups after treatment.Improvements in 24-h urine volume, body weight and 6-minute walking distance were more significant in the experimental group than in the control group after treatment[(1 470.5±200.6)ml vs.(972.5±201.7)ml, (-6.4±2.1)kg vs.(-2.8±1.9)kg, (189.3±13.7)m vs.(151.3±12.5)m, P<0.05]. Changes in serum sodium levels and improvement of LVEF were greater and reduction of N-terminal B-type brain natriuretic peptide(NT-proBNP)levels was more significant in the experimental group than in the control group after treatment[(5.2±2.1)μmol/L vs.(-1.1±2.4)μmol/L, (10.1±4.1)% vs.(7.0±4.0)%, (-6 670±1 815.7)ng/L vs.(-5 025.3±1 876.7)ng/L, P<0.05]. There was no significant difference in the incidence of adverse reactions between the two groups( P>0.05). The experimental group had shorter hospital stays, while the rehospitalization rate, emergency intervention times and mortality had no significant difference between the two groups during the follow-up period( P>0.05). Conclusions:Addition of Tolvaptan to treatment can increase urine volume, improve cardiac function, correct hyponatremia and shorten the length of hospitalization in refractory heart failure patients aged 75 years and older with good safety and has no significant impact on renal function.

15.
Chinese Journal of Geriatrics ; (12): 779-782, 2020.
Article in Chinese | WPRIM | ID: wpr-869472

ABSTRACT

Objective:To investigate the influence of frailty on post-treatment outcomes in elderly heart failure patients with reduced ejection fraction treated with Sacubitril/Valsartan.Methods:The 231 heart failure patients aged 60 years or over with reduced ejection fraction were enrolled from October 2017 to October 2018 in Department of Geriatric Medicine, Henan Provincial People's Hospital.Patients were divided into the frailty group(n=116)and the control group(n=115). Frailty diagnosis was made by five indexes suggested by LP Fried.Both groups were treated with sacubitril/valsartan(49/51 mg)for 1 year.The left ventricular ejection(LVEF), estimated glomerular filtration rate(eGFR), N-terminal pro B-type natriuretic peptide(NT-proBNP)and other clinical and laboratory indexes were detected before and after treatment and compared between the frailty group and the control group.Results:16 subjects in the frailty group and 11 subjects in the control group dropped out of the study.The frailty group versus the control group showed a higher mortality rate of cardiovascular causes(13.0% or 13/100 vs.6.7% or 7/104, χ2=6.437, P=0.027), a higher first re-hospitalization rate(18.0% or 18/100 vs.11.5% or 12/104, χ2=4.458, P=0.043)and a higher all-cause mortality(16.0% or 16/100 vs.8.6% or 9/104, χ2=3.875, P=0.039). In the frailty group, levels of serum NT-proBNP and creatinine were higher and eGFR was lower after treatment than before treatment[(2 253±144) ng/L vs.(2 094±136) ng/L, (137±24) μmol/L vs.(125±23) μmol/L, (49.2±5.9) ml·min -1·1.73 m -2vs.(56.7±6.3) ml·min -1·1.73 m -2, t=3.674, 2.893 and 2.068, P=0.017, 0.026 and 0.029]. In the control group, serum NT-proBNP levels were lower after treatment than before treatment[(1 828±123) ng/L vs.(1 945±128) ng/L, t=1.896, P=0.043], while serum creatinine levels[(120±22) μmol/L vs.(117±19) μmol/L, t=2.099, P=0.650]and eGFR[(59.8±6.5) ml·min -1·1.73 m -2vs.(61.6±6.8) ml·min -1·1.73 m -2, t=2.444, P=0.173]had no significant difference between post-treatment and pre-treatment. Conclusions:Frailty has adverse affects on the mortality, re-hospitalization rate and renal function in elderly heart failure patients with reduced ejection fraction treated with Sacubitril/Valsartan.

16.
Chinese Journal of Radiology ; (12): 869-873, 2020.
Article in Chinese | WPRIM | ID: wpr-868348

ABSTRACT

Objective:To develop and validate a cascaded deep learning algorithm for kidney stone detection on plain CT images.Methods:Plain CT images of the patients with kidney stones were retrospectively archived from January 2018 to July 2018 in Peking University First Hospital. The cases were divided into two datasets according to the date of the CT scanning: training dataset ( n=30) and held-out test dataset ( n=29). The development of the kidney stone detection method consisted of three steps. First, a U-Net model was trained on the training dataset for kidney segmentation, and the model′s performance was estimated with the dice coefficient. Second, the thresholding and region growing methods were used to detect the stones in the renal region predicted by the trained U-Net model. Third, the stones′ lengths (maximal, middle and minimal length) and CT attenuation were calculated and integrated into a structured report automatically. Using the radiologist′s labels and measurements (maximal, middle, minimal length and CT attenuation) as ground truth, the stone detection algorithm performance was evaluated with sensitivity, specificity and precision, and the stone measurement algorithm performance was evaluated with Bland-Altman plots. Results:The held-out test dataset consisted of 29 cases, containing 58 kidneys and 11 358 CT slices. The 38 kidneys containing 56 stones and 20 kidneys did not contain stones. The U-Net model showed good performance, with a mean dice coefficient of 0.96. And 10 945 of 11 358 CT slices had a dice coefficient no less than 0.90. The sensitivity, precision, and specificity of stone detection were 100% (38/38), 100% (38/38) and 100% (20/20) in the organ-level. The sensitivity and precision of stone detection were 100% (56/56) and 96.6% (56/58) in the lesion-level.Conclusion:A cascaded algorithm is constructed and can be used to detect kidney stones in plain CT images. The algorithm can improve efficiency with results automatically integrated into the structured report in clinical practice.

17.
Article in English | WPRIM | ID: wpr-880314

ABSTRACT

BACKGROUND@#We aim to explore the association between self-reported snoring and hypertension among adults aged 30-79 in Chongqing, China.@*METHODS@#A total of 23,342 individuals aged 30-79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension.@*RESULTS@#Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45-59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34-2.02; 45-59: OR = 1.53, 95%CI 1.37-1.72; ≥ 60: OR = 1.25, 95%CI 1.09-1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33-1.63; women: OR = 1.97, 95%CI 1.75-2.23).@*CONCLUSIONS@#People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.


Subject(s)
Adult , Aged , China/epidemiology , Cross-Sectional Studies , Female , Humans , Hypertension/etiology , Male , Middle Aged , Self Report , Snoring/complications
18.
Chinese Journal of Pathology ; (12): 122-128, 2020.
Article in Chinese | WPRIM | ID: wpr-799495

ABSTRACT

Objective@#To investigate the clinicopathological and radiological features of benign fibro-osseous lesion (BFOL).@*Methods@#Sixty-five cases of craniofacial BFOL, eight cases of peripheral ossifying fibroma (POF) and one case of low-grade central osteosarcoma diagnosed at Sichuan Provincial People′s Hospital between January 2010 and March 2019 were collected. The clinicopathologic features, hematoxylin-eosin and immunohistochemical (IHC) staining and radiographic features were analyzed. MDM2 gene amplification was detected by FISH in difficult borderline cases.@*Results@#This cohort of BFOLs included 50 cases of fibrous dysplasia (FD), 12 cases of ossifying fibroma (OF), and three cases of juvenile psammomatoid ossifying fibroma (JPOF). The average ages of patients with FD,OF and JPOF were 31.7, 39.2 and 26.0 years respectively. The male to female ratio was 1.0∶1.8.The average age of POF was 47.0 years, with male to female ratio of 1∶7. Patient of low-grade central osteosarcoma was a 48-year-old man. Twenty-seven cases of FD were located in the jaw, and 23 cases were in other craniofacial bones. Nine cases of OF were located in the jaw, and three cases were in the nasal cavity. Two cases of JPOF were in the nasal sinus, and one was in the jaw. All POF were located in the gingiva, and low-grade central osteosarcoma was located in the mandible. The imaging features of FD were luffa-like or ground-glass like signal shadows with poorly defined borders with expansion. OF had clear borders or sclerosing margins. Both JOF and low-grade central osteosarcoma were expansile intraosseously and with focally invasive nodular masses with ground-glass like signal shadows; and POF showed soft tissue mass with bone formation. Histological features of BFOLs showed mixed fibrous and irregular osteoid lesions. FD had no clear relationship with the host bone and no osteoblasts surrounded the bone trabeculae. Osteoblasts rimming was found in OF, and the boundaries of the host bone were clear. JPOF and low-grade central osteosarcoma infiltrated the host bone focally, and the latter showed mild cellular atypia. MDM2 amplification was detected in low-grade central osteosarcoma.@*Conclusions@#BFOLs are a group of fibro-osseous lesions with similar morphology in the head and neck and face, but their clinical features and prognosis are different; and their imaging and histological characteristics are also slightly different. Attentions should be given to the combination of clinical, imaging and pathologic features of BFOLs, especially the differential diagnosis between BFOLs and low-grade central osteosarcoma. Molecular detection could be used to assist the diagnosis in difficult cases.

19.
Article in Chinese | WPRIM | ID: wpr-798966

ABSTRACT

Objective@#To investigate clinical characteristics and treatment of phytophotodermatitis due to ingesting Chenopodium album.@*Methods@#This study included 11 patients with phytophotodermatitis caused by ingesting Chenopodium album collected from Department of Dermatology, Affiliated Hospital of Jining Medical University from 2013 to 2017. The patients′ general information, clinical manifestations, laboratory test results, treatment and prognosis were retrospectively analyzed.@*Results@#All the 11 patients were female, and their age ranged from 45 to 62 years. They all had a history of ingesting Chenopodium album and exposing to sunlight within 1 - 2 days prior to the disease onset. Clinical manifestations included symmetrically distributed, painful and pruritic, nonpitting, swelling erythema on the face and back of both hands and at sunexposed sites of forearms, with a tense and bright surface. Increased white blood cell counts were observed in 6 patients, and increased eosinophil counts in 1. All of the 11 patients were treated with systemic methylprednisolone, loratadine, ebastine, spironolactone, furosemide and omeprazole as well as topical agents, 2 also received human immunoglobulin treatment, and 3 were also treated with oral ibuprofen and codeine for painful lesions. Ten patients received obvious improvement and were discharged after 7 - 10 days of treatment, and no pigmentation or scars were observed after 1-year follow-up. Skin necrosis occurred on the back of both hands in 1 patient after 7-day treatment, and scars remained in the patient after follow-up of half a year.@*Conclusions@#Chenopodium album-induced phytophotodermatitis commonly manifests as swelling erythema on the exposed body sites. After confirmed diagnosis, Chenopodium album ingestation and sunlight exposure should be avoided, and timely antianaphylactic treatment should be considered to effectively control the disease.

20.
Chinese Medical Journal ; (24): 2090-2097, 2020.
Article in English | WPRIM | ID: wpr-826437

ABSTRACT

BACKGROUND@#TOSO, also named Fas inhibitory molecule 3 (FAIM3), has recently been identified as an immunoglobulin M (IgM) Fc receptor (FcμR). Previous studies have shown that TOSO is specifically over-expressed in chronic lymphocytic leukemia (CLL). However, the functions of TOSO in CLL remain unknown. The B-cell receptor (BCR) signaling pathway has been reported to be constitutively activated in CLL. Here, we aimed to investigate the functions of TOSO in the BCR signaling pathway and the pathogenesis of CLL.@*METHODS@#We over-expressed TOSO in B-cell lymphoma cell lines (Granta-519 and Z138) by lentiviral transduction and knocked down TOSO by siRNA in primary CLL cells. The over-expression and knockdown of TOSO were confirmed at the RNA level by polymerase chain reaction and protein level by Western blotting. Co-immunoprecipitation with TOSO antibody followed by liquid chromatography coupled with tandem mass spectrometry (IP/LCMS) was used to identify TOSO interacting proteins. Western blotting was performed to detect the activation status of BCR signaling pathways as well as B-cell lymphoma 2 (BCL-2). Flow cytometry was used to examine the apoptosis of TOSO-over-expressing B lymphoma cell lines and TOSO-down-regulated CLL cells via the staining of Annexin V and 7-AAD. One-way analyses of variance were used for intergroup comparisons, while independent samples t tests were used for two-sample comparisons.@*RESULTS@#From IP/LCMS, we identified spleen tyrosine kinase (SYK) as a crucial candidate of TOSO-interacting protein and confirmed it by co-immunoprecipitation. After stimulation with anti-IgM, TOSO over-expression increased the phosphorylation of SYK, and subsequently activated the BCR signaling pathway, which could be reversed by a SYK inhibitor. TOSO knockdown in primary CLL cells resulted in reduced SYK phosphorylation as well as attenuated BCR signaling pathway. The apoptosis rates of the Granta-519 and Z138 cells expressing TOSO were (8.46 ± 2.90)% and (4.20 ± 1.21)%, respectively, significantly lower than the rates of the control groups, which were (25.20 ± 4.60)% and (19.72 ± 1.10)%, respectively (P < 0.05 for both). The apoptosis rate was reduced after knocking down TOSO in the primary CLL cells. In addition, we also found that TOSO down-regulation in primary cells from CLL patients led to decreased expression of BCL-2 as well as lower apoptosis, and vice versa in the cell line.@*CONCLUSIONS@#TOSO might be involved in the pathogenesis of CLL by interacting with SYK, enhancing the BCR signaling pathway, and inducing apoptosis resistance.

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