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1.
Journal of Integrative Medicine ; (12): 274-280, 2022.
Article in English | WPRIM | ID: wpr-929222

ABSTRACT

OBJECTIVE@#Acute lung injury (ALI) is a serious respiratory dysfunction caused by pathogen or physical invasion. The strong induced inflammation often causes death. Tanshinone IIA (Tan-IIA) is the major constituent of Salvia miltiorrhiza Bunge and has been shown to display anti-inflammatory effects. The aim of the current study was to investigate the effects of Tan-IIA on ALI.@*METHODS@#A murine model of lipopolysaccharide (LPS)-induced ALI was used. The lungs and serum samples of mice were extracted at 3 days after treatment. ALI-induced inflammatory damages were confirmed from cytokine detections and histomorphology observations. Effects of Tan-IIA were investigated using in vivo and in vitro ALI models. Tan-IIA mechanisms were investigated by performing Western blot and flow cytometry experiments. A wound-healing assay was performed to confirm the Tan-IIA function.@*RESULTS@#The cytokine storm induced by LPS treatment was detected at 3 days after LPS treatment, and alveolar epithelial damage and lymphocyte aggregation were observed. Tan-IIA treatment attenuated the LPS-induced inflammation and reduced the levels of inflammatory cytokines released not only by inhibiting neutrophils, but also by macrophage. Moreover, we found that macrophage activation and polarization after LPS treatment were abrogated after applying the Tan-IIA treatment. An in vitro assay also confirmed that including the Tan-IIA supplement increased the relative amount of the M2 subtype and decreased that of M1. Rebalanced macrophages and Tan-IIA inhibited activations of the nuclear factor-κB and hypoxia-inducible factor pathways. Including Tan-IIA and macrophages also improved alveolar epithelial repair by regulating macrophage polarization.@*CONCLUSION@#This study found that while an LPS-induced cytokine storm exacerbated ALI, including Tan-IIA could prevent ALI-induced inflammation and improve the alveolar epithelial repair, and do so by regulating macrophage polarization.


Subject(s)
Abietanes , Acute Lung Injury/drug therapy , Animals , Cytokine Release Syndrome , Cytokines , Inflammation/drug therapy , Lipopolysaccharides/toxicity , Macrophage Activation , Macrophages , Mice , Triacetoneamine-N-Oxyl/pharmacology
2.
Article in Chinese | WPRIM | ID: wpr-927689

ABSTRACT

Manganese is an element essential for living organisms. Development of industrial technologies and exploitation of mineral resources have led to the release of large amount of Mn(Ⅱ) into the environment, posing a serious threat to human health. Bioremediation can remove the Mn(Ⅱ) from the environment rapidly and effectively without generating secondary pollution, thus received increasing attention. This review summarized the diversity and distribution of Mn(Ⅱ) removal microorganisms and the associated mechanisms, followed by discussing the effect of environmental factors on microbial Mn(Ⅱ) removal. Finally, the challenges and prospects for bioremediation of Mn(Ⅱ) polluted wastewater were proposed.


Subject(s)
Biodegradation, Environmental , Humans , Manganese , Oxidation-Reduction , Waste Water
3.
Article in English | WPRIM | ID: wpr-925179

ABSTRACT

Chaenomeles sinensis is known to inhibit the development and progression of many age-related diseases, but the underlying molecular mechanisms are largely unclear. In the present study, we observed that the ethanol extract of Chaenomeles sinensis scavenged 2,2’-diphenylpicrylhydrazyl and 2,2’-azinobis diammonium radicals in vitro. The ethanol extract of Chaenomeles sinensisactivated antioxidant response element-luciferase activity and induced expression of NRF2 target genes in HaCaT cells. The ethanol extract of Chaenomeles sinensis also suppressed LPS-induced expression of COX-2 and iNOS proteins, and mRNA expression of TNF-α and IL-2 in RAW264.7 cells. Finally, the ethanol extract of Chaenomeles sinensis significantly suppressed testosterone propionate-induced benign prostatic hyperplasia in mice. Together, our study provides the evidence that the ethanol extract of Chaenomeles sinensis inhibits the development of benign prostatic hyperplasia by exhibiting anti-oxidant and anti-inflammatory effects.

4.
Article in Chinese | WPRIM | ID: wpr-912895

ABSTRACT

Objective: To observe the clinical efficacy of combining auricular point sticking and a healthy diet to treat simple obesity in children aged 6-9 years old.Methods: A total of 190 eligible obese kids were divided into an observation group and a control group using the random number table method, with 95 cases in each group. The observation group was intervened by auricular point sticking plus guide on a healthy diet, while the control group was only provided with the guide on a healthy diet. The therapeutic efficacy was observed after intervention for three consecutive months, as well as the changes in body mass (BM), body mass index (BMI), waist circumference (WC), hip circumference (HC), and subcutaneous fat thickness. Results: After the 3-month intervention, the total effective rate was 91.6% in the observation group, versus 74.7% in the control group, and the between-group difference was statistically significant (P<0.01); in both groups, the BM, BMI, WC, HC, and subcutaneous fat thickness all decreased significantly (P<0.05), and were lower in the observation group than in the control group, showing statistical significance (P<0.05). Conclusion: Auricular point sticking plus a healthy diet is safe and effective in treating simple obesity in children, producing more significant efficacy than healthy diet intervention alone.

5.
Article in Chinese | WPRIM | ID: wpr-912851

ABSTRACT

Objective: To explore whether acupuncture can improve sleep disturbance, cognitive impairment and emotional disorders caused by sleep deprivation, and its association with the attenuation of oxidative stress injury in prefrontal cortex. Methods: Fifty-two male Sprague-Dawley rats were randomly divided into a control group (n=10), a model group (n=14), a manual acupuncture (MA) group (n=14), and a sham-MA group (n=14). All the groups were established as sleep deprivation models via the modified multiple platform method, except for the control group. Rats in both the MA group and the sham-MA group received corresponding intervention, respectively. After modeling and intervention, the four groups received three behavioral tests, namely sleep monitoring, by comprehensive lab animal monitoring system (CLAMS), Morris water maze (MWM) test and open-field test (OFT), followed by oxygen free radical level test and Western blot (WB) detection for the expression levels of Bax and Bcl-2. Results: The MA group derived more sleep time within 24 h than either the model group or the sham-MA group (both P<0.05). On MWM orientation navigation test day 1, there were no significant differences in escape latency among the control, MA and sham-MA groups (P>0.05), and the escape latency was significantly shorter in these three groups than that in the model group (all P<0.05). On test day 4, the escape latency was markedly shorter in the MA group than that in either the model group or the sham-MA group (both P<0.05); meanwhile, the MA group showed significantly better performance compared with these two groups in space probe test (both P<0.05). In OFT, compared with the control group, there was a significant decline in the horizontal movement score in the other three groups (all P<0.05), and the decrease was more significant in the model group and the sham-MA group than that in the MA group (both P<0.05). The superoxide dismutase (SOD) content was markedly higher and the malondialdehyde (MDA) content was markedly lower in the MA group than those in the model group and the sham-MA group (all P<0.05). Compared with the model group and the sham-MA group, the expression of Bax was significantly lower and the expression of Bcl-2 was significantly higher in the MA group (all P<0.05). Conclusion: MA therapy can lengthen the sleep time in sleep-deprived rats and improve learning and memory impairments induced by sleep deprivation, and the underlying mechanism may be associated with the enhancement of antioxidant capacity in the prefrontal cortex and the inhibition of hippocampal neuronal apoptosis.

6.
Chinese Journal of Neurology ; (12): 794-801, 2021.
Article in Chinese | WPRIM | ID: wpr-911792

ABSTRACT

Objective:To explore the value and significance of sensorimotor cortex (SMC) in the recovery of upper limb motor function after cerebral infarction in the striatum with blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI).Methods:A total of 17 patients with primary onset of striatal intracapsular infarction (SCI) with unilateral severe upper limb paralysis, who were strictly screened from the Department of Neurology, Affiliated Hospital of Yangzhou University from June 2015 to December 2017, were selected as research subjects, and 15 healthy volunteers were selected as controls. BOLD-fMRI under the passive finger extension (FE) task on the hemiplegic side was performed within one week, one month and three months after the onset of the disease. The activation of SMC was observed by SPM8 software. The activation of corresponding brain activation areas in BOLD-fMRI was observed by Xjview software and compared with the standard brain activation areas dynamically. The upper limb section of the Fugl-Meyer Scale (FM-UL) was used to track the motor function of the upper limb. The upper limb motor function of the selected patients was evaluated before functional magnetic resonance imaging (fMRI) scanning, at one month and three months after onset of the disease.Results:In the controls, fMRI showed that the main brain activation areas were located in the contralateral SMC and bilateral supplementary motor area. According to the activation time course of the affected side SMC and the comparison results with the standard brain activation area, the study patients were divided into three groups: group 1 (six patients), in which the activation intensity of SMC was stronger than that of standard brain activation area in the early stage of onset; group 2 (five patients), in which the activation intensity of SMC in the affected side was stronger than that in the standard brain activation area at one month after onset; group 3 (six patients), in which the activation intensity of SMC in the affected side increased gradually in three months, but still did not exceed the standard brain activation area. The activated voxel values of the affected side SMC in group 1 patients at the first time, one month and three months were 3 570.2±1 125.9, 1 205.8±328.2 and 1 121.5±407.5, respectively, the difference within the group being statistically significant ( F=12.8, P=0.001); the activated voxel values of the affected SMC in group 2 patients were 556.2±171.7, 648.6±177.3 and 993.2±182.9, respectively, and the differences within the group were statistically significant ( F=6.5, P=0.018); the activated SMC values of the affected SMC in group 3 patients were 520.0±375.9, 573.5±375.0 and 680.9±359.8, respectively, and there was no statistically significant difference within the group ( P>0.05). The three times FM-UL scores corresponding to group 1 patients were (10.0±3.3) points, (52.3±4.6) points and (63.7±2.9) points; the three times FM-UL scores corresponding to group 2 patients were (10.6±5.7) points, (36.6±2.4) points and (59.2±3.1) points; and the three times FM-UL scores corresponding to group 3 patients were (9.2±4.0) points, (12.5±3.0) points and (13.3±5.0) points; FM-UL scores in group 1 and group 2 patients showed statistically significant differences within the groups ( F=348.4, 183.6; P<0.001), whereas that in group 3 patients showed no statistically significant difference within the group ( P>0.05). There was no statistically significant difference in the initial FM-UL score among the groups ( P>0.05), while the differences among the groups at one month and three months were statistically significant ( F=191.7,304.5; P<0.001). Conclusions:The survival of SMC on the affected side after cerebral infarction is a prerequisite for the rehabilitation of limb motor function. Its early activation cannot predict the clinical prognosis, but the dynamic enhancement of SMC activation on the affected side is related to the rehabilitation speed of the affected limb.

7.
Article in Chinese | WPRIM | ID: wpr-910840

ABSTRACT

Objective:To explore the effect of applying management by objective (MBO) and key performance indicator (KPI) method in the quality management of physical examination.Methods:The MBO and KPI methods were used to determine the focus of annual physical examination quality control, and to set 9 key physical examination quality control indicators and assessment standards. The results of physical examination quality control in the first quarter of 2018 were selected as the control group, and those in the fourth quarter of 2018 as the observation group. The two groups were compared using the chi-square test or Fisher′s exact test, after which the application effects of MBO and KPI method were discussed.Results:The scores of physical examination quality control in the observation group were higher than those in the control group; however, the difference was not statistically significant. The key indicators of physical examination quality control in the observation group all showed improvement to different degrees when compared with the control group. Among these indicators, the qualified rate of staff hand hygiene compliance, the qualified rate of cardiopulmonary resuscitation operation, and the coincidence rate of major abnormal results of physical examination were increased, but the difference was not statistically significant (95.0% vs 87.5%, P=0.432; 97.5% vs 92.5%, P=0.615; 55.6% vs 51.0%, P=0.232, respectively). Results error rate of physical examination department, completion rate of physical examination quality control documents, client satisfaction, follow-up success rate of major abnormal results of physical examination, and qualified rate of physical examination report were all significantly improved, with statistical significance (1.2% vs 2.2%, P<0.001; 100.0% vs 85.0%, P=0.026; 98.7% vs 96.8%, P<0.001; 68.6% vs 62.6%, P=0.014; 96.2% vs 90.6%, P<0.001, respectively). Conclusion:The application of MBO and KPI methods in the physical examination quality management of physical examination institutions can effectively improve the quality of physical examination.

8.
Article in Chinese | WPRIM | ID: wpr-909544

ABSTRACT

Objective:To estimate the predictive ability of group differences on autistic traits of social communication impairment by comparing the intrinsic functional network connectivity between default mode network and other brain networks between preschoolers with autism and typically developing control.Methods:Sixty preschoolers diagnosed autism according to DSM-5 and 60 typical developing individuals matched by age and sex were analyzed using resting-state functional magnetic resonance imaging (MRI). Establish functional network connections between the default mode network and other brain networks based on the results of the data-driven approach (independent component analysis). Subsequently, the correlation between the connectivity strength with statistical differences and the autistic traits of social communications impairments was analyzed.Results:Relative to typically developing control participants, preschoolers with autism showed increased functional connectivity between the medial prefrontal cortex and subcortical networks (basal ganglia and thalamus, Bg/Th) ( t=3.758, P<0.01, FDR-corrected). The strength of such connections was significantly associated with the severity of autistic core social communication disorders ( r=0.34, P=0.007). Furthermore, the average connection strength of DMN showed a hyper-FNC with the basal ganglion network ( t=3.455, P<0.01, FDR-corrected). Conclusion:There is an excessive functional connection between medial prefrontal cortex and subcortical nucleus in preschool autism children. The abnormal functional connection of DMN may be the key factor of core social disorder in preschool autism children.

9.
Article in Chinese | WPRIM | ID: wpr-908988

ABSTRACT

Incentive system is an indispensable means in the process of standardized residency training, which plays an important role in improving the work efficiency and service quality of residents, teachers and other participants. Based on the analysis of the problems existing in the holistic incentive system, we have implemented a set of personalized incentive measures for the training of residents in department rotation and achieved preliminary results, which provides ideas for exploring personalized incentive system for standardized residency training.

10.
Article in Chinese | WPRIM | ID: wpr-907862

ABSTRACT

Objective:To explore the clinical efficiency evaluation and prognostic factors of aspiration guided by neuronavigation in the treatment of pediatric brain abscess (PBA).Methods:A total of 47 patients with PBA were treated with aspiration guided by neuronavigation between January 2013 and January 2019 at the First Affiliated Hospital of Zhengzhou University.All clinical data were retrospectively analyzed.According to Glasgow Outcome Scale on discharge, all children were divided into 2 groups, namely good prognosis group and poor prognosis group.Prognostic factors were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results:Among the 47 children, 38 children (80.9%) were assigned to the good prognosis group, and 9 children (19.1%) were assigned to the poor prognosis group.Univariate analysis proved that abscess volume>4 cm( χ2=5.650, P=0.017), multiple or multilocular abscess ( χ2=3.258, P=0.027), and abscess located in functional areas ( χ2=6.187, P=0.013) were correlated with poor prognosis.Multivariate analysis revealed that abscess volume>4 cm( OR=5.913, 95% CI: 2.241-25.917, P=0.023) and abscess located in functional areas ( OR=10.519, 95% CI: 3.918-62.513, P<0.001) were independent risk factors for poor prognosis. Conclusion:The treatment of PBA with aspiration guided by neuronavigation is safe, effective and minimal invasive, and the clinical efficiency is satisfactory.Abscess volume>4 cm and abscess located in deepbrain/functional areas are independent risk factors for poor prognosis.

11.
Article in Chinese | WPRIM | ID: wpr-906281

ABSTRACT

Objective:To establish the grade evaluation standard of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces combining traditional character evaluation and modern intrinsic quality analysis. Method:The appearance character parameters (thickness and weight) and contents of internal index components (tanshinones and salvianolic acid B) of 18 batches of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces were determined, and the relative quality constant was calculated. The maximum value of the percentage quality constants of the tested samples was assumed to be 100%, the value ≥80% was classified as the first-class, ≥50% and <80% as the second-class, <50% as the third-class. Result:The relative quality constants of 18 batches of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces ranged from 349 to 884. According to the percentage quality constant, 18 batches of samples were successfully divided into three grades. The relative quality constant of the first-class product was ≥707, including samples ds5, ds8 and ds14, accounting for about 17% of the total number of samples. The relative quality constant of the second-class product was ≥442 and <707, accounting for about 61% of the total number of samples. the other samples were of the third-class, and their relative quality constants were all <442. Conclusion:The method of relative quality constant overcomes the one-sidedness of the single method in the grade evaluation of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces, and the evaluation results can objectively, reasonably and scientifically classify the grade of the decoction pieces, which can provide reference for the establishment of the grade standard of other decoction pieces.

12.
Article in Chinese | WPRIM | ID: wpr-906211

ABSTRACT

Objective:To study the clinical efficacy of orthopedics No.1 prescription combined with celecoxib in the treatment of knee osteoarthritis (KOA) with middle stage of cold-dampness syndrome and investigate its effect on serum cytokines levels. Method:The 72 patients were randomly divided into control group and observation group, with 36 cases each. Patients in both groups were given basic treatment with oral celecoxib capsules (0.2 g/ time, 1 time/day). On the basis of western medicine treatment, patients in observation group were treated with orthopedics No.1 prescription decoction-free granules by fumigation, 1 bag/time, 1 time/day, 5 times/week. Both groups received treatment for 4 weeks. The visual analog pain score (VAS), American knee society knee score (KSS), serum interleukin-1<italic>β </italic>(IL-1<italic>β</italic>), tumor necrosis factor-<italic>α </italic>(TNF-<italic>α</italic>), and transforming growth factor-<italic>β</italic><sub>1 </sub>(TGF-<italic>β</italic><sub>1</sub>) levels were observed before and after treatment, and their clinical efficacy was evaluated. Result:After treatment, VAS score significantly decreased in both groups (<italic>P</italic><0.01), and KSS score significantly increased (<italic>P</italic><0.01), with better clinical effect in observation group. After treatment, serum IL-1<italic>β</italic> and TNF-<italic>α</italic> levels decreased significantly in both groups (<italic>P</italic><0.01), and the levels in observation group were lower than those in control group after treatment (<italic>P</italic><0.05). TGF<italic>-β</italic><sub>1 </sub>content was significantly higher than that before treatment in two groups (<italic>P</italic><0.01). Conclusion:Orthopedics No.1 prescription combined with celecoxib for the treatment of KOA with middle stage of cold-dampness syndrome can effectively relieve the clinical symptoms of patients with KOA, improve joint function, improve quality of life, reduce the contents of inflammatory factors IL-1<italic>β</italic> and TNF-<italic>α</italic> in serum, and increase the expression of TGF-<italic>β</italic><sub>1</sub> level.

13.
Article in Chinese | WPRIM | ID: wpr-905258

ABSTRACT

Objective:To evaluate the efficacy and long-term effect of functional electrical stimulation (FES) on cerebral palsy. Methods:Literature retrieval was carried out in the electronic databases of PubMed, Embase, Web of Science, Cochrane Library, China Biology Medicine Disc (CBM), CNKI, Wanfang Database and VIP. The time limit was from the establishment of these databases to March 26th, 2020. According to the inclusion and exclusion criteria, randomized controlled trials about FES for children with cerebral palsy were included. At least two evaluators extracted the data independently and used Cochrane 5.1.0 bias risk assessment tool to evaluate the quality of included studies. The data was analyzed with Review Manager 5.3 software. Results:A total of eleven studies with 513 children were included. The Gross Motor Function Measure-88 (GMFM-88) D/E scores (MD = 8.14, 95%CI 6.26 to 10.02, P < 0.001), GMFM-88 B score (MD = 8.77, 95%CI 4.00 to 13.53, P < 0.001), modified Ashworth Scale (MAS) score (MD = -1.05, 95%CI -1.25 to -0.84, P < 0.001), Kyphosis angle (MD = -10.67, 95%CI -12.21 to -9.13, P < 0.001), Cobb's angle (MD = -2.66, 95%CI -3.38 to -1.93, P < 0.001), step length (MD = 3.35, 95%CI 1.81 to 4.90, P < 0.001), walking speed (MD = 0.09, 95%CI 0.05 to 0.14, P < 0.001) and GMFM score at six weeks follow-up (MD = 4.84, 95%CI 1.90 to 7.77, P = 0.001) were better in FES group than in the control group. There was no significant difference in MAS score between two groups after six weeks of follow-up (MD = 0.04, 95%CI -0.30 to 0.37, P = 0.84). Conclusion:FES could improve the lower-limb and trunk function of children with cerebral palsy, however, the long-term effect of relieving muscle spasm was not significant.

14.
Article in Chinese | WPRIM | ID: wpr-905067

ABSTRACT

Objective:To explore the effect and mechanism of Guizhitang with different proportions of Cinnamomi Ramulus and Paeoniae Alba Radix on overactive cardiac sympathetic nerves in salt-sensitive hypertensive rats. Method:Randomly divide the forty male 6-week-old salt-sensitive hypertensive rats into five groups: the normal control group, the model group, the Cinnamomi Ramulus and Paeoniae Alba Radix 1∶1 group, the Cinnamomi Ramulus and Paeoniae Alba Radix 1∶2 group,and the Cinnamomi Ramulus and Paeoniae Alba Radix 2∶1 group, each group has 8 animals, the normal control group was fed with low-salt feed, and the remaining four groups were fed with 8% high-salt feed. After 4 weeks of feeding, gastric feeding was started. Give both the normal control group and model group saline and the Cinnamomi Ramulus and Paeoniae Alba Radix 1∶1 group, the 1∶2 group,and the 2∶1 group, were given Guizhitang aqueous solution at 4.0, 5.5 and 5.5 g·kg-1, respectively. Continuous gavage intervention was held for 4 weeks. IITC multi-channel non-invasive sphygmomanometer was used to detect changes of systolic blood pressure before and after treatment in rats. Left ventricular anterior wall end-diastolic thickness (LVAWd) and interventricular septal diastolic thickness (IVSd) were detected by echocardiography. Hematoxylin-eosin(HE)staining and Masson staining were used to observe the myocardial morphological changes of rats in each group, Western blot was used to detect the expression of nerve growth factor (NGF), growth-associated protein 43 (GAP43) and tyrosine hydroxylase (TH) protein. Result:After 4 weeks of intervention with Guizhitang, compared with the normal control group, the blood pressure, LVAWd and IVSd of the model group were significantly increased, and the expressions of NGF, TH and GAP43 protein were significantly increased (P<0.01). HE and Masson staining results showed that the model group had myocardial cell edema, a large number of inflammatory cell infiltration, myocardial fiber hyperplasia and disordered arrangement, and a large amount of collagen deposition could be seen in the intercellular substance. Compared with model group, the systolic blood pressure of rats in each Guizhitang group increased slowly, and the expression of NGF, TH and GAP43 protein decreased (P<0.05,P<0.01),the Cinnamomi Ramulus and Paeoniae Alba Radix 1∶1 group has the best effect. The results of echocardiography shows that the 1∶1 Guishao group could reduce LVAWd and IVSd levels (P<0.05,P<0.01), the Cinnamomi Ramulus and Paeoniae Alba Radix 1∶2 group could reduce IVSd level (P<0.05), there was no statistical difference in LVAWd, there was no statistical difference in LVAWd and IVSd in 2∶1 group. In terms of myocardial morphology, each group of Guizhitang can reduce cell edema and inflammatory cell infiltration, reduce myocardial fiber hyperplasia and collagen deposition, and improve the disorder of myocardial fiber arrangement. Among them, the 1∶1 group has the best effect. Conclusion:Guizhitang can inhibit the overactive activation of cardiac sympathetic nervous system,reduce the extent of myocardial fibrosis, inflammatory infiltration and myocardial hypertrophy, and protect salt-sensitive hypertension rats, whose mechanism may be related to regulating the expression of heart NGF.Among them, the Cinnamomi Ramulus and Paeoniae Alba Radix 1∶1 group is better than the 1∶2 and 2∶1 group in reducing myocardial fibrosis, inflammatory infiltration and myocardial hypertrophy.

15.
Article in Chinese | WPRIM | ID: wpr-885708

ABSTRACT

Objective:To investigate the feasibility and efficacy of endoscopic placement of transpapillary parallel-style bilateral metal stents for malignant hilar biliary stricture.Methods:A total of 55 patients with malignant hilar biliary stricture (Bismuth Ⅱ-Ⅳ) were treated with an improved endoscopic drainage technique (endoscopic transpapillary parallel-style bilateral metal stenting) from January 2012 to December 2018 in Shanghai Oriental Hepatobiliary Surgery Hospital. The technical success rate, clinical success rate, incidence of complications, success rate of endoscopic re-intervention, stent patency and overall survival were analyzed.Results:The technical success rate of endoscopic placement of bilateral metal stents was 96.4% (53/55), the clinical success rate was 96.2% (51/53), and the early complication incidence was 13.2% (7/53). The median stent patency was 9.2 months (95% CI: 8.0-10.3 months), the success rate of endoscopic re-intervention of bilateral biliary systems was 92.3% (12/13), and the median overall survival was 6.7 months (95% CI: 4.7-8.8 months). Conclusion:This modified technique of bilateral metal stent placement is safe and effective for malignant hilar biliary stricture that is unsuitable for surgery.

16.
Article in Chinese | WPRIM | ID: wpr-885695

ABSTRACT

Objective:To compare the efficacy of bilateral and unilateral metallic stenting in the treatment of unresectable malignant hilar biliary obstruction.Methods:From January 2012 to December 2018, a total of 300 patients with malignant hilar biliary obstruction (Bismuth type Ⅱ-Ⅳ) were treated with endoscopic metallic stenting in Oriental Hepatobiliary Surgery Hospital. Ninety-four patients with bilateral metallic stenting (bilateral metallic stent group) and 94 patients with unilateral metallic stenting (unilateral metallic stent group) were matched and analyzed by propensity score matching. The clinical success rate, the total number of interventions, the stent patency and overall survival time were compared between the two groups.Results:The clinical success rate in the bilateral metallic stent group was significantly higher than that of the unilateral metallic stent group [98.9% (93/94) VS 78.7% (74/94), χ2=19.352, P<0.001], and the mean number of intervention in the bilateral metallic stent group was significantly less than that of the unilateral metallic stent group (1.2±0.5 times VS 1.7±0.9 times, t=-4.345, P<0.001). The stent patency time in the bilateral metallic stent group was significantly longer than that of the other group [10.0 (8.0, 12.1) months VS 5.7 (5.2, 6.3) months, χ2=19.789, P<0.001]. The median survival time of patients in the bilateral group was numerically longer than that in the unilateral group, but did not reach statistical significance [7.6 (6.3, 8.9) months VS 4.6 (3.7, 5.7) months, χ2=3.628, P=0.057]. Conclusion:Endoscopic bilateral metallic stenting is superior to unilateral metallic stenting in the clinical management of malignant hilar biliary obstruction unsuitable for surgery.

17.
Chinese Critical Care Medicine ; (12): 244-248, 2021.
Article in Chinese | WPRIM | ID: wpr-883867

ABSTRACT

In mass casualty incidents (MCI), the number of casualties can far exceed the capacity of medical emergency units to treat and transport in a very short period of time. A rapid MCI triage according to the severity of their injuries, can not only effectively use limited medical resources, but also improve the survival rate of injured patients. With the emergence of artificial intelligence (AI) and augmented reality (AR), smart glasses have been developed and used in different scenarios, and have achieved remarkable results in the medical field. This article focuses on the role and advantages of smart glasses in the triage of MCI, while proposing the problems in the application of smart glasses. At the same time, we elaborate on the development status of smart glasses in the triage, and discuss the application trend and development direction of smart glasses in the triage of pre-hospital injuries.

18.
Article in Chinese | WPRIM | ID: wpr-882912

ABSTRACT

Objective:To explore the diagnosis, treatment and prognostic of pediatric intracranial atypical teratoid/rhabdoid tumor(AT/RT).Methods:A total of 15 pediatric patients with intracranial AT/RT were treated between January 2012 and June 2019 at the First Affiliated Hospital of Zhengzhou University.The clinical data were retrospectively analyzed.Overall survival (OS) rate and progression free survival (PFS) rate were calculated by adopting Kaplan- Meier method.The differences between the 2 groups were tested by performing Log- rank method, and the prognostic factors were analyzed by COX regression. Results:There were 12 males and 3 females, with the median age of 5.5 years (ranging from 8 months to 17.1 years). All patients underwent surgical resection.Gross-total resection (GTR) was achieved in 10 cases and subtotal resection (STR) was carried out in 5 patients.The conducted treatments were as follows: surgery+ radiotherapy+ chemotherapy+ intrathecal injection in 6 cases, surgery+ chemotherapy+ intrathecal injection in 4 cases, surgery+ radiotherapy in 2 cases, and surgery alone in 3 cases.Until January 2020, the median survival time of all the 15 patients was 18 months (ranged 1-27 months), and the survival rate was 33.3%.The 1-year OS rate and PFS rate for all 15 cases were 71.5% and 49.7%, respectively.The 2-year OS rate and PFS rate were 17.9% and 0, respectively. Log- rank analyses revealed that the 1-year OS rates of children less than 3 years old and those older than 3 years were 87.5% and 57.1%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with GTR and those with STR were 90.0% and 40.0%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with tumor dissemination and those without tumor dissemination were 100.0% and 33.3%, respectively( χ2=9.865, P=0.002). The 1-year OS rates of children in the standard-risk group and those in the high-risk group were 88.9% and 41.7%, respectively ( χ2=5.111, P=0.024). COX regression analyses proved that age, the extent of tumor resection, tumor dissemination and risk stratification are independent risk factors for prognosis [hazard radio( HR)=3.411, 3.795, 5.245, 3.397; P=0.025, 0.011, 0.001, 0.017]. Conclusions:Pediatric intracranial AT/RT is rare.The preliminary diagnosis and prognosis are difficult and poor, respectively.The complete resection of tumors with maximal safety remains the primary treatment.Age, the extent of tumor resection, tumor dissemination and risk stratification are independent prognostic factors for AT/RT children.

19.
Article in Chinese | WPRIM | ID: wpr-882599

ABSTRACT

Objective:By adopting network pharmacology to study the mechanism of Yinchen-Erchen Decoction in treating non-alcoholic steatohepatitis (NASH). Methods:TCMSP was used to collect the chemical constituents of Yinchen-Erchen Decoction, and the effective active ingredients were obtained. Then the target of action was speculated. GeneCards database was used to collect the related genes of NASH. The visualized network of drug-target and disease-target was established by the Cytoscape software. After the analysis of key target genes, PPI network map was established to enrich GO and KEGG pathways based on key target proteins. Results:A total of 45 active ingredients and 114 drug target proteins, 463 NASH related genes and 33 drug and disease targets were obtained from the main chemical constituents of Yinchen-Erchen Decoction. The protein interaction network found that IL6, CASP3, MYC may be the key targets of Yinchen-Erchen Decoction in the treatment of NASH. GO and KEGG enrichment analysis identified 34 and 79 signal pathways related to inflammation, cell apoptosis, diabetes, NAFLD, cancer and so on. Conclusions:Yinchen-Erchen Decoction has multi-pathway and multi-target characteristics in treating NASH. It reveals the key targets, biological processes and signal pathways involved, and provide reference and basis for the following study.

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Article in English | WPRIM | ID: wpr-922549

ABSTRACT

Osteosarcoma (OS) is the most common primary bone tumor in children and adolescents. It is an aggressive tumor with a tendency to spread to the lung, which is the most common site of metastasis. Patients with advanced OS with metastases have poor prognoses despite the application of chemotherapy, thus highlighting the need for novel therapeutic targets. The tumor microenvironment (TME) of OS is confirmed to be essential for and supportive of tumor growth and dissemination. The immune component of the OS microenvironment is mainly composed of tumor-associated macrophages (TAMs). In OS, TAMs promote tumor growth and angiogenesis and upregulate the cancer stem cell-like phenotype. However, TAMs inhibit the metastasis of OS. Therefore, much attention has been paid to investigating the mechanism of TAMs in OS development and the progression of immunotherapy for OS. In this article, we aim to summarize the roles of TAMs in OS and the major findings on the application of TAMs in OS treatment.

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