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1.
Article in Chinese | WPRIM | ID: wpr-940281

ABSTRACT

Tong (dredging) method in traditional Chinese medicine (TCM) emphasizes soothing the stagnated Qi, blood, and body fluid in zang-fu organs, meridians, and collaterals to remove pathogens, reinforce vital Qi, and balance Yin and Yang of the human body. Tong method can be adopted to disperse sweat pore, attack pathogenic Qi, harmonize Yin and Yang, as well as tonify deficiency, and resolve stagnation. It has been proved effective in treating coronary heart disease (CHD), which falls into the category of "chest impediment and heart pain" in TCM, with the key pathogenesis lying in blood vessel obstruction. Therefore, dredging blood vessels is the primary therapeutic principle for CHD. Specifically, there are four aspects. The first is dispersing and dredging the sweat pore of the heart. If the sweat pore is occluded by pathogenic cold, which makes Yang-qi undissipated, Cinnamomi Ramulus, Piperis Longi Fructus, Alpiniae Officinarum Rhizoma, and Asari Radix et Rhizoma can be prescribed for warming and dredging heart Yang. If the Yang-qi of the heart and chest stagnated in the body, which hinders Qi and blood to nourish the myocardium, resulting in chest pain, Poria and Alismatis Rhizoma can be prescribed. For CHD due to atherosclerosis and inflammation, heat-clearing, toxin-removing, and inflammation-resisting Chinese medicinal herbs such as Coptidis Rhizoma and Rhei Radix et Rhizoma are recommended. The second is attacking and dredging the collaterals of the heart. Salviae Miltiorrhizae Radix et Rhizoma, Chuanxiong Rhizoma, Notoginseng Radix et Rhizoma, etc. can be prescribed for blood stasis, Trichosanthis Fructus, Allii Macrostemonis Bulbus, Pinelliae Rhizoma, etc. for phlegm, and Aquilariae Lignum Resinatum, Euodiae Fructus, etc. for pathogenic cold. Since the chronic disease can affect collaterals, Moschus and Santali Albi Lignum can be added to promote blood circulation and remove the obstruction of collaterals of the heart. The third is harmonizing and dredging the mind. Cinnamomi Ramulus, Coptidis Rhizoma, Cinnamomi Cortex, etc. are selected for restoring the coordination between the heart and the kidney. According to the specific syndrome, the methods of nourishing the mind and calming the nerves through tranquilizing the mind, calming down the mind, and inducing resuscitation can be selected using such Chinese medicines as Ziziphi Spinosae Semen, Polygalae Radix, and Draconis Ossa. The fourth is tonifying and dredging the Qi and blood of the heart. The deficiency syndrome of CHD is divided into Qi deficiency and kidney deficiency. Invigorating Qi and strengthening the heart are the first essentials for the treatment of CHD. In Qi invigoration, Qi and blood must be strengthened simultaneously to strengthen the heart and clear the pulse. Hence, Bazhentang modified by Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos can be chosen. In kidney Qi tonifying, kidney and heart must be strengthened simultaneously, and the methods of tonifying kidney and activating blood can be used. Ginseng Radix et Rhizoma and Astragali Radix are considered as the first choice for tonifying heart Qi, and Epimedii Folium and Morindae Officinalis Radix for tonifying kidney Qi, which are added with Salviae Miltiorrhizae Radix et Rhizoma and Rehmanniae Radix Praeparata to obtain the kidney-tonifying and blood-activating prescription. It is suitable for treating CHD due to kidney deficiency and blood stasis. Simultaneous treatment of heart and kidney is more suitable for middle-aged and elderly patients and chronically ill patients. Tong method can be used in various clinical diseases as well as CHD.

2.
Article in English | WPRIM | ID: wpr-939848

ABSTRACT

Immunoglobulin G4-related sialadenitis (IgG4-RS) is an immune-mediated fibro-inflammatory disease and the pathogenesis is still not fully understood. The aim of this study was to explore the role and mechanism of interleukin-13 (IL-13) in the cellular senescence during the progress of IgG4-RS. We found that the expression of IL-13 and IL-13 receptor α1 (IL-13Rα1) as well as the number of senescent cells were significantly higher in the submandibular glands (SMGs) of IgG4-RS patients. IL-13 directly induced senescence as shown by the elevated activity of senescence-associated β-galactosidase (SA-β-gal), the decreased cell proliferation, and the upregulation of senescence markers (p53 and p16) and senescence-associated secretory phenotype (SASP) factors (IL-1β and IL-6) in SMG-C6 cells. Mechanistically, IL-13 increased the level of phosphorylated signal transducer and activator of transcription 6 (p-STAT6) and mitochondrial-reactive oxygen species (mtROS), while decreased the mitochondrial membrane potential, ATP level, and the expression and activity of superoxide dismutase 2 (SOD2). Notably, the IL-13-induced cellular senescence and mitochondrial dysfunction could be inhibited by pretreatment with either STAT6 inhibitor AS1517499 or mitochondria-targeted ROS scavenger MitoTEMPO. Moreover, IL-13 increased the interaction between p-STAT6 and cAMP-response element binding protein (CREB)-binding protein (CBP) and decreased the transcriptional activity of CREB on SOD2. Taken together, our findings revealed a critical role of IL-13 in the induction of salivary gland epithelial cell senescence through the elevated mitochondrial oxidative stress in a STAT6-CREB-SOD2-dependent pathway in IgG4-RS.


Subject(s)
Cellular Senescence/genetics , Humans , Immunoglobulin G/metabolism , Interleukin-13/pharmacology , Mitochondria/metabolism , Sialadenitis/metabolism
3.
Article in English | WPRIM | ID: wpr-939774

ABSTRACT

OBJECTIVE@#To explore the molecular bases of Chinese medicine (CM) syndrome classification in chronic hepatitis B (CHB) patients in terms of DNA methylation, transcription and cytokines.@*METHODS@#Genome-wide DNA methylation and 48 serum cytokines were detected in CHB patients (DNA methylation: 15 cases; serum cytokines: 62 cases) with different CM syndromes, including dampness and heat of Gan (Liver) and gallbladder (CHB1, DNA methylation: 5 cases, serum cytokines: 15 cases), Gan stagnation and Pi (Spleen) deficiency (CHB2, DNA methylation: 5 cases, serum cytokines: 15 cases), Gan and Shen (Kidney) yin deficiency (CHB3, DNA methylation: 5 cases, serum cytokines: 16 cases), CHB with hidden symptoms (HS, serum cytokines:16 cases) and healthy controls (DNA methylation: 6 cases). DNA methylation of a critical gene was further validated and its mRNA expression was detected on enlarged samples. Genome-wide DNA methylation was detected using Human Methylation 450K Assay and furthered verified using pyrosequencing. Cytokines and mRNA expression of gene were evaluated using multiplex biometric enzyme-linked immunosorbent assay (ELISA)-based immunoassay and reverse transcription-quantitative polymerase chain reaction (RT-qPCR), respectively.@*RESULTS@#Totally 28,667 loci, covering 18,403 genes were differently methylated among CHB1, CHB2 and CHB3 (P<0.05 and |Δβ value| > 0.17). Further validation showed that compared with HS, the hg19 CHR6: 29691140 and its closely surrounded 2 CpG loci were demethylated and its mRNA expressions were significantly up-regulated in CHB1 (P<0.05). However, they remained unaltered in CHB2 (P>0.05). Levels of Interleukin (IL)-12 were higher in CHB3 and HS than that in CHB1 and CHB2 groups (P<0.05). Levels of macrophage inflammatory protein (MIP)-1α and MIP-1β were higher in CHB3 than other groups and leukemia inhibitory factor level was higher in CHB1 and HS than CHB2 and CHB3 groups (P<0.05). IL-12, MIP-1α and MIP-1β concentrations were positively correlated with human leukocyte antigen F (HLA-F) mRNA expression (R2=0.238, P<0.05; R2=0.224, P<0.05; R=0.447, P<0.01; respectively). Furthermore, combination of HLA-F mRNA and differential cytokines greatly improved the differentiating accuracy among CHB1, CHB2 and HS.@*CONCLUSIONS@#Demethylation of CpG loci in 5' UTR of HLA-F may up-regulate its mRNA expression and HLA-F expression was associated with IL-12, MIP-1α and MIP-1β levels, indicating that HLA-F and the differential cytokines might jointly involve in the classification of CM syndromes in CHB.@*REGISTRATION NO@#ChiCTR-RCS-13004001.


Subject(s)
Chemokine CCL3/genetics , Chemokine CCL4/genetics , Cytokines/genetics , DNA Methylation/genetics , HLA Antigens , Hepatitis B, Chronic/genetics , Histocompatibility Antigens Class I , Humans , Interleukin-12/genetics , Medicine, Chinese Traditional , RNA, Messenger , Syndrome
4.
Article in Chinese | WPRIM | ID: wpr-939755

ABSTRACT

In order to improve the operation difficulties in the narrow space of the nasal maxillary sinus, the nasal continuum minimally invasive surgical robot system is designed. The ball-and-socket joints and NiTiNol tubes are used as the main body of the continuum structure to improve the degree of freedom. The hardware systems and software systems are designed. The security control policies are planned. Finally, the robot confirmed prototype experiments are conducted and the feasibility of continuum robot confirmed through master-slave control experiment and animal experiment.


Subject(s)
Animals , Biomechanical Phenomena , Equipment Design , Minimally Invasive Surgical Procedures , Robotic Surgical Procedures , Robotics , Software
5.
Article in Chinese | WPRIM | ID: wpr-939692

ABSTRACT

OBJECTIVE@#To screen differentially expressed gene (DEG) related to myelodysplastic syndrome (MDS) based on Gene Expression Omnibus (GEO) database, and explore the core genes and pathogenesis of MDS by analyzing the biological functions and related signaling pathways of DEG.@*METHODS@#The expression profiles of GSE4619, GSE19429, GSE58831 including MDS patients and normal controls were downloaded from GEO database. The gene expression analysis tool (GEO2R) of GEO database was used to screen DEG according to | log FC (fold change) |≥1 and P<0.01. David online database was used to annotate gene ontology function (GO). Metascape online database was used to enrich and analyze differential genes in Kyoto Encyclopedia of Genes and Genomes (KEGG). The protein-protein interaction network (PPI) was constructed by using STRING database. CytoHubba and Mcode plug-ins of Cytoscape were used to analyze the key gene clusters and hub genes. R language was used to diagnose hub genes and draw the ROC curve. GSEA enrichment analysis was performed on GSE19429 according to the expression of LEF1.@*RESULTS@#A total of 74 co-DEG were identified, including 14 up-regulated genes and 60 down regulated genes. GO enrichment analysis indicated that BP of down regulated genes was mainly enriched in the transcription and regulation of RNA polymerase II promoter, negative regulation of cell proliferation, and immune response. CC of down regulated genes was mainly enriched in the nucleus, transcription factor complexes, and adhesion spots. MF was mainly enriched in protein binding, DNA binding, and β-catenin binding. KEGG pathway was enriched in primary immunodeficiency, Hippo signaling pathway, cAMP signaling pathway, transcriptional mis-regulation in cancer and hematopoietic cell lineage. BP of up-regulated genes was mainly enriched in type I interferon signaling pathway and viral response. CC was mainly enriched in cytoplasm. MF was mainly enriched in RNA binding. Ten hub genes and three important gene clusters were screened by STRING database and Cytoscape software. The functions of the three key gene clusters were closely related to immune regulation. ROC analysis showed that the hub genes had a good diagnostic significance for MDS. GSEA analysis indicated that LEF1 may affect the normal function of hematopoietic stem cells by regulating inflammatory reaction, which further revealed the pathogenesis of MDS.@*CONCLUSION@#Bioinformatics can effectively screen the core genes and key signaling pathways of MDS, which provides a new strategy for the diagnosis and treatment of MDS.


Subject(s)
Computational Biology , Gene Expression Profiling , Gene Expression Regulation, Neoplastic , Gene Ontology , Humans , Myelodysplastic Syndromes/genetics
6.
Article in Chinese | WPRIM | ID: wpr-934573

ABSTRACT

Objective:To analyze the composition, the changes of expense structure and the influencing factors of hospitalization expenses, for reference in optimizing the cost control of day surgery.Methods:Collection of the first page data of patients with the top three diseases(varicose veins of lower limbs, chronic cholecystitis and varicocele)in the day surgery volume ranking in three tertiary general hospitals in a city in 2020. The confounding factors were eliminated through propensity matching. The structural change of hospitalization expenses was analyzed by structural change degree, and the influencing factors of hospitalization expenses were analyzed by grey correlation degree and multiple linear regression.Results:After 1∶1 propensity matching of the first page data of 752 patients with day surgery and non day surgery, 98 patients with lower extremity varicose veins, 356 patients with chronic cholecystitis and 38 patients with varicocele were finally included. Compared with non day hand, the total hospitalization cost of day surgical instruments decreased, and the cost structure changes of chronic cholecystitis, varicocele and varicose veins of lower limbs were 14.59%, 6.20% and 16.20% respectively. Among them, the general medical service fee, nursing fee and examination and laboratory fee showed a downward trend, and the fees of materials and drugs showed an upward trend. General medical service fee, nursing fee, examination and laboratory fee, clinical diagnosis fee, treatment fee, drug fee, material fee and other expenses presented a high correlation with the cost of day surgery(grey correlation>0.90). The payment method, wound healing type and discharge diagnosis can influence the cost of day surgery( P<0.05). Conclusions:Compared with non daytime surgery, the total hospitalization cost of day surgery has a certain cost control effect, but it can not reduce the cost of all projects. The main influencing factors are the internal composition of the cost, payment method and so on. The hospitals should focus on tapping the internal cost control potential of day surgery and further expanding the coverage of day surgery diseases.

7.
Article in Chinese | WPRIM | ID: wpr-933457

ABSTRACT

Objective:To explore the differences of risk stratification of very high-risk or extreme high-risk atherosclerotic cardiovascular diseases (ASCVD) and the attainment rates of low-density lipoprotein cholesterol (LDL-C) management targets evaluated by three different criteria, and the causal attributions of these differences.Methods:Patients with ASCVD were consecutively enrolled from January 1 to December 31 in 2019, and were evaluated for very high-risk or extreme high-risk and LDL-C goal attainment rates with 2018 American guideline on the management of blood cholesterol (2018AG), 2019 China Cholesterol Education Program (CCEP) Expert Advice for the management of dyslipidemias (2019EA) and 2020 Chinese expert consensus on lipid management of very high-risk ASCVD patients(2020EC), respectively. The causal attributions of the differences in attainment rates were analyzed as well.Results:A total of 1 864 ASCVD patients were included in this study. According to 2018AG, 2019EA and 2020EC, the proportions of the patients with very high-risk or extreme high-risk were 59.4%, 90.7%, and 65.6%, respectively. The absolute LDL-C target attainment rates were 37.2%, 15.7%, and 13.7%, respectively, the differences between each two rates were statistically significant (all P<0.001). As to the differences in attainment rates between 2020EC and 2018AG, 61.5% were due to the different LDL-C goal attainment values and 38.5% were caused by the different risk stratifications, while for the differences between 2020EC and 2019EA attainment rates, different LDL-C goal attainment values were responsible for 13.2%, and different risk stratifications were responsible for 86.8% of the differences. Conclusions:There are significant differences in the proportions and LDL-C attainment rates among the three different criteria for very high-risk or extreme high-risk ASCVD. 2020EC showed a moderate proportion of patients with extreme high-risk, and had the lowest LDL-C attainment rate. The differences between 2020EC and 2018AG are mainly due to the LDL-C target values, and the differences between 2020EC and 2019EA are mainly caused by the risk stratifications.

8.
Article in Chinese | WPRIM | ID: wpr-931951

ABSTRACT

It is unclear whether antidepressants have the same effects on the brain function at different periods of treatment.In this paper, in order to improve the understanding of the neurobiological mechanisms of antidepressants from brain network level, find the target of antidepressants, optimize treatment strategy, four common neuroimaging techniques were reviewed to investigate the changes of brain functional imaging in patients with major depressive disorder at different periods (short-term, acute and long-term) after antidepressant treatment.After short-term antidepressant treatment, the changes of brain functional imaging mainly involved the amygdala, insula, prefrontal cortex, dorsal anterior cingulate cortex and so on, and these short-term changes of brain functional imaging could predict acute efficiency.After acute stage of antidepressant treatment, the changes of brain functional imaging were mostly located in the brain regions of cortical-limbic circuit and default mode network.The effect of long-term antidepressant treatment on brain functional imaging still needs to be further studied.In the future, the experimental design should be optimized and multiple neuroimaging techniques should be combined to conduct longitudinal long-term studies at multiple time points.

9.
Article in Chinese | WPRIM | ID: wpr-923496

ABSTRACT

@#A novel allicin pro-drug tablet containing antacid pellets was developed to realize pH-regulated allicin release and to guarantee allicin yield in stomach environment.Firstly, allicin precursor pellets containing antacid pellet were prepared and artificial gastric juice was used as the medium to determine the yield of the allicin.Then, the total lipid cholesterol (TC), triglyceride cholesterol (TG), high density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) were used as indicators to study the hypolipidemic effect of allicin precursor pellets in rats.The dissolution test showed that in artificial gastric juice, the yield of allicin-containing antacid pellets exceeded 90%.In pharmacodynamic studies, it was found that antacid pellets showed the expected hypolipidemic effect on hyperlipidemia rats compared without antacid pellets.There was a very significant difference in blood lipid levels between the two test groups (P < 0.05).The allicin pro-drug tablets containing antacid pellets can effectively lower blood lipids.

10.
Article in English | WPRIM | ID: wpr-922536

ABSTRACT

BACKGROUND@#Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.@*OBJECTIVE@#In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.@*SEARCH STRATEGY@#The search strategy was structured by medical subject headings and search terms such as "acupuncture therapy" and "functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020.@*INCLUSION CRITERIA@#SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.@*DATA EXTRACTION AND ANALYSIS@#Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A κ index was used to score the level of agreement between the 2 reviewers.@*RESULTS@#Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as "critically low" confidence and one study as "low" confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have "low risk" of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as "moderate" quality, 57.5% (23/40) as "low" quality, and 20.0% (8/40) as "very low" quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.@*CONCLUSION@#Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.@*SYSTEMATIC REVIEW REGISTRATION@#PROSPERO CRD42020189173.


Subject(s)
Acupuncture Therapy , Constipation/therapy , Humans , Quality of Life , Systematic Reviews as Topic
11.
Article in Chinese | WPRIM | ID: wpr-928157

ABSTRACT

This study aims to explore the effect of icariin(ICA) on mitochondrial dynamics in a rat model of chronic renal failure(CRF) and to investigate the molecular mechanism of ICA against renal interstitial fibrosis(RIF). CRF was induced in male Sprague-Dawley(SD) rats with 5/6(ablation and infarction, A/I) surgery(right kidney ablation and 2/3 infarction of the left kidney). Four weeks after surgery, the model rats were randomized into the following groups: 5/6(A/I) group, 5/6(A/I)+low-dose ICA group, and 5/6(A/I)+high-dose ICA group. Another 12 rats that received sham operation were randomly classified into 2 groups: sham group and sham+ICAH group. Eight weeks after treatment, the expression of collagen-Ⅰ(Col-Ⅰ), collagen-Ⅲ(Col-Ⅲ), mitochondrial dynamics-related proteins(p-Drp1 S616, p-Drp1 S637, Mfn1, Mfn2), and mitochondrial function-related proteins(TFAM, ATP6) in the remnant kidney tissues was detected by Western blot. The expression of α-smooth muscle actin(α-SMA) was examined by immunohistochemical(IHC) staining. The NRK-52 E cells, a rat proximal renal tubular epithelial cell line, were cultured in vitro and treated with ICA of different concentration. Cell viability was detected by CCK-8 assay. In NRK-52 E cells stimulated with 20 ng·mL~(-1) TGF-β1 for 24 h, the effect of ICA on fibronectin(Fn), connective tissue growth factor(CTGF), p-Drp1 S616, p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6 was detected by Western blot, and the ATP content and the mitochondrial morphology were determined. The 20 ng·mL~(-1) TGF-β1-stimulated NRK-52 E cells were treated with or without 5 μmol·L~(-1) ICA+10 μmol·L~(-1) mitochondrial fusion promoter M1(MFP-M1) for 24 h and the expression of fibrosis markers Fn and CTGF was detected by Western blot. Western blot result showed that the levels of Col-Ⅰ, Col-Ⅲ, and p-Drp1 S616 were increased and the levels of p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6 were decreased in 5/6(A/I) group compared with those in the sham group. The levels of Col-Ⅰ, Col-Ⅲ, and p-Drp1 S616 were significantly lower and the levels of p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6 were significantly higher in ICA groups than that in 5/6(A/I) group. IHC staining demonstrated that for the expression of α-SMA in the renal interstitium was higher in the 5/6(A/I) group than in the sham group and that the expression in the ICA groups was significantly lower than that in the 5/6(A/I) group. Furthermore, the improvement in the fibrosis, mitochondrial dynamics, and mitochondrial function were particularly prominent in rats receiving the high dose of ICA. The in vitro experiment revealed that ICA dose-dependently inhibited the increase of Fn, CTGF, and p-Drp1 S616, increased p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6, elevated ATP content, and improved mitochondrial morphology of NRK-52 E cells stimulated by TGF-β1. ICA combined with MFP-M1 further down-regulated the expression of Fn and CTGF in NRK-52 E cells stimulated by TGF-β1 compared with ICA alone. In conclusion, ICA attenuated RIF of CRF by improving mitochondrial dynamics.


Subject(s)
Adenosine Triphosphate/pharmacology , Animals , Female , Fibrosis , Flavonoids , Humans , Infarction/pathology , Kidney , Kidney Failure, Chronic , Male , Mitochondrial Dynamics , Rats , Rats, Sprague-Dawley , Renal Insufficiency, Chronic , Transforming Growth Factor beta1/metabolism
12.
Article in Chinese | WPRIM | ID: wpr-912489

ABSTRACT

Immune disorders are currently recognized as the major cause of aggravation of clinical symptoms in corona virus disease 2019 (COVID-19) patients. This review summarized the characteristics of the immune response to COVID-19 from the abnormal dynamics of lymphocyte subsets, including the decrease in the count of natural killer cell and T cell subsets and the large accumulation of cytokines during disease progression. This review also clarified the possible mechanisms of changes in key lymphocyte subsets and the dynamic of cytokines. Thus, it provided new strategies for clinical treatment and granted potential targets for drug discovery.

13.
Article in Chinese | WPRIM | ID: wpr-912326

ABSTRACT

The treatment of heart failure is a common clinical problem faced by the medical community all over the world. It is also the only cardiovascular disease in the world that is on the rise. Although drug therapy for heart failure has made great progress in recent years, there are still many problems. Therefore, reversing ventricular remodeling, assisting or even replacing the function of the damaged heart and improving the prognosis and quality of life of patients with heart failure through surgical treatment will become the main battlefield for the future treatment of heart failure. As a transitional support therapy or permanent replacement therapy before heart transplantation, ventricular assist device can significantly improve the survival and quality of life of patients with heart failure, and is becoming an important treatment method for patients with end-stage heart failure. This paper aim to review the history and prospect of ventricular assist devices after heart failure.

14.
Chinese Journal of Dermatology ; (12): 920-923, 2021.
Article in Chinese | WPRIM | ID: wpr-911532

ABSTRACT

Nail unit tumors are a group of rare tumors only occurring in the nail unit, including onychopapilloma, onychomatricoma, onychocytic matricoma, onycholemmal carcinoma, and so on. These tumors have specific clinical manifestations and pathological features due to their special anatomical locations. This review focuses on clinical manifestations, histopathological characteristics and treatment of the above tumors.

15.
Chinese Critical Care Medicine ; (12): 779-785, 2021.
Article in Chinese | WPRIM | ID: wpr-909404

ABSTRACT

Objective:To verify the specific differentiated subsets of monocytes in sepsis, and to screen and construct the differential gene set of monocytes used for early diagnosis of sepsis.Methods:Patients with sepsis admitted to Guangdong Provincial People's Hospital from June 2020 to March 2021 were enrolled, and peripheral blood mononuclear cells (PBMC) were extracted. Single-cell sequencing technology and pseudo-time analysis were used to verify the differential subsets of monocytes. Bioinformatics methods were used to analyze the expression of genes in differential subsets of monocytes and screen out differential genes for the preliminary construction of a candidate differential gene set. The digital polymerase chain reaction (PCR) technology was used to verify the candidate differential genes in PBMC of sepsis patients and sepsis human myeloid leukemia mononuclear cells (THP-1) models, and the Venn diagram was used to construct the final differential gene set of monocytes. Gene Expression Omnibus (GEO) database was used to validate the differential gene set of monocytes.Results:① The results of cell annotation and pseudo-time analysis showed that the differentiation of NEAT1 +CD163 + monocyte occurred in the early stage of sepsis was significantly different from other subsets, which validated that NEAT1 +CD163 + monocyte was the characteristic subset in the pathological process of sepsis. ② Twenty-two differential genes related to sepsis were screened out from the gene expression of NEAT1 +CD163 + monocyte. After further verification by digital PCR, basic leucine zipper ATF-like transcription factor (BATF), JUNB proto-oncogene, carcinoembryonic antigen-related cell adhesion molecule 4 (CEACAM4), chromosome 9 open reading frame 95 (C9orf95), G protein subunit alpha 15 (GNA15), complement C3a receptor 1 (C3AR1), transforming growth factor beta 1 (TGFB1) and mitochondrial carrier homolog 1 (MTCH1) were screened out to construct the final differential gene set of monocytes. ③ The external validation results showed that C9orf95 gene had no data in GSE154918 and GSE133822 from GEO, it was excluded during validation. In GSE154918, the expressions of BATF, JUNB, CEACAM4, GNA15, C3AR1, TGFB1, and MTCH1 in the sepsis group were significantly higher than those in the healthy control group (log 2expression level: BATF was 12.78±0.08 vs. 11.39±0.35, JUNB was 16.88±0.07 vs. 16.04±0.03, CEACAM4 was 14.73±0.08 vs. 13.77±0.05, GNA15 was 13.16±0.06 vs. 12.30±0.04, C3AR1 was 14.62±0.13 vs. 12.87±0.05, TGFB1 was 16.95±0.05 vs. 16.57±0.36, MTCH1 was 14.80±0.02 vs. 14.61±0.15, all P < 0.05). In GSE133822, the expressions of BATF, CEACAM4, GNA15, and C3AR1 in the sepsis group were significantly higher than those in the health control group (log 2expression level: BATF was 8.66±0.16 vs. 7.92±0.14, CEACAM4 was 9.20±0.16 vs. 8.36±0.20, GNA15 was 10.66±0.18 vs. 10.13±0.16, C3AR1 was 11.49±0.27 vs. 10.48±0.16, all P < 0.05), while the expressions of JUNB, TGFB1, and MTCH1 were not statistically different between two groups. The results of gene set variation analysis (GSVA) showed that the enrichment scores of monocytes differential gene set of sepsis group were significantly higher than those of the healthy control group in both GSE154918 (0.38±0.04 vs. -0.44±0.02) and GSE133822 (0.56±0.02 vs. 0.20±0.05, both P < 0.01). Receiver operator characteristic curve (ROC curve) analysis showed that the differential gene set of monocytes had a reliable diagnostic value for early sepsis with the area under ROC curve (AUC) of 0.993 [95% confidence interval (95% CI) was 0.980-1.000] in GSE154918 and 0.944 (95% CI was 0.873-1.000) in GSE133822. Conclusion:A differential gene set of monocytes (BATF, JUNB, CEACAM4, GNA15, C3AR1, TGFB1, and MTCH1) screened out by single-cell sequencing and digital PCR technology has a reliable diagnostic value for the early sepsis, and may provide a new idea for the early diagnosis of sepsis.

16.
Article in Chinese | WPRIM | ID: wpr-906015

ABSTRACT

Objective:To explore the effect of Bushen Tongluo prescription (BSTLP) on the synaptic plasticity of hippocampal neurons in vascular dementia (VD) model rats and its mechanism. Method:SD male rats of SPF grade were selected. The rat model of VD was established by permanent bilateral ligation of the common carotid artery several times. The model rats were randomly divided into a model group, an insulin-like growth factor-1 (IGF-1, 20 μg·kg<sup>-1</sup>) group, high-dose (3 g·kg<sup>-1</sup>), medium-dose (1.5 g·kg<sup>-1</sup>), and low-dose (0.75 g·kg<sup>-1</sup>) BSTLP groups. A sham operation group was also set. Drugs were administered to rats by gavage once a day for four weeks. The model group and the sham operation group received the same volume of normal saline. After the last administration, all the rats were detected for spatial learning and memory by the Morris water maze. The apoptosis of hippocampal neurons was detected by terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL) assay. The changes in synaptic morphological structure and the number of dendritic spines in hippocampal neurons were detected by Golgi's method. The expression levels of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), mammalian target of rapamycin (mTOR), synaptophysin (SYP), and amyloid precursor protein (APP) in hippocampal neurons were detected by Western blot. Result:Compared with the sham operation group, the model group showed prolonged escape latency, lengthened swimming distance, dwindled the number of times for the platform crossing after platform removal (<italic>P</italic><0.05), increased apoptotic cells (<italic>P</italic><0.05), declining synaptic dendritic spines (<italic>P</italic><0.05), down-regulated expression levels of PI3K, Akt, mTOR, and SYP proteins, and up-regulated expression level of APP protein in hippocampal neurons (<italic>P</italic><0.05). Compared with the model group, the BSTLP groups and the IGF-1 group showed shortened escape latency and swimming distance, increased number of times for the platform crossing after platform removal (<italic>P</italic><0.05),declining apoptotic cells (<italic>P</italic><0.05), up-regulated expression levels of PI3K, Akt, mTOR, and SYP proteins, and down-regulated expression level of APP protein in hippocampal neurons (<italic>P</italic><0.05). Compared with the IGF-1 group, the high-dose BSTLP group showed no significant difference in the escape latency, swimming distance, the number of times for the platform crossing after platform removal, apoptotic cells, synaptic dendritic spines, and expression levels of PI3K, Akt, mTOR, SYP, and APP proteins in hippocampal neurons. However, the differences were significant in the medium-dose and low-dose BSTLP groups (<italic>P</italic><0.05). Conclusion:BSTLP can improve the learning and memory of rats with VD. The mechanism is presumedly related to the activation of thePI3K/Akt/mTOR pathway and improvement of synaptic plasticity of hippocampal neurons.

17.
Article in Chinese | WPRIM | ID: wpr-883121

ABSTRACT

Objective:To design and develop an unplanned extubation clinical decision support system, aiming to provide a reference for nurses' clinical decision-making.Methods:Through literature review and expert consultation, the knowledge base of the clinical decision support system for unplanned extubation was constructed, and the system function and interface were designed.Results:The authoritative coefficients of the two rounds of expert consultation were 0.853 and 0.867, respectively, and the Kendall ′s W were 0.458 and 0.492, respectively. The final built knowledge base included catheter evaluation module, unplanned extubation evaluation module, and knowledge reasoning rule module. At present, the knowledge base had sorted out 48 first-level items, 9 second-level items, 72 third-level items in the catheter evaluation module, and 5 first-level items, 12 second-level items, and 73 third-level items in the unplanned extubation evaluation module. Entry, 40 knowledge reasoning rules. Conclusions:The clinical decision-making system for unplanned extubation has changed the implementation of unplanned extubation risk early warning, optimized the management process, and realized the interaction of the hospital system. It can conduct dynamic unplanned extubation risk assessment based on individualization and assist nurses Make clinical decisions and promote the safety of nursing management.

18.
Article in Chinese | WPRIM | ID: wpr-882963

ABSTRACT

Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.

19.
Protein & Cell ; (12): 261-278, 2021.
Article in English | WPRIM | ID: wpr-880901

ABSTRACT

TANK-binding kinase 1 (TBK1), a core kinase of antiviral pathways, activates the production of interferons (IFNs). It has been reported that deacetylation activates TBK1; however, the precise mechanism still remains to be uncovered. We show here that during the early stage of viral infection, the acetylation of TBK1 was increased, and the acetylation of TBK1 at Lys241 enhanced the recruitment of IRF3 to TBK1. HDAC3 directly deacetylated TBK1 at Lys241 and Lys692, which resulted in the activation of TBK1. Deacetylation at Lys241 and Lys692 was critical for the kinase activity and dimerization of TBK1 respectively. Using knockout cell lines and transgenic mice, we confirmed that a HDAC3 null mutant exhibited enhanced susceptibility to viral challenge via impaired production of type I IFNs. Furthermore, activated TBK1 phosphorylated HDAC3, which promoted the deacetylation activity of HDAC3 and formed a feedback loop. In this study, we illustrated the roles the acetylated and deacetylated forms of TBK1 play in antiviral innate responses and clarified the post-translational modulations involved in the interaction between TBK1 and HDAC3.

20.
Chinese Critical Care Medicine ; (12): 1181-1186, 2021.
Article in Chinese | WPRIM | ID: wpr-931745

ABSTRACT

Objective:To compare the characteristics and outcomes of culture-positive sepsis (CPS) with culture-negative sepsis (CNS) patients in order to understand the impact of CNS on prognosis and explore the possible risk factors for mortality.Methods:A retrospective cohort study was conducted. Patients with sepsis were identified from the Medical Information Mart for Intensive Care database-Ⅳ v0.4 (MIMIC-Ⅳ v0.4). Patients were divided into CPS and CNS groups according to the culture results within 24 hours before and after the diagnosis of sepsis. General information, baseline characteristics, and medical operation data between CNS and CPS groups were compared. Logistic regression analysis was used to calculate the relationship between CNS and in-hospital mortality under three regression models. Chi-square analysis and mediation analysis were used to analyze the effect of initial antibiotic and prior antibiotic use within 90 days on the in-hospital mortality of CNS. Results:A total of 8 587 patients with sepsis were enrolled in the final analysis, including 5 483 patients in the CPS group and 3 104 patients in the CNS group. Compared with the CPS group, the patients in the CNS group were younger [years old: 68 (56, 79) vs. 70 (58, 81)], had higher sequential organ failure assessment (SOFA) score and higher proportion of using mechanical ventilation, renal replacement therapy and vasopressin within 24 hours after intensive care unit (ICU) admission [SOFA score: 3 (2, 5) vs. 3 (2, 4), mechanical ventilation: 48.61% (1 509/3 104) vs. 39.25% (2 152/5 483), renal replacement therapy: 13.69% (425/3 104) vs. 9.68% (531/5 483), vasopressin: 15.79% (490/3 104) vs. 13.44% (737/5 483)], longer length of ICU stay [days: 5 (3, 10) vs. 3 (2, 6)] and higher in-hospital mortality [25.00% (776/3 104) vs. 18.53% (1 016/5 483)], with significant differences (all P < 0.01). However, there was no significant difference in gender, ICU type, simplified acute physiology score Ⅱ (SAPS Ⅱ), and Charlson comorbidity index (CCI) score between the two groups. After adjustment for multiple confounding factors, CNS was still a risk factor for in-hospital mortality [odds ratio ( OR) = 1.441, 95% confidence interval (95% CI) was 1.273-1.630, P < 0.001]. The results of Chi-square analysis and mediation analysis showed that the initial antibiotic had no significant effect on the higher in-hospital mortality of CNS, while the prior use of antibiotics within 90 days was related to higher in-hospital mortality of CNS ( OR = 1.683, 95% CI was 1.328-2.134, P < 0.05). The mediating effect of CNS in prior antibiotic use within 90 days and in-hospital death was significant ( Z = 5.302, P < 0.001), accounting for 7.58%. Conclusions:Compared with CPS, CNS was more severe and had a worse prognosis. Prior use of antibiotics within 90 days may be related to the higher in-hospital mortality of CNS patients, but it could not fully explain the high mortality of CNS.

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