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1.
Chinese Journal of Trauma ; (12): 618-627, 2021.
Article in Chinese | WPRIM | ID: wpr-909912

ABSTRACT

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions,9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury,injury level,severity of injury,segment and type of fracture,complications,death and other data were collected by medical record questionnaire,and analyzed according to geographical region,age and gender.Results:Medical records of 4,134 patients were included in this study,with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million (95% CI 50.122-50.846). The highest incidence in the Eastern region was 53.791 / 1 million (95% CI 53.217-54.365). In the whole country,the main causes of injury were high falls (29.58%),as well as in the Western region (40.68%),while the main causes of injury in the Eastern and Central regions were traffic injuries (31.22%,30.10%). The main injury level was cervical spinal cord in the whole country (64.49%),and the proportion of cervical spinal cord injury in the Central region was the highest (74.68%),and the proportion of lumbosacral spinal cord injury in the Western region was the highest (32.30%). The highest proportion of degree of injury was incomplete quadriplegia (55.20%),and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation,77.95% in the Western region and only 54.77% in the Central region. In the whole country,the head was the main combined injury (37.87%),as well as in the Eastern and Central regions,while the proportion of chest combined injury in the Western region was the highest (38.57%). A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients (0.56%) died in hospital,of which 17(73.91%) died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level,incomplete quadriplegia as the main degree of injury,head as the main combined injury,and respiratory complications as the main complication.

2.
Acta Pharmaceutica Sinica ; (12): 3370-3376, 2021.
Article in Chinese | WPRIM | ID: wpr-906850

ABSTRACT

italic>Tripterygium wilfordii Hook. f. is a valuable medicinal plant, with anti-tumor, anti-inflammatory, immunosuppressive and other pharmacological activities. Triterpenoids are one of the main active components that exert pharmacological effects. However, the content of triterpenoids dominated by triptolide is very low in Tripterygium wilfordii, and the analysis of the biosynthetic pathway of triterpenoids in Tripterygium wilfordii provides an effective new idea for obtaining these compounds. 2,3-Oxidosqualene cyclases (OSCs) are the key enzyme that catalyzes the formation of triterpene skeleton diversity. Based on the genome and transcriptome data of Tripterygium wilfordii, 16 OSC genes were identified and analyzed. Phylogenetic analysis showed that 16 TwOSC proteins could be mainly classified as four groups. They are β-amyrin synthase group, friedelin synthase group, multifunctional amyrin synthase and cycloartenol synthase group. TwOSC6 was successfully cloned. Functional characterization analysis revealed that TwOSC6 can catalyze the formation of α-amyrin and β-amyrin. This indicates that TwOSC6 is a multifunctional amyrin synthase. This provides new gene resources for the diversity of Tripterygium wilfordii triterpenoids, as well as new gene elements for biosynthesis triterpenoids.

3.
Article in Chinese | WPRIM | ID: wpr-906381

ABSTRACT

Angelicae Sinensis Radix, derived from a medicinal and edible plant Angelica sinensis, is one of the traditional bulk Chinese medicines. In addition to gynecological blood stagnation and deficiency, its indications also include dysmenorrhea, deficiency and cold-induced abdominal pain, and rheumatoid arthritis. With the in-depth study of Angelicae Sinensis Radix, its anti-inflammatory and analgesic activities have attracted widespread attention. However, there has been no systemic report. The present study comprehensively reviewed the anti-inflammatory and analgesic activities of Angelicae Sinensis Radix (including its compositions, extracts, and different processed products) and mechanisms published in recent 30 years. The anti-inflammatory effect of Angelicae Sinensis Radix was achieved mainly by blocking the expression of proteins and genes in nuclear factor-κB (NF-κB), mitogen-activated protein kinases (MAPK), and Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling pathways, inhibiting the release of inflammatory mediators including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), prostaglandin E2 (PGE2) and IL-1β, and maintaining the high sensitivity of immune cells in the host to external stimuli. The mechanism of analgesic effect may be related to the suppression of the production of algesic substances (such as inflammatory factors and chemokines) or blocking of the amplification and transmission of pain perception in cascade reaction. Furthermore, the study also pointed out some problems in modern research and proposed suggestions on its future research to provide references for investigation and clinical applications of Angelicae Sinensis Radix.

4.
Article in Chinese | WPRIM | ID: wpr-906230

ABSTRACT

Objective:To explore the molecular mechanism of modified Guizhi Fulingwan in rats with uterine fibroids. Method:Seventy-two female adult SD rats of SPF grade were randomly divided into a model group, a normal group, and a preventive administration group. The model group and preventive administration group were established by estrogen and progestin loading method. After successful modeling, the rats in the model group were randomly divided into a western medicine group (mifepristone), the high-dose traditional Chinese medicine(TCM) group, and a low-dose TCM group. All the rats were dosing as required once a day for 28 consecutive days. Hematoxylin-eosin(HE)staining was used to observe the morphological changes of the uterus. The micRNA gene chip was used to detect the expression profile of uterine micRNA gene. Differential expressions of micRNA were screened by bioinformatics methods. Gene function enrichment was used to predict the possible signaling pathways in rats with uterine fibroids by modified Guizhi Fulingwan. Result:Compared with the normal group, microRNA of the model group was 1 up-regulated and 9 down-regulated. Compared with the model group, microRNA of the high-dose group of TCM group was 2 up-regulated and 1 down-regulated, in the preventive administration group, 9 was up-regulated and 2 was down-regulated. Gene function enrichment analysis indicated that four signaling pathways were closely related to uterine fibroids. They were mitogen-activated protein kinase (MAPK) signaling pathway, Wnt signaling pathway, mammalian rapamycin target protein (mTOR) signaling pathway and vascular endothelial cell growth factor (VEGF) signaling pathway. Conclusion:Modified Guizhi Fulingwan affected the expression profile of micRNA in rat model of uterine fibroids induced by estrogen and progesterone, suggesting that modified Guizhi Fulingwan may involve in a variety of biological processes such as signal transduction and gene regulation in the treatment of uterine fibroids.

5.
Article in Chinese | WPRIM | ID: wpr-906047

ABSTRACT

Objective:To observe the effects of Scutellariae Radix-Hedyotidis Herba on the proliferation of human lung adenocarcinoma A549 cells and the expression of interleukin-6(IL-6), phosphatidylinositol 3-kinase (PI3K),protein kinase B (Akt), p-protein kinase B (p-Akt), mechanistic target of rapamycin (mTOR), hypoxia-inducible factor-1<italic>α </italic>(HIF-1<italic>α</italic>), and Cyclin D<sub>1</sub> at the cellular level, and to explore their molecular mechanism. Method:Following the set-up of the blank group (complete medium), low-, moderate-,and high-dose (20, 40, and 60 mg·L<sup>-1</sup>) Scutellariae Radix-Hedyotidis Herba groups, and low-, moderate-, and high-dose (5, 10, and 20 mg·L<sup>-1</sup>) cisplatin groups, the cell were treated with the corresponding drugs for 24, 48, and 72 h for detecting their viability by tetrazolium bromide (MTT) colorimetry. A549 cells were then divided into the blank group, Scutellariae Radix-Hedyotidis Herba group, cisplatin group, and combined medication group and intervened with the<sup> </sup>complete medium, 40 mg·L<sup>-1 </sup>Scutellariae Radix-Hedyotidis Herba, 10 mg·L<sup>-1</sup> cisplatin, and 40 mg·L<sup>-1 </sup>Scutellariae Radix-Hedyotidis Herba + 10 mg·L<sup>-1 </sup>cisplatin, respectively, for 24, 48 and 72 h, followed by the measurement of inhibitory effects against the proliferation of A549 cells in each experimental group. The level of IL-6 in cell culture supernatant was determined by enzyme-linked immunosorbent assay (ELISA) after 72 h. The mRNA expression levels of HIF-1<italic>α</italic> and Cyclin D<sub>1</sub> in each group were assayed by real-time polymerase chain reaction (Real-time PCR), and the protein expression levels of PI3K, Akt, p-Akt, mTOR, HIF-1<italic>α</italic>, and Cyclin D<sub>1</sub> by Western blot. Result:After 24 h intervention, Scutellariae Radix-Hedyotidis Herba did not significantly inhibit the proliferation of A549 cells. However, 48 h later, the inhibitory effect in Scutellariae Radix-Hedyotidis Herba groups were significantly enhanced in comparison with that in the blank group (<italic>P</italic><0.05), exhibiting a time-dependent response. After 72 h of action, no significant change was present in the inhibitory effect of each Scutellariae Radix-Hedyotidis Herba group, so the optimal concentration of Scutellariae Radix-Hedyotidis Herba was set at 40 mg·L<sup>-1</sup> for follow-up experiments. As demonstrated by the comparison with the blank group, cisplatin at each concentration inhibited the cell proliferation in a time-dependent manner (<italic>P<</italic>0.05). Considering the cell survival rate, the best concentration of cisplatin was set at 10 mg·L<sup>-1</sup>. Compared with the blank group, Scutellariae Radix-Hedyotidis Herba combined with cisplatin remarkably inhibited the proliferation of A549 cells in a time-dependent manner (<italic>P<</italic>0.05), and the differences between the combined medication group and the other two groups became more significant after 72 h of medication (<italic>P<</italic>0.01). The IL-6 level in each experimental group, especially in the combined medication group, significantly declined in contrast to that in the blank group (<italic>P<</italic>0.01). The mRNA expression levels of HIF-1<italic>α</italic> and Cyclin D<sub>1</sub> in all experimental groups were obviously lower than those in the blank group, with the most significant changes observed in the combined medication group (<italic>P</italic><0.05,<italic>P</italic><0.01). The protein expression levels of PI3K, p-Akt, mTOR, HIF-1<italic>α</italic>, and Cyclin D<sub>1</sub> in each experimental group was significantly down-regulated(<italic>P</italic><0.05,<italic>P</italic><0.01), and the levels in the combined medication group were even lower than those in the cisplatin group (<italic>P<</italic>0.01). Conclusion:Scutellariae Radix-Hedyotidis Herba has an inhibitory effect on the proliferation of A549 cells, which may be related to its inhibition against the expression and secretion of IL-6/PI3K/Akt/mTOR-HIF-1<italic>α</italic> axis.

6.
Article in Chinese | WPRIM | ID: wpr-922023

ABSTRACT

OBJECTIVE@#To study the effect of down-regulating miR-488 targeting Jag1 on the injury of hypoxia-reoxygenation myocardial H9c2 cells.@*METHODS@#A hypoxic-reoxygenated myocardial H9c2 cell injury model was constructed. miR-488 inhibitor was used to transfect the cells. CCK-8 method and flow cytometry were used to detect cell proliferation and apoptosis in each group. Lactate dehydrogenase (LDH), superoxide dismutase (SOD), malonaldehyde (MDA), catalase (CAT) levels were detected. Western blotting was used to detect the expression of Bcl-2 associated X Protein (Bax) and B cell lymphoma/lewkmia-2 (Bcl-2). Target genes of miR-488 were predicted, and a luciferase reporter system was used to verify the targeting relationship between the two. Myocardial H9c2 cells were co-transfected with miR-488 inhibitor and Jag1 siRNA, and treated with hypoxia and reoxygenation, cell proliferation, apoptosis, LDH, SOD, MDA, CAT levels, and Bax, Bcl-2 protein expression were detected.@*RESULTS@#The expression of miR-488 in the hypoxia-reoxygenated myocardial H9c2 cells was increased, along with reduced cell proliferation, increased apoptosis, increased Bax protein expression, decreased Bcl-2 protein expression, increased MDA, decreased CAT and SOD, and increased LDH level in the supernatant of cell culture. When myocardial H9c2 cells were transfected with miR-488 inhibitor and treated with hypoxia and reoxygenation, the expression of miR-488 was decreased, along with increased cell proliferation, decreased apoptosis, decreased Bax protein expression, increased Bcl-2 protein expression, decreased MDA, increased CAT and SOD, and decreased LDH level in the supernatant of cell culture. Down-regulation of miR-488 could target and down-regulate Jag1 expression. And Jag1 siRNA could reverse the effect of miR-488 inhibitor on the proliferation, apoptosis, LDH, SOD, MDA, CAT levels and the expression of Bax and Bcl-2 of hypoxic-reoxygenated myocardial H9c2 cells.@*CONCLUSION@#Down-regulating miR-488 targeted Jag1 can attenuate hypoxia-reoxygenation induced myocardial H9c2 cell injury.


Subject(s)
Apoptosis/genetics , Down-Regulation , Humans , Hypoxia/genetics , Jagged-1 Protein/genetics , MicroRNAs/genetics , Myocardial Reperfusion Injury , Myocytes, Cardiac
7.
Article in English | WPRIM | ID: wpr-921380

ABSTRACT

OBJECTIVES@#This prospective study was performed to evaluate whether the distal-triangular flap was a practical alternative surgical approach for extracting mandibular third molars.@*METHODS@#Sixty participants with impacted mandibular third molars were randomly divided into three groups: group A, distal-triangular flap; group B, Szmyd flap; and group C, envelope flap. The impacted third molars were extracted by the corresponding flapping method. During a three-month follow-up observation after the extraction, the postoperative pain, swelling, mouth opening, and periodontal status were recorded and analyzed by ANOVA and chi-square tests.@*RESULTS@#The 60 participants had successful extraction and 3-month follow-up observation. No participant suffered from postoperative infections, lower lip disorder, or tongue sensory disorders. No statistical differences were found in the postoperative symptoms and signs of the three flap designs, such as postoperative pain, swelling, mouth opening, and periodontal status (@*CONCLUSIONS@#The distal-triangular flap was as safe and reliable as the Szmyd and envelope flaps but more advantageous because of its convenient operative field exposure and low requirement for the patient's mouth opening. Thus, the distal-triangular flap is one of the alternative flap options for extracting impacted mandibular third molars.


Subject(s)
Humans , Mandible/surgery , Molar, Third/surgery , Prospective Studies , Tooth Extraction , Tooth, Impacted/surgery
8.
Article in Chinese | WPRIM | ID: wpr-882416

ABSTRACT

Objective:To study the effect of psoralen on the proliferation, invasion and migration of HTB-47 and CRL-1932 renal cancer cells cultured in vitro, and to further explore the internal mechanism of psoralen inhibiting renal cancer.Methods:The experimental group was HTB-47 and CRL-1932 renal cancer cells treated with dimethyl sulfoxide solution containing 30 μg/ml psoralen, and the control group was renal cancer cells treated with dimethyl sulfoxide. Scratch test, CCK8, Transwell, and Western blot were used to detect the effect of psoralen on renal cancer cells.Results:Compared with the control group, the proliferation, invasion and migration of renal cancer cells treated with psoralen in the experimental group were significantly inhibited. In the renal cancer cells treated with psoralen, the protein expression levels of MKI67, PCNA, MMP2 and MMP9 were significantly decreased (all P<0.05). Conclusions:Psoralen can significantly inhibit the proliferation, invasion and migration of HTB-47 and CRL-1932 renal cancer cells in vitro. The mechanism may be to inhibit the progression of renal cancer by regulating MKI67, PCNA, MMP2 and MMP9.

9.
Chinese Journal of Traumatology ; (6): 273-279, 2021.
Article in English | WPRIM | ID: wpr-888416

ABSTRACT

PURPOSE@#Low-velocity penetrating brain injury (LVPBI) caused by foreign bodies can pose life-threatening emergencies. Their complexity and lack of validated classification data have prevented standardization of clinical management. We aimed to compare the trans-base and trans-vault phenotypes of LVPBI to help provide guidance for clinical decision-making of such injury type.@*METHODS@#A retrospective study on LVPBI patients managed at our institution from November 2013 to March 2020 was conducted. We included LVPBI patients admitted for the first time for surgery, and excluded those with multiple injuries, gunshot wounds, pregnancy, severe blunt head trauma, etc. Patients were categorized into trans-base and trans-vault LVPBI groups based on the penetration pathway. Discharged patients were followed up by outpatient visit or telephone. The data were entered into the Electronic Medical Record system by clinicians, and subsequently derived by researchers. The demography and injury characteristics, treatment protocols, complications, and outcomes were analyzed and compared between the two groups. A t-test was used for analysis of normally distributed data, and a Mann-Whitney U test for non-parametric data. A generalized linear model was further established to determine whether the factors length of stay and performance scale score were influenced by each factor.@*RESULTS@#A total of 27 LVPBI patients were included in this analysis, comprised of 13 (48.1%) trans-base cases and 14 (51.9%) trans-vault cases. Statistical analyses suggested that trans-base LVPBI was correlated with deeper wounds; while the trans-vault phenotype was correlated with injury by metal foreign bodies. There was no difference in Glasgow Coma Scale score and the risk of intracranial hemorrhage between the two groups. Surgical approaches in the trans-base LVPBI group included subfrontal (n = 5, 38.5%), subtemporal (n = 5, 38.5%), lateral fissure (n = 2, 15.4%), and distal lateral (n = 1, 7.7%). All patients in the trans-vault group underwent a brain convex approach using the foreign body as reference (n = 14, 100%). Moreover, the two groups differed in application prerequisites for intracranial pressure monitoring and vessel-related treatment. Trans-base LVPBI was associated with higher rates of cranial nerve and major vessel injuries; in contrast, trans-vault LVPBI was associated with lower functional outcome scores.@*CONCLUSION@#Our findings suggest that trans-base and trans-vault LVPBIs differ in terms of characteristics, treatment, and outcomes. Further understanding of these differences may help guide clinical decisions and contribute to a better management of LVPBIs.

10.
Chinese Journal of Biotechnology ; (12): 2039-2049, 2021.
Article in Chinese | WPRIM | ID: wpr-887780

ABSTRACT

Triptolide has wide clinical applications due to its anti-inflammatory, anti-tumor and immunosuppressive activities. In this study, we investigated the effect of blocking isopentenyl pyrophosphate (IPP) translocation on the biosynthesis of triptolide by exogenously adding D,L-glyceraldehyde (DLG) to the suspension cells of Ttripterygium wilfordii at different stages (7 d, 14 d). Subsequently, the cell viability, biomass accumulation, triptolide contents, as well as the profiles of the key enzyme genes involved in the upstream pathway of triptolide biosynthesis, were analyzed. The results showed that IPP translocation is involved in the biosynthesis of triptolide. IPP is mainly translocated from the plastid (containing the MEP pathway) to the cytoplasm (containing the MVA pathway) in the early stage of the culture, but reversed in the late stage. Blocking the translocation of IPP affected the expression of key enzyme genes involved in the upstream pathway of triptolide, which in turn affected the accumulation of triptolide. Understanding the characteristics and mechanism of IPP translocation provides a theoretical basis for further promoting triptolide biosynthesis through synthetic biology.


Subject(s)
Diterpenes , Epoxy Compounds , Hemiterpenes , Organophosphorus Compounds , Phenanthrenes
11.
China Pharmacy ; (12): 2019-2024, 2021.
Article in Chinese | WPRIM | ID: wpr-886588

ABSTRACT

OBJECTIVE:To explore the regularity and characteristics of adverse drug reactions (ADR)induced by alectinib , and to provide reference for rational drug use in clinic. METHODS :Retrieved from CNKI ,Wanfang database ,VIP,PubMed, Web of Science and Embase database during the inception to Mar. 1st,2021,case reports of alectinib-induced ADR were collected , summarized and analyzed with descriptive statistical analysis method in terms of general information ,occurrence time of ADR , involved organ/system ,clinical manifestations ,treatment and outcome ,etc. RESULTS :A total of 17 literatures were included , involving 17 patients. Among them ,4 cases(23.53%)were males ,and 13 cases(76.47%)were females. The mean age of the patients was (61.82±14.18)years old. The patients were from 5 countries/regions,among which America took the largest ratio (41.18%). Most ADR occurred within 30 days(52.94%)after therapy. ADR mainly involved skin and its appendants (35.29%), followed by respiratory system (23.53%),urinary system (11.76%),cardiovascular system (11.76%),gastrointestinal system (11.76%)and blood system (5.87%);hair loss ,pancreatitis and duodenal perforation belonged to ADRs not recorded in the drug instructions. After 17 patients suffered from ADR ,2 patients still continued to use aletinib ,while 15 patients withdrew aletinib and some patients received symptomatic and supportive treatment ,and their symptoms improved. Among them ,10 patients restarted aletinib treatment after their symptoms improved ,and 8 patients did not suffered from ADR again. CONCLUSIONS :Female patients and patients over 50 years old are more likely to suffer from ADR after using aletinib ,and most of ADR occur within 1 month after treatment. ADR involves many organs/systems ,mainly skin and its appendants. Special attention should be paid to ADR such as hair loss ,pancreatitis and duodenal perforation.

12.
International Eye Science ; (12): 1570-1575, 2021.
Article in Chinese | WPRIM | ID: wpr-886438

ABSTRACT

@#Rhegmatogenous retinal detachment(RRD)is the separation of the retinal nerve sensory layer and the pigment epithelium layer caused by retinal tears. It is a kind of ophthalmic emergency. If it is not treated in time, the blinding rate is close to 100%. Surgery is an important way to treat RRD. With the deepening of disease awareness and the improvement of retinal reattachment techniques, RRD reattachment has achieved a higher anatomical success rate, but in clinical, the postoperative visual experience of patients is still not ideal. This article mainly summarizes the influencing factors of RRD visual function prognosis and provides guidance for clinical treatment.

13.
Cancer Research and Clinic ; (6): 349-352, 2021.
Article in Chinese | WPRIM | ID: wpr-886061

ABSTRACT

Objective:To observe the clinical efficacy and safety of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) combined with traditional medicine retention enema for treatment of chronic radiation proctitis.Methods:A total of 128 patients pathologically diagnosed as cervical cancer and endometrial cancer with grade 1-2 chronic radiation proctitis at Xiangyang Central Hospital from October 2017 to October 2019 were enrolled in a random, single-blind, control trial. The patients were divided into the control group and the experiment group according to the random number table, and the control group was given the treatment regimen of gentamicin + dexamethasone + Yunnan Baiyao retention enema, and the experimental group was given the treatment regimen of rhGM-CSF + gentamicin + dexamethasone + Yunnan Baiyao retention enema; both regimens treated twice daily for three weeks. The clinical symptom before and after enema treatment based on the subjective, objective, management and analytic (SOMA) scale was scored and the efficacy was evaluated by combining with stool routine and rectoscopy.Results:According to the SOMA scale, the scores of hematochezia, diarrhea, tenesmus, abdominal pain after enema were lower than those before enema, and the differences were statistically significant (all P<0.05); however, the scores of all symptoms before treatment of both groups were not statistically significant different (all P>0.05). The score of hematochezia in the experimental group after enema was lower than that in the control group [(0.33±0.15) scores vs. (0.48±0.32) scores, t=2.045, P=0.022], and the scores of other symptoms in both groups were not statistically significant different (all P>0.05). The overall effective rate was 79.69% (51/64) in the control group and 90.63% (58/64) in the experimental group, and difference was statistically significant (χ 2=6.485, P=0.026). All patients had no obvious adverse reactions. Conclusions:rhGM-CSF combined with traditional medicine retention enema for treatment of chronic radiation proctitis in patients with cervical cancer and endometrial cancer is highly effective and easy to operate, and patients are well tolerated, which is worthy of clinical promotion.

14.
Article in Chinese | WPRIM | ID: wpr-882987

ABSTRACT

Objective:To investigate the acceptance of advance care planning and its influencing factors in heart failure patients.Methods:A total of 208 patients with heart failure were surveyed by general data questionnaires and advance care planning acceptance questionnaires.Results:The total score of advance care planning acceptance of heart failure patients was (44.26 ± 11.73), the score of feeling dimension was (13.67 ± 5.72), the score of attitude dimension was (30.59 ± 6.33). 53.4%(111/208) of patients were willing to accept the talking about advance care planning. Regression analysis results showed that education level, New York Heart Association (NYHA) classification, communication status with medical staff and whether they had received life-sustaining treatment were important factors influencing of the acceptance of advance care planning in patients with heart failure.Conclusion:Patients with heart failure had higher acceptance of advance care planning. In clinical work, it is necessary to strengthen the scientific popularization of advance care planning in patients with low education level, low NYHA grade and no exposure to life-sustaining treatment. And strengthen the daily communication with patients to prepare for the follow-up advance care planning related communication.

15.
Article in English | WPRIM | ID: wpr-878439

ABSTRACT

The morbidity rate of medication-related osteonecrosis of the jaws (MRONJ) increased rapidly in recent years. Thusfar, the mechanism of MRONJ has no consensus. The possible mechanisms may include bone remodeling inhibition theory, angiogenesis inhibition theory, oral microorganism infection theory, immunosuppression theory, cytotoxicity-targeted oral epithelial cells, microcrack formation of maxillary or mandibular bone, and single nucleotide polymorphism. However, the efficacy of prevention and treatment based on a single mechanism is not ideal. Routine oral examination before MRONJ-related drug treatment, treatment of related dental diseases, and regular oral follow-up during drug treatment are of great significance for the prevention of MRONJ. During the treatment of MRONJ, the stage of MRONJ must be determined accurately, treatment must be standardized in accordance with the guidelines, and personalized adjustments must be made considering the specific conditions of patients. This review aimed to combine the latest research and guidelines for MRONJ and the experiences on the treatment of MRONJ in the Maxillofacial Surgery Department of West China Hospital of Stomatology, Sichuan University, and discuss the strategies to improve the clinical process.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control , Bone Density Conservation Agents , Bone Remodeling , China , Humans , Jaw
16.
Article in Chinese | WPRIM | ID: wpr-878426

ABSTRACT

OBJECTIVES@#The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided.@*METHODS@#A total of 182 patients with mixed dentition were randomly divided into the nasopalatine nerve block and greater palatine nerve block groups. Then, 219 patients with permanent dentition were divided into an adolescent group (13-18 years old) and adult group (over 19 years old), all of whom underwent bilateral greater palatine nerve block. Palatal mucosal pain sensation was tested pre- and post-anesthesia with Von Frey hairs.@*RESULTS@#Among the children with mixed dentition, bilateral greater palatine nerve block tended to result in better anesthetic effects than nasopalatine nerve block (@*CONCLUSIONS@#The sensation of the anterior hard palatine seems mainly dominated by the greater palatine nerve until mixed dentition and gradually shifted to the nasopalatine nerve in conjunction with maxillary development and tooth replacement. Hence, the innervation of the anterior hard palatine induce a secondary development during the development of the maxilla.


Subject(s)
Adolescent , Adult , Child , Dentition, Mixed , Humans , Maxilla , Maxillary Nerve , Nerve Block , Palate , Palate, Hard , Young Adult
18.
Journal of Clinical Hepatology ; (12): 888-892, 2021.
Article in Chinese | WPRIM | ID: wpr-875901

ABSTRACT

ObjectiveTo investigate the clinical features, diagnosis, treatment, and prognosis of autoimmune pancreatitis (AIP) alone versus AIP with IgG4 sclerosing cholangitis (IgG4-SC). MethodsA retrospective analysis was performed for the clinical data of 40 patients with type 1 AIP who were admitted to The First Affiliated Hospital of Zhengzhou University from June 2015 to January 2020, among whom 29 patients had AIP alone and 11 had AIP with IgG4-SC. The two groups were compared in terms of clinical manifestations, laboratory examination, imaging findings, treatment, and prognosis. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to calculate recurrence rate and plot recurrence curve, and the log-rank test was used for univariate analysis. ResultsCompared with the AIP group, the AIP+IgG4-SC group had significantly higher number of affected organs [3.0(3.0-4.0) vs 3.0(1.5-3.5), Z=-2.172, P=0035] and response index before treatment [12.0(12.0-15.0) vs 12.0(9.0-13.5), Z=-2.157, P=0.032]. The AIP+IgG4-SC group had a significantly higher median serum IgG level than the AIP group [21.0(15.8-23.7) g/L vs 14.8(13.3-15.7) g/L, Z=-2.711, P=0.004]. During the median follow-up time of 15.8 (6.5-31.3) months, the AIP+IgG4-SC group had a significantly higher recurrence rate than the AIP group (χ2=8.155, P=0.004). ConclusionPatients with AIP and IgG4-SC tend to have higher serum IgG4 level, number of affected organs, and recurrence rate than those with AIP alone. Early identification, diagnosis, and treatment can reduce the recurrence rate of AIP.

19.
Journal of Clinical Hepatology ; (12): 364-369, 2021.
Article in Chinese | WPRIM | ID: wpr-873407

ABSTRACT

ObjectiveTo investigate the difference in protein expression between hepatocellular carcinoma (HCC) patients with recurrence and those with good prognosis, the differential expression and regulatory mechanism of miR-152-3p target proteins, and the role of miR-152-3p in the recurrence of HCC. MethodsTMT-labeled proteomic sequencing and RT-PCR were used to measure the expression of proteins and the expression of miR-152-3p in the HCC tissue of six patients with recurrence at 2 years after HCC resection and six patients with good prognosis at 5 years. Six databases were used to analyze the target genes of miR-152-3p, and Gene Ontology, DAVID, and REACTOME databases were used to perform target gene screening, enrichment annotation, and signal transduction pathway enrichment analysis. Gene mutation frequency and survival curve analysis were performed for the target genes of miR-152-3p to verify the role of miR-152-3p target genes in patients with HCC recurrence. The independent samples t-test was used for comparison of continuous data between two groups, and a Kaplan-Meier analysis was performed to investigate the survival rates of liver-related genes. ResultsCompared with the patients with HCC recurrence, the patients with good prognosis after HCC resection had a significantly higher transcriptional expression level of miR-152-3p in HCC tissue (P<0.05). The results of protein sequencing showed that there were 365 differentially expressed proteins in HCC tissue between the patients with good prognosis and the patients with recurrence, and the analysis of HCC recurrence databases showed that 17 proteins were regulated by miR-152-3p. Further analysis of the signaling pathways showed that the function of the 17 target genes regulated by miR-152-3p was enriched in the translation and regulation of mitochondria and ribosome, and multiple enrichment revealed that six target genes were closely associated with mitochondrial respiratory chain complex, i.e., AKAP1, FOXRED1, MRPL28, MRPL50, SHC1, and STAU1. Gene mutation frequency and survival curve analysis showed that the loss or weakening of the function of mitochondrial respiratory chain-related target proteins seriously affected the prognosis and survival rate of patients. ConclusionThere is a significant difference in the expression of miR-152-3p in HCC tissue between patients with good prognosis and those with recurrence after HCC resection, and miR-152-3p may lead to the recurrence of HCC by regulating the target genes AKAP1, FOXRED1, MRPL28, MRPL50, SHC1, and STAU1, acting on the mitochondrial respiratory chain, and affecting the oxidative respiratory function of cells.

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Article in Chinese | WPRIM | ID: wpr-879464

ABSTRACT

OBJECTIVE@#To explore clinical effects of minimally invasive osteotomy and manual reduction in treating hallux valgus.@*METHODS@#From January 2018 to May 2019, 31 patients (42 feet) with hallux valgus were treated with minimally invasive osteotomy and manual reduction, including 3 males and 28 females aged from 18 to 76 years old with an average of (50.1± 4.9) years old. Preoperative and postoperative hallux valgus (HVA), intermetatarsal angles(IMA), length difference between 1 and 2 metatarsals were recorded and compared, and American Orthopedic Foot and Ankle Society (AOFAS)score were observed and measured.@*RESULTS@#Thirty-one patients (42 feet) were followed up from 14 to 18 months with an average of (15.1± 1.2) months. HVA, IM before operation were (38.5±5.4)°, (13.0± 1.1)°, and improved to (14.3±4.7)°and (9.1±1.5)°after operation respectively(@*CONCLUSION@#Minimally invasive osteotomy and manual reduction in treating hallux valgus have advantages of shorter operation time, less length of incision, and could correct hallux valgus deformity, improve front feet and receive good clinical effect in further.


Subject(s)
Adolescent , Adult , Aged , Female , Hallux Valgus/surgery , Humans , Male , Metatarsal Bones/surgery , Middle Aged , Osteotomy , Radiography , Treatment Outcome , Young Adult
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