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1.
Article in Chinese | WPRIM | ID: wpr-936317

ABSTRACT

We report a case of giant hysteromyoma and complex pelvic adhesion treated by robotic assisted laparoscopic total hysterectomy and bilateral salpingectomy. The patient was diagnosed with uterine fibroids after physical examination in 1998 but did not receive any treatment, and regular examinations reported progressive growth of the fibroids. Ultrasound suggested multiple uterine fibroids, and pelvic MRI indicated large uterine fibroids with bleeding. Robot-assisted laparoscopic total hysterectomy and bilateral salpingectomy were performed after relevant examinations, and the operation was completed smoothly. The patient was discharged 4 days after surgery with good appearance of the abdominal wall and good recovery during the follow-up. With its unique advantages, robot-assisted laparoscopy provides a minimally invasive surgical approach for giant hysterectomy with complex pelvic adhesions.


Subject(s)
Female , Humans , Hysterectomy , Laparoscopy , Leiomyoma/surgery , Robotics , Uterus
2.
Article in Chinese | WPRIM | ID: wpr-940693

ABSTRACT

ObjectiveTo explore the intervention effect of Erxian decoction on intestinal microflora after ovariectomy in rats by 16S rRNA gene sequencing. MethodThirty-two female healthy SD rats were randomly divided into a Sham operation (Sham) group, a model (OVX) group, an estrogen (E) group, and an Erxian decoction (EXD) group, with 8 rats in each group. The rats in the E group and the EXD group received 1.8×10-4 g·kg-1 estradiol valerate solution and 9 g·kg-1 Erxian decoction, respectively, and those in the Sham group and the OVX group received an equal volume of distilled water once a day for 16 weeks. After 16 weeks, the levels of serum estrogen and blood lipid were detected. The fecal DNA was extracted, followed by 16S rRNA gene sequencing and analysis. ResultCompared with the Sham group, the OVX group showed reduced serum estrogen level (P<0.01) and increased serum levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (P<0.05). Compared with the OVX group, the E group and the EXD group showed increased serum estrogen level (P<0.01) and reduced TC and LDL-C (P<0.05). Alpha diversity showed that there was no significant change in intestinal microflora diversity after ovariectomy. Beta diversity showed that there were significant differences in the structure of intestinal microflora in the four groups. The intervention of Erxian decoction could improve the changes in intestinal microflora after ovariectomy. LEfSe was used to analyze the differential flora in the four groups. The results showed that the Sham group and the OVX group had 3 differential bacterial phyla and 18 differential bacterial genera, the OVX group and the E group had 1 differential bacterial phylum and 12 differential bacterial genera, and the OVX group and the EXD group had 3 differential bacterial phyla and 5 differential bacterial genera. Estrogen intervention could reverse the change trend of Ruminococcus 1, Anaerovibrio, and Turicibacter in the OVX group. Erxian decoction intervention could reverse the change trend of Bacteroidetes, Firmicutes, Prevotella 9, Ruminococcaceae UCG-014, Ruminococcus 1, and Fusicatenibacter in the OVX group. ConclusionThe structure and function of intestinal microflora in ovariectomized rats changed obviously, and Erxian decoction could ameliorate the change.

3.
Article in Chinese | WPRIM | ID: wpr-940633

ABSTRACT

ObjectiveTo optimize the extraction and purification process of Gardeniae Fructus for industrial production, and to obtain the total iridoid and total crocin extracts. MethodOrthogonal test was used to optimize the water extraction process by taking contents of geniposide, genipin gentiobioside, gardenoside, crocin-1 and crocin-2 as indicators and the decocting time, decocting times and water amount as factors. The purification process was optimized by single factor test, and four different types of macroporous adsorption resins were screened. The process conditions such as resin type, maximum loading amount, water washing amount, ethanol concentration, ethanol dosage, and flow rate of sample loading were mainly investigated. In addition, the drying methods (vacuum drying and spray drying) of the extract were investigated, and a pilot scale-up verification test was carried out. ResultThe optimal water extraction process of Gardeniae Fructus was to add 15, 10 times the amount of water for decocting twice, 1 h each time. The optimal purification process was as follows:the water extract through SP825L macroporous resin column, the amount of crude drug-the amount of resin (1∶1.5), the sample loading flow rate of 3 BV h-1, adding 2 BV of water to remove impurities, adding 4 BV of 30% ethanol to obtain the iridoid part, then adding 3 BV of 70% ethanol to obtain the crocin part, collecting the ethanol lotion, and drying at 70 ℃. Under these conditions, the extraction amount of total iridoids was 590.75 mg·g-1 with the transfer rate of 70.48%, and the yield of dry extract was 8.89%. The extraction amount of total crocins was 83.37 mg·g-1 with the transfer rate of 22.20%, and the dry extract yield was 2.60%. ConclusionThe optimized extraction and purification process is stable and feasible with high extraction rate of active components, which is suitable for the industrial extraction and purification of active parts of Gardeniae Fructus.

4.
Article in Chinese | WPRIM | ID: wpr-940452

ABSTRACT

ObjectiveTo explore the mechanism of coking death and apoptosis of A549 cells induced by Tingli Dazao Xiefeitang. MethodA549 cells were randomized into blank group, traditional Chinese medicine(TCM) low, medium, and high concentration groups, which were treated with 20, 40, 60 mg·L-1 Tingli Dazao Xiefeitang, and TCM low, medium, and high concentration groups, respectively, and blank group was treated with equal volume culture medium. After 48 h of treatment, cell migration was detected by scratch assay and cell apoptosis was detected by flow cytometry. The relative expression levels of cysteine aspartate protease-1(Caspase-1), NOD-like receptor protein 3 (NLRP3), dermoderin D (GSDMD), Survivin protein and nuclear transcription factor -κB (NF-κB) pathway proteins were detected by Western blot. The levels of intracellular reactive oxygen species (ROS) were determined by DCFH-DA fluorescence probe, and the contents of tumor necrosis factor -β (TNF-β) and interleukin-1β (IL-1β) in supernatant were determined by enzyme-linked immunosorbent assay (ELISA). ResultCompared with blank group, the scratch healing rate, apoptosis rate, relative expression of Survivin protein, Caspase-1, GSDMD, NLRP3, ROS and NF-κB phosphorylation levels were significantly increased in low, medium and high concentration groups. The contents of TNF-β and IL-1β in supernatant were significantly increased (P<0.05). Compared with the low concentration group, the scratch healing rate, apoptosis rate, Survivin protein relative expression, Caspase-1, GSDMD, NLRP3 relative expression, ROS and NF-κB phosphorylation levels were significantly increased in the medium and high concentration groups. The contents of TNF-β and IL-1β in supernatant were significantly increased (P<0.05). Compared with the TCM group, the scratch healing rate, apoptosis rate, Survivin protein relative expression, Caspase-1, GSDMD, NLRP3 relative expression, ROS and NF-κB phosphorylation levels were significantly increased in the high concentration group. The contents of TNF-β and IL-1β in supernatant were significantly increased (P<0.05). ConclusionTingli Dazao Xiefeitang can improve NLRP3 protein expression, inhibit Survivin protein expression and promote apoptosis of A549 cells. At the same time, it can activate NF-κB pathway and ROS system, up-regulate the expression of Caspase-1 and GSDMD, mediate scortosis of A549 cells.

5.
Article in Chinese | WPRIM | ID: wpr-907139

ABSTRACT

ObjectiveTo analyze allergen-specific IgE (sIgE) in the serum of patients with allergic diseases, and provide the basis for clinical diagnosis and treatment. MethodsThe serum sIgE of 29 902 patients with allergic diseases in Hangzhou City of Zhejiang Province was detected by ELISA, and the result was analyzed with gender, age, time distribution. ResultsThe positive rate of total IgE (tIgE) in 29 902 patients with allergic diseases was 77.34%. The most common inhaled allergens were dust mite (36.75%), ragweed (11.23%) and tree pollen (9.06%), and the most common food allergens were egg protein (9.90%), milk (8.88%) and crab (4.62%). The positive rate of sIgE in men was higher than that in women. The positive rate of sIgE in people less than 18 years old was higher than that in people more than 18 years old. The positive rates of tree pollen sIgE decreased year by year. Most patients were allergic to one allergen, accounting for 52.52% of the total sIgE positive patients. ConclusionDust mite, ragweed, tree pollens, egg protein and milk are important allergens in Hangzhou. The prevention and treatment of allergic diseases should focus on these allergens. We should understand that the distribution of allergens in different ages and genders is different, so the prevention and treatment should focus on different aspects.

6.
Article in Chinese | WPRIM | ID: wpr-907116

ABSTRACT

ObjectiveTo analyze allergen-specific IgE (sIgE) in the serum of patients with allergic diseases, and provide the basis for clinical diagnosis and treatment. MethodsThe serum sIgE of 29 902 patients with allergic diseases in Hangzhou City of Zhejiang Province was detected by ELISA, and the result was analyzed with gender, age, time distribution. ResultsThe positive rate of total IgE (tIgE) in 29 902 patients with allergic diseases was 77.34%. The most common inhaled allergens were dust mite (36.75%), ragweed (11.23%) and tree pollen (9.06%), and the most common food allergens were egg protein (9.90%), milk (8.88%) and crab (4.62%). The positive rate of sIgE in men was higher than that in women. The positive rate of sIgE in people less than 18 years old was higher than that in people more than 18 years old. The positive rates of tree pollen sIgE decreased year by year. Most patients were allergic to one allergen, accounting for 52.52% of the total sIgE positive patients. ConclusionDust mite, ragweed, tree pollens, egg protein and milk are important allergens in Hangzhou. The prevention and treatment of allergic diseases should focus on these allergens. We should understand that the distribution of allergens in different ages and genders is different, so the prevention and treatment should focus on different aspects.

7.
Article in Chinese | WPRIM | ID: wpr-906161

ABSTRACT

Zexietang is derived from Jingui Yaolue (《金匮要略》), which is composed of Alismatis Rhizoma and Atractylodis Macrocephalae Rhizoma, and has the effect of inducing diuresis and invigorating the spleen to produce water. Compared with western medicine in the treatment of related diseases, Zexietang can not only improve the curative effect, but also reduce the occurrence of adverse reactions, so as to achieve long-term stable administration. The authors sorted out and analyzed the chemical composition, pharmacological effect and clinical application of Zexietang in recent years. It was found that the main active components of Zexietang were alismol A and B, 23-acetyl-alismol B and C, atractylenolides (atractylenolide Ⅰ, Ⅱ, Ⅲ) and polysaccharides. Pharmacological experiments showed that they had diuretic, hypolipidemic, anti-inflammatory and others. And it can be used in the treatment of hypertension, hyperlipidemia, vertigo, cerebral vascular insufficiency and other diseases combined with other Chinese materia medica, and the curative effect is obvious. By summarizing the research status of Zexietang in recent years, its active components and pharmacological mechanism can be further clarified, which provides the basis for the clinical application of Zexietang and guides the direction of its further research.

8.
Article in Chinese | WPRIM | ID: wpr-906069

ABSTRACT

The small size, moderate drug loading, and targeting properties of nano-preparations make them can be excellent delivery tools for drugs, genes or proteins crossing the cell or blood-brain barrier (BBB). Currently, facilitating drug crossing BBB with innovative nano-drug delivery systems is considered as a strategic approach for the prevention, diagnosis and treatment of central nervous system (CNS) diseases. However, with the deepening of the research, the adverse reactions and toxicity of nanocarriers have gradually attracted the attention of researchers. Based on this, this paper summarized the situation of BBB-penetrating targeted nano-preparations at home and abroad in recent years from the perspective of classification of types and properties of nanocarriers, and analyzed the advantages and disadvantages of each carrier. The results showed that nano-preparations with active ingredients of traditional Chinese medicine (TCM) as carriers have become a promising way of cancer treatment, but the complexity and diversity of TCM components limited its application to a certain extent. Further studies should be strengthened to lay a foundation for the application and development of TCM nano-preparations in the field of CNS diseases.

9.
Article in Chinese | WPRIM | ID: wpr-942507

ABSTRACT

Objective: To study the clinical diagnosis and treatment strategies for vein-related pulsatile tinnitus patients with transverse sinus stenosis. Methods: The clinical data of patients with vein-related pulsatile tinnitus, from January 2015 to August 2019, were collected,whose digital subtraction angiography showing transverse sinus stenosis. Taking December 2019 as the last follow-up time, we analyzed the clinical characteristics, CT angiography and digital subtraction angiography results, lumbar puncture pressure and cerebrospinal fluid composition, and other auxiliary examination results (pure tone audiometry, fundus examination of papilledema, carotid ultrasonography, bone density screening, endocrinous test), as well as tinnitus handicap inventory, treatment options and follow-up results. Results: 83 patients were enrolled with female of 89.2% (74/83) and male of 10.8%(9/83); 65.1% (54/83) with right tinnitus, 31.3% (26/83) with left tinnitus, and 3.6% (3/83) with bilateral tinnitus; 67.5% (56/83) with right dominant sinus, 19.3% (16/83) with left dominant sinus, 13.3% (11/83) with bilateral equalization; Bilateral and ipsilateral stenosis accounted for 55.4% and 44.6% respectively; BMI was overweight or obese in 41 cases (49.4%, 41/83). Patients with tinnitus handicap inventory level three or above accounted for 79.5% (66/83). Eventually, 33 patients chose conservative observation (39.8%, 33/83), 40 patients (48.2%), 8 patients (9.6%) and 2 patients (2.4%) received sigmoid sinus-related surgery, interventional surgery, or emissary vein occlusion respectively. The mean follow-up time of 74 patients was 26.2 months. The data of 48 surgery patients showed that the pressure differences of venous sinus among the recurrent patients were more obvious; Interventional surgery with simultaneous stenting placement was effective. Tinnitus did not decrease in two patients with emissary vein occlusion. Analysis of 26 patients with lumbar puncture revealed eight cases of normal cranial pressure and 18 cases of high cranial pressure. The sinus pressure difference between the two groups was different (P=0.025), but the difference of age of onset, concomitant symptoms, BMI, proportion of empty sella or papilledema was not statistically significant (P>0.05). Conclusions: The evaluation of patients with vein-related pulsatile tinnitus requires a standardized procedure. Papilledema cannot be used as a sensitive indicator in patients with early intracranial hypertension. Venous sinus pressure difference may be one of the indicators of intracranial hypertension, and the lumbar puncture is the gold standard for the diagnosis. Weight loss can be used as a conservative treatment during the observation period. Significant sinus stenosis is a risk factor for recurrence in patients undergoing sigmoid sinus surgery. Interventional stenting is an effective treatment for tinnitus secondary to transverse sinus stenosis.


Subject(s)
Constriction, Pathologic/complications , Cranial Sinuses , Female , Humans , Male , Neoplasm Recurrence, Local , Stents , Tinnitus/etiology
10.
Article in Chinese | WPRIM | ID: wpr-879151

ABSTRACT

The paclitaxel-loaded and folic acid-modified poly(lactic-co-glycolic acid) nano-micelles(PTX@FA-PLGA-NMs) were prepared by the emulsion solvent evaporation method, and the parameters of paclitaxel-loaded nano-micelles were optimized with the particle size and PDI as evaluation indexes. The morphology of the nano-micelles was observed by transmission electron microscopy(TEM), and the stability, drug loading and encapsulation efficiency were systematically investigated. In vitro experiments were performed to study the cytotoxic effects of nano-micelles, apoptosis, and cellular uptake. Under the optimal parameters, the nano-micelles showed the particle size of(125.3±1.2) nm, the PDI of 0.086±0.026, the zeta potential of(-20.0±3.8) mV, the drug loading of 7.2%±0.75%, and the encapsulation efficiency of 50.7%±1.0%. The nano-micelles were in regular spherical shape as observed by TEM. The blank FA-PLGA-NMs exhibited almost no inhibitory effect on the proliferation and growth of tumor cells, while the drug-loaded nano-micelles and free PTX exhibited significant inhibitory effects. The IC_(50) of PTX@FA-PLGA-NMs and PTX was 0.56 μg·mL~(-1) and 0.66 μg·mL~(-1), respectively. The paclitaxel-loaded nano-micelles were potent in inhibiting cell migration as assessed by the scratch assay. PTX@FA-PLGA-NMs had good pro-apoptotic effect on cervical cancer HeLa cells and significantly promoted the uptake of HeLa cells. The results of in vitro experiments suggested that PTX@FA-PLGA-NMs could target and treat cervical cancer HeLa cells. Therefore, as nanodrug carriers, PTX@FA-PLGA-NMs with anti-cancer activity are a promising nano-system for improving the-rapeutic effects on tumors.


Subject(s)
Antineoplastic Agents, Phytogenic/pharmacology , Cell Line, Tumor , Drug Carriers , Female , Folic Acid , Glycolates , HeLa Cells , Humans , Micelles , Paclitaxel , Particle Size , Uterine Cervical Neoplasms/drug therapy
11.
Article in Chinese | WPRIM | ID: wpr-875950

ABSTRACT

Objective The present study was conducted to identify the Vibrio cholera type and to analyze its antibiotic resistance in an epidemic of cholera in Haiyan County in 2018, which would provide the references for prevention and control of cholera. Methods Stool samples of the patient and his close contacts as well as the food and environmental samples were collected for identification of the type of Vibrio cholerae and the toxin gene. The resistance of identified Vibrio cholerae to 20 different common antibiotics were tested. Results A total of 176 samples were collected, including 101 stool samples from the case and his close contacts, 35 environmental samples and 40 food samples. Among those samples, only one strain of V. cholerae, O139, was isolated from the patient's first feces sample. It was detected as a toxin gene of ctxA positive by real-time fluorescence PCR. Antibiotic resistance test showed that the strain was sensitive to norfloxacin, levofloxacin, ciprofloxacin, cefotaxime, cephalothin, ampicillin, and amoxicillin. It was 100% resistant to tetracycline, doxycycline, neomycin, kanamycin, streptomycin, and rifampicin. Conclusion V. cholerae O139 strain with ctxA is detected in an epidemic of cholera. Norfloxacin, levofluoxacin and some other antibiotics could be used for clinical treatment and prevention. It should pay attention to this strain of V. cholera regarding the multiple drug resistance and the change of antibiotic resistance.

12.
Article in Chinese | WPRIM | ID: wpr-886761

ABSTRACT

Objective To analyze the epidemiological characteristics and diagnosis of imported malaria before and after malaria elimination in Nanjing City of Jiangsu Province, so as to provide the scientific evidence for formulating the malaria control strategy after malaria elimination. Methods Data pertaining to the epidemic situation and individual investigation of malaria in Nanjing City before (from 2012 to 2016) and after malaria elimination (from 2017 to 2020) were captured from the National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention and were analyzed statistically. Results A total of 178 malaria cases were reported in Nanjing City from 2012 to 2020, and all were imported cases. There were 99 malaria cases reported before malaria elimination in Nanjing City, including 78 cases with Plasmodium falciparum malaria (78.79%), 5 cases with P. vivax malaria (5.05%), 10 cases with P. ovale malaria (10.10%), 3 cases with P. malariae malaria (3.03%) and 3 cases with mixed infections (3.03%), and 79 malaria cases reported after elimination, including 63 cases with P. falciparum malaria (79.75%), 5 cases with P. vivax malaria (6.33%), 9 cases with P. ovale malaria (11.39%), 2 cases with P. malariae malaria (2.53%). There was no significant difference in the proportion of each type of malaria cases in Nanjing City before and after malaria elimination (χ2 =2.400, P > 0.05). Malaria cases mainly acquired Plasmodium infections in African regions, and no significant difference was seen in the proportion of malaria cases returning to Nanjing City from African countries before and after malaria elimination (χ2 = 0.093, P > 0.05). The number of malaria cases peaked in Nanjing City in January and during the period from May to July before elimination, and there was no apparent seasonal variation in the distribution of malaria cases after elimination. The proportion of malaria cases living in Nanjing City was significantly greater after malaria elimination than before elimination (72.15% vs. 55.56%; χ2 = 5.187, P = 0.023). The proportions of businessmen and international students were both 5.05% before malaria elimination, and increased to 15.19% and 13.92% after elimination, respectively (χ2 = 5.229 and 4.229, both P values < 0.05). The percentage of definitive diagnosis of malaria at initial diagnosis was 18.75% in county-level hospitals before malaria elimination and increased to 61.11% after elimination (χ2 = 6.275, P = 0.012), while the proportion of malaria cases with definitive diagnoses in county-level hospitals was 4.04% before malaria elimination and increased to 13.92% after elimination (χ2 = 5.562, P = 0.018). During the period from 2012 to 2020, the proportion of malaria cases with definitive diagnoses within 1 to 3 days post-admission increased from 27.27% in Nanjing City before malaria elimination to 45.57% after elimination (χ2 = 6.433, P = 0.011). Conclusions The epidemic situation of imported malaria remains serious in Nanjing City during the post-elimination stage, and malaria parasite infections predominantly occur in African regions. In addition, there are changes in regional and occupational distributions of malaria cases and the diagnostic capability of malaria increases in county-level hospitals in Nanjing City after malaria elimination. Further improvements in the malaria surveillance system and the diagnostic and treatment capability of malaria in medical institutions at each level are required to consolidate malaria elimination achievements in Nanjing City.

13.
Article in English | WPRIM | ID: wpr-829010

ABSTRACT

Objectives@#This paper aimed to investigate the prevalence of diabetes mellitus (DM) and explore the associated risk factors in a very elderly southwest Chinese population.@*Methods@#From September 2015 to June 2016, a cross-sectional survey was conducted to obtain a representative sample of 1,326 participants over 80 years old living in Chengdu. The presence of DM was based on fasting plasma glucose (FPG) and 2-h plasma glucose (2-hPG) levels during an oral glucose tolerance test (OGTT). A logistic regression model was used to calculate the odds ratios ( s) and 95% confidence intervals ( s) of the potential associated factors.@*Results@#The participants' mean age was 83.5 ± 3.1 years. The overall prevalence of DM was 27.4%. The prevalence was higher in males (30.2%) than females (24.7%) ( = 0.02). The prevalence of DM increased with body mass index (BMI) and decreased with aging. The multivariate analysis suggested that male sex ( = 1.433; 95% , 1.116-1.843), hypertension ( = 1.439; 95% , 1.079-1.936), overweight or obesity ( = 1.371; 95% , 1.023-1.834), high heart rate (≥ 75 beats/min; = 1.362; 95% , 1.063-1.746), and abdominal obesity ( = 1.615; 95% , 1.216-2.149) were all significantly positively correlated with DM. However, age was negatively correlated with DM ( = 0.952; 95% , 0.916-0.989).@*Conclusions@#The prevalence of DM and newly diagnosed DM in a very elderly southwest Chinese population was high. OGTT screening should be performed regularly in people aged ≥ 80 years to ensure timely diagnosis of DM.


Subject(s)
Aged, 80 and over , China , Epidemiology , Cross-Sectional Studies , Diabetes Mellitus , Epidemiology , Female , Humans , Male , Prevalence , Risk Factors
14.
Chinese Medical Journal ; (24): 2020-2026, 2020.
Article in English | WPRIM | ID: wpr-826423

ABSTRACT

BACKGROUND@#Youzhi artificial intelligence (AI) software is the AI-assisted decision-making system for diagnosing skin tumors. The high diagnostic accuracy of Youzhi AI software was previously validated in specific datasets. The objective of this study was to compare the performance of diagnostic capacity between Youzhi AI software and dermatologists in real-world clinical settings.@*METHODS@#A total of 106 patients who underwent skin tumor resection in the Dermatology Department of China-Japan Friendship Hospital from July 2017 to June 2019 and were confirmed as skin tumors by pathological biopsy were selected. Dermoscopy and clinical images of 106 patients were diagnosed by Youzhi AI software and dermatologists at different dermoscopy diagnostic levels. The primary outcome was to compare the diagnostic accuracy of the Youzhi AI software with that of dermatologists and that measured in the laboratory using specific data sets. The secondary results included the sensitivity, specificity, positive predictive value, negative predictive value, F-measure, and Matthews correlation coefficient of Youzhi AI software in the real-world.@*RESULTS@#The diagnostic accuracy of Youzhi AI software in real-world clinical settings was lower than that of the laboratory data (P < 0.001). The output result of Youzhi AI software has good stability after several tests. Youzhi AI software diagnosed benign and malignant diseases by recognizing dermoscopic images and diagnosed disease types with higher diagnostic accuracy than by recognizing clinical images (P = 0.008, P = 0.016, respectively). Compared with dermatologists, Youzhi AI software was more accurate in the diagnosis of skin tumor types through the recognition of dermoscopic images (P = 0.01). By evaluating the diagnostic performance of dermatologists under different modes, the diagnostic accuracy of dermatologists in diagnosing disease types by matching dermoscopic and clinical images was significantly higher than that by identifying dermoscopic and clinical images in random sequence (P = 0.022). The diagnostic accuracy of dermatologists in the diagnosis of benign and malignant diseases by recognizing dermoscopic images was significantly higher than that by recognizing clinical images (P = 0.010).@*CONCLUSION@#The diagnostic accuracy of Youzhi AI software for skin tumors in real-world clinical settings was not as high as that of using special data sets in the laboratory. However, there was no significant difference between the diagnostic capacity of Youzhi AI software and the average diagnostic capacity of dermatologists. It can provide assistant diagnostic decisions for dermatologists in the current state.

15.
Journal of Preventive Medicine ; (12): 466-470, 2020.
Article in Chinese | WPRIM | ID: wpr-822833

ABSTRACT

Objective@# To understand the awareness of palliative care and its influencing factors in community residents in Hangzhou,so as to provide basis for the development of palliative care service.@*Methods@#By convenient sampling method,the residents in the urban-rural junction of Xihu District were recruited. A self-designed questionnaire was used to investigate their awareness of palliative care. The logistic regression model was employed to analyze the influencing factors.@*Results @#A total of 519 questionnaires were recovered,with a response rate of 97.92%. There were 227 males and 292 females,accounting for 43.74% and 56.26%,respectively. There were 43,218 and 258 residents with more,basic and little understanding about palliative care, accounting for 8.29%,42.00% and 49.71%. The residents learned about palliative care mainly through television and radio,with 245 cases accounting for 47.21%;and they thought that the main reason for low awareness of palliative care was a lack of related knowledge,with 396 cases accounting for 76.30%. The results of multivariate logistic regression analysis showed that 50-59 years old(OR = 0.467,95% CI:0.285-0.767),primary school education and below(OR = 2.248,95%CI:1.239-4.079)and experience of caring for dying patients(OR = 1.551,95% CI:1.094-2.199)were the influencing factors for the awareness of palliative care. @*Conclusion@#The residents in Hangzhou had relatively low awareness of palliative care,which were associated with age,education level and experience of caring for dying patients.

16.
Journal of Preventive Medicine ; (12): 460-465, 2020.
Article in Chinese | WPRIM | ID: wpr-822830

ABSTRACT

Objective@#To evaluate the effects of office blood pressure(OBP)combined with ambulatory blood pressure monitoring(ABPM)on the diagnosis of hypertension.@*Methods@#The residents aged 35-79 years without hypertension history,whose casual OBP were 120~159 mm Hg/80~99 mm Hg,were enrolled from 4 communities of Hangzhou and Zhuji from 2015 to 2018. They were performed OBP measurements on other two days in 4 weeks and ABPM in a week. There were 2 criteria of OBP as elevated OBP on the first day or in 3 different days,and 4 criteria of ABPM as elevated mean BP in 24 hours, daytime, nighttime and either of the above time. Receiver operating characteristic(ROC)curve was employed to evaluate the effects of different OBP criteria combined with ABPM criteria on the diagnosis of masked hypertension(MH)and white-coat hypertension(WCH).@* Results@#Taking 3-day-OBP as a golden standard,the 1-day-OBP with 4 ABPM criteria had the areas under the ROC curve(AUC)of 0.79-0.81,sensitivity of 57.58%-62.77% and specificity of 100.00% in MH;had the AUC of 0.95-0.98,sensitivity of 100.00% and specificity of 88.96%-96.80% in WCH. The Kappa values were all less than 0.6,known as low consistency. Taking either time of ABPM as a golden standard,24 hours,daytime and nighttime ABPM criteria with OBP had the AUC of 0.90-0.92,sensitivity of 79.17%-83.90% and specificity of 100.00% in MH(all Kappa>0.6),when with 1-day-OBP,the Kappa values were all more than 0.8,known as high consistency;had the AUC of 0.95-1.00,sensitivity of 100.00% and specificity of 89.54%-99.37% in WCH,the Kappa values of daytime ABPM were all more than 0.6,known as high consistency. @* Conclusions @# If limited by options, 1-day-OBP could be used instead of 3-day-OBP for detection of WCH or exclusion of MH yet with less accuracy; 24 hours or daytime ABPM instead of either time of ABPM was reliable.

17.
Journal of Preventive Medicine ; (12): 437-441, 2020.
Article in Chinese | WPRIM | ID: wpr-822821

ABSTRACT

Objective@#To learn the prevalence and influencing factors of dyslipidemia among the residents aged 35-75 years in Zhejiang Province, so as to provide basis for prevention and control of dyslipidemia. @*Methods@#Based on the national high-risk early screening and comprehensive intervention program for cardiovascular disease, multi-stage stratified cluster sampling method was adopted to select 35-75 year-old permanent residents from six cities (counties or districts) in Zhejiang Province. A questionnaire survey was used to collect demographic data;physical examination and laboratory test were carried out. A multivariate logistic regression model was used to analyze the influencing factors for dyslipidemia. @*Results @#A total of 44 440 residents were investigated and 40 751 residents responded,accounting for 91.70%. The crude prevalence rate of dyslipidemia was 36.88% (15 027 cases) and the age-standardized one was 34.58%. The crude prevalence rates of hypercholesterolemia, hypertriglyceridemia and high low density lipoprotein-cholesterol were 18.10%, 14.05%, 10.57% and 15.78%, respectively,the age-standardized ones were 16.11%, 13.76% and 14.53%, respectively.The results of multivariate logistic regression analysis showed that age (OR=1.006, 95%CI:1.004-1.008),urban residence (OR=1.139, 95%CI: 1.087-1.194),smoking (OR=1.099, 95%CI: 1.033-1.170),drinking (OR=0.915,95%CI: 0.863-0.970),underweight (OR=0.623, 95%CI: 0.528-0.735), overweight (OR=1.624,95%CI: 1.552-1.699), obesity (OR=2.128, 95%CI: 1.985-2.281), diabetes (OR=1.600, 95%CI: 1.493-1.715), hypertension (OR=1.218, 95%CI: 1.165-1.273) and hyperurcemia (OR=1.789, 95%CI: 1.679-1.905) were associated with dyslipidemia. @*Conclusions@#The age-standardized prevalence rate of dyslipidemia among the residents aged 35-75 years in Zhejiang Province was lower than that in the whole country,but the prevalence rates of hypercholesterolemia,hypertriglyceridemia and high low density lipoprotein-cholesterol were relatively high.

18.
Article in Chinese | WPRIM | ID: wpr-873121

ABSTRACT

Objective::To investigate the evolution of cardiac function and blood pressure in ovariectomized rats and the effect and mechanism of Erxiantang. Method::Healthy 10-week-old female SPF SD rats were randomly divided into sham operation group, model group, estrogen group(estradiol valerate, 0.18 mg·kg-1) and Erxiantang group(7.5 g·kg-1). The rats were intragastrically administered 2 weeks after ovariectomy, once a day for 12 weeks.Sham operation groups and model groups were given equal volumes of purified water.At the 4th week, 8th week, and 12th week after administration, the cardiac function, blood pressure, and levels of estrogen (E2) in rat serum were measured by non-invasive ultrasound cardiogram (UCG), tail artery detection techniques and radioimmunoassay.The levels of endothelin-1 (ET-1) and angiotensin 2(Ang Ⅱ) in rat serum were detected by enzyme-linked immuno sorbent assay (ELISA). The cardiac morphology and apoptosis were detected by hematoxylin-eosin (HE) staining, electron microscopy and Terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL). Result::Compared with sham operation group, the ejection fraction (EF) decreased and the left ventricular end systolic volume (LVVols) increased in the model group at 4th week after administration(P<0.05). There was no significant difference in cardiac function between the groups at 8th week.The left ventricular end diastolic diameter (LVIDs), LVVols, left ventricular end diastolic diameter (LVIDd), and left ventricular end diastolic volume (LVVold) were significantly increased in the model group at 12th week (P<0.01). At the 4th weeks, 8th week and 12th week, the systolic blood pressure (SBP) of the model group increased (P<0.05) and showed an increasing trend, and the diastolic blood pressure (DBP) did not change significantly.At the 12th week, the levels of E2 in serum decreased (P<0.05), ET-1 and Ang Ⅱ increased of the model group (P<0.01). The cardiac myofibrils were irregular, some myofilament was broken, and mitochondrial palsy was disordered, broken or disappeared, and cardiac apoptosis increased (P<0.01). Compared with the model group, myocardial contraction and diastolic function were significantly improved in Erxian decoction group, and blood pressure was decreased.The levels of E2 in serum was increased (P<0.05). The levels of ET-1 was decreased (P<0.05), and AngⅡ in serum was significantly decreased (P<0.01). The mitochondrial morphological structure was improved and the cardiac apoptotic rate was significantly decreased (P<0.01). Conclusion::After the ovariectomy, the rats showed a series of pathological changes such as decreased heart function and increased blood pressure.Compared with the decrease of heart function, the changes of blood pressure appeared earlier.Erxiantang exerts its intervention on cardiac function and blood pressure in ovariectomized rats by regulating E2, blood active substances and cardiac apoptosis.

19.
Article in Chinese | WPRIM | ID: wpr-872650

ABSTRACT

Objective:To observe the changes of myocardial microvessel density, microvascular endothelial cell morphology and hemorheology in ovariectomized rats and explore the interventional effects of Erxian decoction. Method:Thirty-two healthy 10 week-old female SPF SD rats were randomly divided into sham operation group, model group, estrogen group (estradiol valerate, 0.18 mg·kg-1) and Erxian decoction group (9 g·kg-1). The rats were intragastrically administered 2 weeks after ovariectomy, once a day for 16 weeks. Sham operation groups and model groups were given equal volumes of purified water. After 16 weeks of administration, the cardiac function was measured by noninvasive ultrasound cardiogram (UCG), CD34 in the myocardial tissue was tested by immunofluorescence staining to measure the microvessel density, the morphological structure of microvessels of myocardial tissue were detected by transmission electron microscope, the levels of estrogen (E2) in rat plasma were detected by radioimmunoassay, the levels of endothelin-1 (ET-1), prostacyclin I2 (PGI2), thromboxane A2 (TXA2), endothelial growth factor (VEGF), and von Willebrand Factor (vWF) in rat plasma were detected by enzyme-linked immuno sorbent assay (ELISA), four items of coagulation was detected by blood coagulation analyzer, whole blood viscosity and plasma viscosity were detected by hemorheology. Result:Compared with sham operation group, the ejection fraction (EF) decreased (P<0.01), the left ventricular short axis shortening rate (FS) decreased (P<0.01), and the left ventricular end systolic volume (LVVols) increased (P<0.01), myocardial microvessel density significantly reduced (P<0.01), the endothelial cells were swollen and the cytoplasm was cavitation, E2 in rat plasma decreased (P<0.01), ET-1, VEGF, vWF increased (P<0.01), prostacyclin I2 /thromboxane A2 (PGI2/TXA2) decreased (P<0.01), plasma activated partial prothrombin time (APTT) decreased (P<0.01), fibrinogen (FIB) increased (P<0.01), whole blood viscosity, plasma viscosity, and cassone viscosity increased (P<0.01), whole blood high-cut, low-cut index, and red blood cell (RBC) aggregation index increased (P<0.05) in model group. Compared with model group, EF and FS increased (P<0.05), LVVols decreased (P<0.05), myocardial microvessel density significantly increased (P<0.01), the endothelial cell edema was improved, and transport vesicles were clearly visible, E2 in rat plasma increased (P<0.01), ET-1, VEGF, decreased (P<0.01), PGI2/TXA2 increased (P<0.01), APTT increased (P<0.01), whole blood viscosity, whole blood high shear relative index, RBC aggregation index decreased (P<0.05), Kasson viscosity and plasma viscosity decreased (P<0.01) in Erxian decoction group. Conclusion:Erxian decoction increases myocardial microvessel density, protects the structural integrity of microvascular endothelial cells, improves its endothelial secretion function and hemorheology in ovariectomized rats, and protects heart function.

20.
Chinese Medical Journal ; (24): 1182-1191, 2020.
Article in English | WPRIM | ID: wpr-827629

ABSTRACT

BACKGROUND@#Atrial natriuretic peptide (ANP) and its natriuretic peptide receptors A (NPR-A) and C (NPR-C) are involved in the regulation of physiological and pathophysiological process of blood pressure. The present study aimed to determine the role of NPR-C in the development of salt-sensitive hypertension.@*METHODS@#The Dahl salt-sensitive (DS) and salt-resistant (DR) rats were used in this study. Animals were matched according to their age and weight, and then placed on either a high-salt (HS, 8%) or a normal-salt (NS, 0.4%) diet for 6 weeks randomly using random number table. The systolic blood pressure (SBP), plasmatic sodium concentration (PLNa), urinary sodium excretion (UVNa), and serum creatinine concentration (Scr) were measured. The concentration of ANP in blood and tissues (heart and kidney) was detected by enzyme-linked immunosorbent assay. The expression of ANP, NPR-A, and NPR-C in kidney was evaluated with western blot analysis. Regarding renal redox state, the concentration changes in malondialdehyde (MDA), lipofuscin, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox), and nitric oxide synthase (NOS) in kidney were detected by a spectrophotometric method. The kidney damage was evaluated using pathological techniques and the succinodehydrogenase (SDHase) examination. Furthermore, after an intra-peritoneal injection of C-atrial natriuretic peptide (ANP)4-23 (C-ANP4-23), an NPR-C receptor agonist, the SBP, biochemical values in blood and urine, and renal redox state were evaluated. The paired Student's t test and analysis of variance followed by the Bonferroni test were performed for statistical analyses of the comparisons between two groups and multiple groups, respectively.@*RESULTS@#The baseline SBP in all groups was within the normal range. At the end of the 6-week experiment, HS diet significantly increased the SBP in DS rats from 116.63 ± 2.90 mmHg to 162.25 ± 2.15 mmHg (t = -10.213, P  0.05). The significant increase of PLNa, UVNa, and Scr related to an HS diet was found in both DS and DR rats (all P < 0.05). However, significant changes in the concentration (t = -21.915, P < 0.001) and expression of renal ANP (t = -3.566, P = 0.016) and the expression of renal NPR-C (t = 5.864, P = 0.002) were only observed in DS hypertensive rats. The significantly higher desmin immunochemical staining score (t = -5.715, P = 0.005) and mitochondrial injury score (t = -6.325, P = 0.003) accompanied by the lower SDHase concentration (t = 3.972, P = 0.017) revealed mitochondrial pathologic abnormalities in podocytes in DS rats with an HS diet. The distinct increases of MDA (t = -4.685, P = 0.009), lipofuscin (t = -8.195, P = 0.001), and Nox (t = -12.733, P < 0.001) but not NOS (t = -0.328, P = 0.764) in kidneys were also found in DS hypertensive rats. C-ANP4-23 treatment significantly decreased the SBP induced by HS in DS rats (P < 0.05), which was still higher than NS groups with the vehicle or C-ANP4-23 treatment (P < 0.05). Moreover, the HS-induced increase of MDA, lipofuscin, Nox concentrations, and Nox4 expression in DS rats was significantly attenuated by C-ANP4-23 treatment as compared with those with HS diet and vehicle injection (all P < 0.05).@*CONCLUSIONS@#The results indicated that the renal NPR-C might be involved in the salt-sensitive hypertension through the damage of mitochondria in podocytes and the reduction of the anti-oxidative function. Hence, C-ANP4-23 might serve as a therapeutic agent in treating salt-sensitive hypertension.

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