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Objective:To compare the effect of prognosis between drug-coated balloon (DCB) and drug eluting stent (DES) interventional therapy in patients with coronary heart disease.Methods:The clinical data of 346 coronary heart disease patients underwent interventional therapy because of small vessel lesion, in-stent restenosis and bifurcation lesion in Xuanwu Hospital, Capital Medical University from December 2018 to July 2021 were retrospectively analyzed. Among them, 179 patients were treated with DES (DES group), including small vessel lesion 81 cases, in-stent restenosis 35 cases, and bifurcation lesion 63 cases; 167 patients were treated with DCB (DCB group), including small vessel lesion 69 cases, in-stent restenosis 62 cases, and bifurcation lesion 36 cases. The major adverse cardiac and cerebrovascular event (MACCE) within 1 year after discharge was compared between two groups. Non-inferiority was analyzed, and non-inferiority margin was set to be 4%.Results:There was no statistical difference in the incidence of MACCE between DCB group and DES group: 3.59% (6/167) vs. 7.26% (13/179), P>0.05. There were no statistical differences in the incidences of MACCE in patients with small vessel lesion, in-stent restenosis and bifurcation lesion between DCB group and DES group: 1.45% (1/69) vs. 4.94% (4/81), 8.06% (5/62) vs. 14.29% (5/35) and 0 vs. 6.35% (4/63); P>0.05. Non-inferiority analysis result showed that DCB was non-inferior to DES on the prognosis in patients with coronary heart disease (95% CI - 8.41% to 1.07%). Conclusions:Non-inferiority of DCB versus DES is shown in coronary heart disease patients with small vessel lesion, in-stent restenosis and bifurcation lesion.
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Objective:To analyze the relationship between stress hyperglycemia (SHG) and the prognosis of acute myocardial infarction (AMI) without diabetes mellitus (DM).Methods:Using a retrospective cohort study method, 396 AMI patients without DM or impaired glucose tolerance (IGT) and admitted glycated hemoglobin A 1c (HbA 1c)≤6.0% from January 2018 to December 2020 in Xuanwu Hospital, Capital Medical University were selected. Among them, 238 patients did not have SHG at admission (group A), 85 patients had SHG at admission but their blood glucose level did not reach the diagnostic criteria for DM (group B), and 73 patients had SHG at admission and their blood glucose level reached the diagnostic criteria for DM (group C). The baseline data and the incidence of main adverse cardiovascular and cerebrovascular events (MACCE) were recorded. Multivariate Cox regression was used to analyze the independent risk factors of MACCE after discharge in AMI patients without DM. Results:The incidence of MACCE after discharge in group B and group C was significantly higher than that in group A: 29.4% (25/85) and 35.6% (26/73) vs. 18.5% (44/238), the incidence in group C was significantly higher than that in group B, and there was statistical difference ( P<0.05). Multivariate Cox regression analysis result showed that SHG on admission was an independent risk factor for MACCE after discharge in AMI patients without DM ( P<0.05), and LVEF on admission was an independent protective factor for MACCE after discharge in AMI patients without DM ( P<0.01). Conclusions:SHG on admission is the independent risk factor of MACCE in AMI patient without DM. Early detection, assessment and proper intervention measures based on clinical reality should be advocated for the AMI patients with SHG to further improve the prognosis.
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To explore the research hotspots and frontier directions of pyroptosis in the field of traditional Chinese medicine(TCM), the authors searched CNKI and Web of Science for literature related to pyroptosis in TCM, screened literature according to the search strategy and inclusion criteria, and analyzed the publication trend of the included literature. VOSviewer was used to draw author cooperation and keyword co-occurrence network diagrams, and CiteSpace was employed for keyword clustering, emergence, and timeline view. Finally, 507 Chinese literature and 464 English literature were included, and it was found that the number of Chinese and English literature was increasing rapidly year by year. The co-occurrence of the authors showed that in terms of Chinese literature, there was a representative research team composed of DU Guan-hua, WANG Shou-bao and FANG Lian-hua, and for English literature, the representative research team was composed of XIAO Xiao-he, BAI Zhao-fang and XU Guang. The network visualization of Chinese and English keywords revealed that inflammation, apoptosis, oxidative stress, autophagy, organ damage, fibrosis, atherosclerosis, and ischemia-reperfusion injury were the primary research diseases and pathological processes in TCM; berberine, resveratrol, puerarin, na-ringenin, astragaloside Ⅳ, and baicalin were the representative active ingredients; NLRP3/caspase-1/GSDMD, TLR4/NF-κB/NLRP3, and p38/MAPK signaling pathways were the main research pathways. Keyword clustering, emergence, and timeline analysis indicated that the pyroptosis research in TCM focused on the mechanism of TCM monomers and compounds intervening in diseases and pathological processes. Pyroptosis is a research hotspot in the area of TCM, and the current discussion mainly focuses on the mechanism of the therapeutic effect of TCM.
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Piroptosis , Medicina Tradicional China , Proteína con Dominio Pirina 3 de la Familia NLR , Reconocimiento de Normas Patrones Automatizadas , ApoptosisRESUMEN
The goal of this study was to investigate the regulatory effect of angiotensin converting enzyme 2 (ACE2) on cellular inflammation caused by avian infectious bronchitis virus (IBV) and the underlying mechanism of such effect. Vero and DF-1 cells were used as test target to be exposed to recombinant IBV virus (IBV-3ab-Luc). Four different groups were tested: the control group, the infection group[IBV-3ab-Luc, MOI (multiplicity of infection)=1], the ACE2 overexpression group[IBV-3ab Luc+pcDNA3.1(+)-ACE2], and the ACE2-depleted group (IBV-3ab-Luc+siRNA-ACE2). After the cells in the infection group started to show cytopathic indicators, the overall protein and RNA in cell of each group were extracted. real-time quantitative polymerase chain reaction (RT-qPCR) was used to determine the mRNA expression level of the IBV nucleoprotein (IBV-N), glycoprotein 130 (gp130) and cellular interleukin-6 (IL-6). Enzyme linked immunosorbent assay (ELISA) was used to determine the level of IL-6 in cell supernatant. Western blotting was performed to determine the level of ACE2 phosphorylation of janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3). We found that ACE2 was successfully overexpressed and depleted in both Vero and DF-1 cells. Secondly, cytopathic indicators were observed in infected Vero cells including rounding, detaching, clumping, and formation of syncytia. These indicators were alleviated in ACE2 overexpression group but exacerbated when ACE2 was depleted. Thirdly, in the infection group, capering with the control group, the expression level of IBV-N, gp130, IL-6 mRNA and increased significantly (P < 0.05), the IL-6 level was significant or extremely significant elevated in cell supernatant (P < 0.05 or P < 0.01); the expression of ACE2 decreased significantly (P < 0.05); protein phosphorylation level of JAK2 and STAT3 increased significantly (P < 0.05). Fourthly, comparing with the infected group, the level of IBV-N mRNA expression in the ACE2 overexpression group had no notable change (P > 0.05), but the expression of gp130 mRNA, IL-6 level and expression of mRNA were elevated (P < 0.05) and the protein phosphorylation level of JAK2 and STAT3 decreased significantly (P < 0.05). In the ACE2-depleted group, there was no notable change in IBV-N (P > 0.05), but the IL-6 level and expression of mRNA increased significantly (P < 0.05) and the phosphorylation level of JAK2 and STAT3 protein decreased slightly (P > 0.05). The results demonstrated for the first time that ACE2 did not affect the replication of IBV in DF-1 cell, but it did contribute to the prevention of the activation of the IL-6/JAK2/STAT3 signaling pathway, resulting in an alleviation of IBV-induced cellular inflammation in Vero and DF-1 cells.
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Animales , Humanos , Chlorocebus aethiops , Interleucina-6/genética , Janus Quinasa 2/farmacología , Virus de la Bronquitis Infecciosa/metabolismo , Factor de Transcripción STAT3/metabolismo , Enzima Convertidora de Angiotensina 2/farmacología , Receptor gp130 de Citocinas/metabolismo , Células Vero , Transducción de Señal , Inflamación , ARN MensajeroRESUMEN
OBJECTIVE@#To reveal the underlying relationships between Chinese medicine (CM) syndromes and ultrafiltration (UF) in the treatment of heart failure based on a metabonomic approach.@*METHODS@#Seventeen acute decompensated heart failure (ADHF) patients were enrolled, and their CM syndromes before and after UF were collected. In addition, their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis. Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples. Partial least-squares to latent structure-discriminant analyses were used for data analysis.@*RESULTS@#An obvious difference was observed pre- and post-treatment. A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine, 1-methylhistidine, phytosphingosine, O-decanoyl-R-carnitine, etc. were screened out, showing a significant change after UF. The major adjusted metabolic pathways were purine metabolism, histidine metabolism, leucine and isoleucine metabolism, arginine and proline metabolism, carnitine shuttle, sphingolipid metabolism and phospholipid metabolism.@*CONCLUSIONS@#Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.
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This study evaluated the safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine of Wenxin Granules in the treatment of arrhythmia(ventricular premature beat and atrial premature beat) with deficiency of Qi and Yin. The multi-criteria decision analysis(MCDA) model was adopted, and the criterion layer and index layer were weighted by experts. CSC v2.0 was used for clinical comprehensive evaluation. This study embodies the clinical value of Wenxin Granules, promotes its safe, effective and rational use, and provides a basis for national medical decision-making. The multi-source evidence shows that the major adverse reaction of Wenxin Granules is gastrointestinal damage. According to the available studies, Wenxin Granules has controllable risk and thus is rated as grade B in terms of safety. The systematic evaluation of effectiveness shows that compared with antiarrhythmic western medicine, Wenxin Granules demonstrates improved clinical efficacy and electrocardiogram efficacy, which is supported by high-quality evidence, and thus the effectiveness of Wenxin Granules is evaluated as grade A. Economic research shows that Wenxin Granules is more economical than antiarrhythmic western medicine, which is supported by sufficient evidence and clear results, and thus the economy of this preparation is rated as grade B. The indications and contraindications of Wenxin Granules are clear and detailed to different types of arrhythmia, which, together with the precise positioning and prominent clinical innovation and industrial innovation, rates it as grade A in terms of innovation. The suitability of drug storage, prescription circulation, dosage form and course of treatment basically meet the clinical medication needs of doctors and patients, and thus the suitability of Wenxin Granules is evaluated as grade B. Because of the few restrictions and the sustainable resources of medicinal materials, the accessibility of Wenxin Granules is evaluated as grade A. The prescription compatibility focuses on the pathogenesis characteristics of deficiency of Qi and Yin, and there are more than 3 000 cases studied. Therefore, the characteristics of traditional Chinese medicine of Wenxin Granules are evaluated as grade B. Based on the evidence from all the above dimensions, Wenxin Granules has the clinical comprehensive value of class A and prominent characteristics of traditional Chinese medicine. It is suggested to include Wenxin Granules into the policy results related to basic clinical medication management according to the procedure.
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Humanos , Antiarrítmicos , Medicina Tradicional China , Qi , Resultado del Tratamiento , Complejos Prematuros Ventriculares , Deficiencia YinRESUMEN
The impact of sexual dysfunction (SD) is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 (mean ± s.d.: 44.16 ± 10.14) years and diagnosed with pituitary adenomas, were retrospectively analyzed. One hundred and fifty-nine patients (62.6%) complained of SD prior to surgery. The mean International Index of Erectile Function (IIEF-5) in patients with giant adenomas was 16.13 ± 2.51, much smaller than those with microadenomas or macroadenomas (P < 0.05). All the patients showed significant improvement in terms of erectile dysfunction (ED) following surgery (P < 0.05). In addition, complete resection achieved a higher degree of SD relief than partial resection. The incidence of SD in functioning pituitary adenomas (FPAs) was much higher than that in nonfunctioning pituitary adenomas (NFPAs) (P < 0.05). In addition, compared with NFPAs, males with prolactinomas (82.8%) had the higher prevalence of SD and significantly improvement following surgical intervention (P < 0.05). An inverse relationship was identified between decreasing testosterone levels and increasing incidence of SD before surgery (P < 0.05). There was no significant difference between 6 months and 12 months after surgery in serum testosterone level (P > 0.05). Our results indicated that surgical therapy could be optimized for improvements in SD and that testosterone levels can be used as a sensitive indicator to predict the recovery rate of sexual function in patients with pituitary adenomas following surgery and the serum testosterone level will stay stable in 6 months after surgery.
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Adolescente , Adulto , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Adenoma/cirugía , Estudios de Cohortes , Disfunción Eréctil/etiología , Imagen por Resonancia Magnética , Análisis Multivariante , Neoplasias Hipofisarias/cirugía , Valor Predictivo de las Pruebas , Pronóstico , Prolactinoma/cirugía , Estudios Retrospectivos , Factores de Riesgo , Disfunciones Sexuales Fisiológicas/etiología , Testosterona/sangre , Resultado del TratamientoRESUMEN
Simulations can mimic the environment that refers to the surgery operation to improve the technical skills of the trainees. In this paper, we designed a new cardiac surgery simulative training system. The isolated pig heart was selected as the heart model. A mechanical device was designed to achieve the beating of heart model. At the same time, adjusting frequencies of mechanical movement could change the rating of heartbeat. In order to validate the rationality of the system, 12 non-medical specialty students and 12 medical specialty students were divided into two groups, which consecutively accepted seven-days of training for off-pump coronary artery bypass grafting using the cardiac surgery simulative training system. The time for completing bypass grafting before and after training were recorded. And the bridging outcomes of each trainee were assessed by 3 surgery cardiac surgeons using the object structured assessments of technical skill (OSATS) criteria. After training, each trainee could finish the bypass suturing in a shorter time than before training, and the scores of each trainee assessed by OSATS criteria were also improved. The results showed that the cardiac surgery simulative training system had better training effect in improving the surgical techniques, operation skills and proficiency of surgical instruments of trainees.
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Background@#Decision-making concerning the treatment of choroid plexus tumor (CPT) in pediatric patients remains a topic of considerable debate. The aim of this work was to describe clinical features and prognostic risk factors of CPT in the pediatric population and to provide theoretical opinions regarding clinical decisions for CPT.@*Methods@#The data of 96 patients with CPT and younger than 14 years were retrospectively analyzed. Clinical characteristics such as pathological type of CPTs, rate and severity of hydrocephalus, treatment and outcome, and recurrence were investigated. For categorical variables, the Pearson's Chi-square test was performed. The Mann-Whitney U-test was used for comparisons between nonnormally distributed parameters. Log-rank test was used for progression-free survival (PFS).@*Results@#The study included 70 choroid plexus papilloma (CPP) cases, 17 atypical choroid plexus papilloma (aCPP) cases, and 9 choroid plexus carcinoma (CPC) cases. Compared with patients with CPP or aCPP, patients with CPC had a shorter disease course (median: CPP, 4 months; aCPP, 2 months; CPC, 1 month; H: 23.5, P 0.05). Patients with CPC experienced shorter time for recurrence than those with CPP or aCPP (χ = 40.1, P < 0.0001).@*Conclusions@#Our results indicated that CPP in the fourth ventricle could trigger serious clinical symptoms at an early stage, requiring early intervention. Adjuvant treatment might be necessary for patients with partially resected CPP, aCPP, and CPC to achieve a favorable outcome.
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Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Neoplasias del Plexo Coroideo , Mortalidad , Patología , Cirugía General , Hidrocefalia , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Pronóstico , Factores de RiesgoRESUMEN
Objective To study the performance of knee arthroscopy in patients with acute posteromedial corner injury and to explore the use of arthroscopy to help diagnosis. Methods From April to August 2017, the arthroscopic posteromedial corner after operation of 7 cases of acute knee joint injury patients data were retrospectively studied, treatment are in the same group. They were two man and three women, 37 ~ 59 years of old (average 49.6 years). All patients were selected for preoperative MRI to indicate medial collateral ligament damage. The VAS score was evaluated preoperative. When check-up knee flexion and 30° valgus stress test positive and 0° valgus stress test positive. Intraoperative arthroscopy was performed to confirm the injury of the Posteromedial corner. The medial meniscus was formed or stitched. The medial collateral ligament and Posteromedial corner were repaired. The knee X-ray examination were measured preoperative and in 2 months after surgery, Evaluation of the knee VAS score in 2 months after surgery. Results All patients were followed up for 2 months. The medial meniscus were easily observed and raise easily 5 cases undergoing arthroscopic surgery. All 7 patiens were showed the injury of the joint capsule ligament complex. All of the 7 cases showed the injury of the joint capsule ligament complex. Preoperative and postoperative knee medial clearance for 2 months in knee valgus stress buckling 30° [(9.2 ± 1.3) vs (3.0 ± 1.0) mm]. Preoperative and postoperative knee medial clearance for 2 months in knee valgus stress 0° [(8.8 ± 1.1) vs (2.9 ± 1.0) mm]. There were statistically significant differences (P < 0.05). After 2 months in knee valgus stress buckling is compared with the normal control group 30° [(3.0 ± 1.0) vs (2.9 ± 1.2) mm]. After 2 months in 0° knee valgus stress compared with normal control group [(2.9 ± 1.0) vs (2.8 ± 1.2) mm]. There was no statistical difference (P > 0.05). Preoperative and postoperative knee joint pain VAS score [(5.4 ± 0.3) vs (2.3 ± 1.1)]. There were statistically significant differences (P < 0.05). Conclusion Under arthroscopy detection in patients with acute Posteromedial corner injury. If it is easy to observe posterior horn of medial meniscus and the medial meniscus angle is easy to raise; The medial meniscus posterior horn joint capsule and ligament damage. They were indicated acute Posteromedial corner injury. Timely deal with medial meniscus and repair Posteromedial corner, the stability of the knee joint can be satisfactory.
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The research progress of puerarin and its derivatives in anti-inflammatory and anti-gout activities was reviewed in this paper. Puerarin possesses anti-inflammatory activity by affecting immunocyte, inflammation cytokines and signaling pathway. Puerarin also has anti-gout activity through inhibition of xanthine oxidase, promoting the excretion of uric acid to reduce serum uric acid level. Although its ability in reducing uric acid level was lower than that of allopurinol in clinical application, puerarin can also enhance the total antioxidant and free radical scavenging with stronger anti-inflammatory effect, so it will be a promising research direction to find new drugs with better anti-gout activity and less side effects by modifying the chemical structure of puerarin.
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Objective:To investigate the early clinical treatment and prognosis of multi-segment intramedullary cervical ependymoma.Methods:Twenty patients with multi-segment (more than 3 segments) intramedullary spinal ependymoma (McCormic grade Ⅰ) were microsurgically treated with assistance of intraoperative neuroelectrophysiological monitoring.None of them received postoperative radiotherapy.Preoperatively all the patients underwent MRI examination and their neurologically function was assessed by McCormic classification method.They were followed up for an average of 2.7 years (The follow-up ranged from 3 months to 4 years).All the patients underwent review of the MRI examination and their postoperative neurological function was assessed by McCormic classification method again.Evaluation was accomplished according to the results of the follow-up.Results:All tumors were intramedullary.The length of the tumor body varied from 3 to 8 vertebral segments with an average of 4.2 vertebral segments.Gross total removal was achieved in all the 20 patients through one-stage operation.The pathology of these patients was ependymoma (WHO grades Ⅰ to Ⅱ).Two cases were lost during the follow-up due to the change of contact,but the hospital records of them showed that they recovered well at discharge.Eighteen cases were followed up constantly after operation.A case which ran through the whole cervical spinal cord had short-term mild motor dysfunction after operation,which manifested as weakness of the left side muscle strength to grade Ⅳ (which recovered to grade Ⅴ during the follow-up period).Results of the follow-up showed that these 18 patients recovered well.Preoperative symptoms,such as limb numbness and painness were significantly alleviated.There was no obvious motor dysfunction.The bowel and bladder function of these 18 patients were almost normal.The McCormic scores of these 18 patients remained in grade Ⅰ.No recurrence was found on review of the MRI examination.The main complications were a certain degree of deep sensory disturbance of lower extremities.The operation did not significantly affect the patient's life and work.Conclusion:Aggressive surgical therapy is a good treatment strategy for early multi-segment intramedullary cervical ependymoma.There is nearly no recurrence after operation and no postoperative radiotherapy is needed after gross total removal of tumors.
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<p><b>BACKGROUND</b>Large and giant medial sphenoid wing meningiomas that are located deeply in the skull base where they are closely bounded by cavernous sinus, optic nerve, and internal carotid artery make the gross resection hard to achieve. Also, this kind of meningiomas is often accompanied by a series of severe complications. Therefore, it was regarded as a formidable challenge to even the most experienced neurosurgeons. This study aimed to investigate the clinical features and management experience of patients with large and giant medial sphenoid wing meningiomas.</p><p><b>METHODS</b>In this study, 53 patients (33 female and 20 male, mean age of 47.5 years) with large and giant medial sphenoid wing meningiomas were treated surgically between April 2004 to March 2012, with their clinical features analyzed, management experience collected, and treatment results investigated retrospectively.</p><p><b>RESULTS</b>In this study, gross total resection (Simpson I and II) was applied in 44 patients (83%). Fifty-three patients had accepted the routine computed tomography scan and magnetic resonance imaging scan as postoperative neuroradiological evaluation. Their performance showed surgical complications of vascular lesions and helped us evaluate patients' conditions, respectively. Meanwhile, the drugs resisting cerebral angiospasm, such as Nimodipine, were infused in every postoperative patient through vein as routine. As a result, 11 patients (21%) were found to have secondary injury of cranial nerves II, III, and IV, and nine patients got recovered during the long-term observing follow-up period. Temporary surgical complications of vascular lesions occurred after surgery, such as cerebral angiospasm, ischemia, and edema; 24 patients (45%) appeared to have infarction and dyskinesia of limbs. Overall, visual ability was improved in 41 patients (77%). No patient died during the process.</p><p><b>CONCLUSIONS</b>Microsurgical treatment may be the most effective method for the large and giant medial sphenoid wing meningiomas. The surgical strategy should focus on survival and postoperative living quality.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Meníngeas , Cirugía General , Meningioma , Cirugía GeneralRESUMEN
<p><b>OBJECTIVE</b>To assess the acceptability and influence factors of early antiretroviral therapy (ART) among HIV-positive men who have sex with men (MSM) .</p><p><b>METHODS</b>From June to August 2012, through convenience sampling, HIV-positive MSM who were willing to cooperate with the survey were selected from the Hangzhou and Ningbo AIDS prevention and control database. A total of 280 HIV-positive MSM who did not receive ART participated in the study.Using self-designed questionnaire, general demographic information, awareness of AIDS knowledge, sexual behavior, use of condom, current physical condition, awareness and attitude towards early ART were investigated.Excluding 60 HIV-infected MSM whose CD4(+)T count didn't meet the inclusion criteria, a total of 220 subjects were included in the analysis. Chi-square was used to compare the difference of early ART acceptance among subjects with different characteristics.Non-conditional logistic regression was used to analyze the influence factors of the acceptability of early ART.</p><p><b>RESULTS</b>The acceptance rate of early ART among HIV-infected MSM was 62.7% (138/220). Delaying the disease development, preventing partners from infection, not worrying others to suspect them of having HIV, and partners unknowing the HIV-infected status were the factors which had a relatively higher acceptance rate of early ART. Correspondingly, the acceptance rate was 68.8% (130/189), 68.7% (103/150), 78.4% (69/88) and 72.5% (74/102) respectively and the acceptance rate among subjects with opposite opinions or characteristics was 24.1% (7/29) , 50.0% (30/60), 52.7% (68/129) and 45.8% (58/107) respectively (chi-square values were 21.46, 6.43, 14.84 7.55, all P values <0.05).Logistic regression analysis showed that delaying the disease development (OR = 11.50, 95%CI:3.29-40.22) and preventing partners from infection (OR = 3.72, 95%CI:1.53-9.03) were inclined to the acceptance of early ATR.While concerning others' suspection of them having HIV (OR = 0.19, 95%CI:0.08-0.48) and partners knowing the HIV-infected status were inclined to unacceptance of ART(OR = 0.31, 95%CI:0.13-0.70).</p><p><b>CONCLUSION</b>The acceptability of early ART among HIV-positive MSM is high. The recognition of early ART and concern of privacy leak are the major influence factors which can stimulate the acceptance of early ART.</p>
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Adolescente , Adulto , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Terapia Antirretroviral Altamente Activa , Infecciones por VIH , Quimioterapia , Psicología , Homosexualidad Masculina , Psicología , Modelos Logísticos , Aceptación de la Atención de SaludRESUMEN
This project was designed to investigate the role of angiotensin converting enzyme 2 (ACE2) in the diabetic renal injury by observing the expression of ACE2 in the kidney and the level of angiotensin II (AngII) in the circulatory system and kidney tissue of rats with diabetes. SD rats were randomly divided into control group and diabetes group. Diabetic nephropathy model was established by i.p. injection of streptozotocin (STZ). The rats were sacrificed separately on the 15th or 30th day after STZ injection. Biochemical parameters including blood glucose and renal function were examined. The expression of ACE2 in the kidney was detected by real-time PCR and Western blot. The contents of AngII in plasma and kidney were detected by radioimmunoassay. The results are as follows: (1) 48-72 h after STZ injection, the rats showed polyuria, polydipsia and their activity reduced. (2) Blood glucose levels were 4.9-6.5 mmol/L in the control rats, 14.0-17.5 mmol/L in the diabetes group rats on the 15th day, and higher than 24 mmol/L in the diabetes group rats on the 30th day; (3) There was a significant increase of urine glucose level (P < 0.05), and a slight but not significant increase of urine protein level (P > 0.05) in the diabetes group on the 15th day; On the 30th day, the levels of urine glucose and urine protein were significantly higher than those in the control group (P < 0.01); (4) Compared with the control group, the expression of ACE2 mRNA was slightly increased (P > 0.05), and the expression of ACE2 protein was significantly increased (P < 0.05) in the rats of diabetic model group on the 15th day; however, on the 30th day, ACE2 mRNA expression in the rats of diabetic model group was significantly lower than the control group (P < 0.05), and the expression of ACE2 protein was slightly lower than the control group (P = 0.0718). (5) Compared with the control group, the levels of AngII in plasma and kidney of the diabetic rats increased slightly on the 15th day (P > 0.05); while the AngII levels in diabetic model group rats were significantly higher (P < 0.05) than that in control rats on the 30th day. These results suggest that ACE2 plays a positive role in the protection against the pathogenesis of early renal damage. ACE2 expression is reduced gradually with the deepened degree of diabetic kidney damage, leading to the accumulation of AngII in the kidney, thereby increasing the renal injury.
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Animales , Ratas , Angiotensina II , Sangre , Metabolismo , Glucemia , Diabetes Mellitus Experimental , Nefropatías Diabéticas , Riñón , Peptidil-Dipeptidasa A , Metabolismo , Ratas Sprague-DawleyRESUMEN
Objective To analyze the clinical and imaging features of a family(3 patients)with familial hemangioblastoma,and their diagnosis and prognosis.Methods The detailed data about clinical and imaging features of all patients diagnosed as familial hemangioblastoma,admitted to our hospital from October 2004 to May 2010,were analyzed,and the lesions of other regions,besides the tumor lesion,were observed.Results No lesions of other regions were noted in these 3 patients.Cranial MRI showed that 2 had cystic and solid tumor and 1 had solid tumor;,total removal was performed on these patients under microscope; regular follow-up was given and no recurrence was noted.Conclusion Familiar hemangioblastoma is serious hereditary disease; and MRI is the most important detective method; microsurgical operation is the most important therapy.Early diagnosis and treatment should be given to the patients with familiar hemangioblastoma due to its high recunence rate,having difficulty in operation and its trend to combining with other lesions of the other parts.
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<p><b>BACKGROUND</b>The subtemporal transtentoral approach has been reported for nearly two decades; however it was not well used due to some limitations in dealing with large and giant petroclival meningiomas. The clinical outcome and merit of the modified subtemporal transpetrosal apex approach in large and giant petroclival meningiomas, as well as the choices, the improvements and the therapy strategies of the microsurgical approach in such patients were evaluated in this study.</p><p><b>METHODS</b>Totally 25 cases of large and giant petroclival meningiomas undergone the modified subtemporal transpetrosal apex approach between April 2004 and January 2010 were enrolled in this study. The choice and improvement of the approach, the basis of anatomy and related research, the effect of accessory equipment, the exposure of tumor and the changes of neurofunction pre- and post-operation were all reviewed retrospectively. The operation outcomes and complications in this approach were also compared with those in the transpetrous presigmoid approach done in 14 cases in the same period.</p><p><b>RESULTS</b>All 25 cases underwent the modified subtemporal transpetrosal apex approach under electrophysiologic monitoring of cranial nerves and brain stem function. Trochlear nerve was partly wrapped in 14 cases, totally wrapped but can be explored in the initial segment of the cerebellum tentorium in 8 cases, totally wrapped and could not be seen until tumor was partly removed in 3 cases. The cerebellum tentorium was cut along the temporal bone from the anterior part of the apex to the mastoid part of superior petrous sinus in 6 cases, from the posterior part of the apex to the mastoid part of superior petrous sinus in 19 cases. Gross tumor resection was accomplished in 17 (68%) patients, subtotal resection in 7 (28%) patients, and partial resection in 1 (4%) patient. The most common postoperative complication was new neurological deficits or aggravations of preexisting deficit (64%). Follow-up ranged from 3 to 69 months. Compared with the transpetrous presigmoid approach done in 14 cases in the same period, the modified subtemporal transpetrosal apex approach showed obvious advantages such as simplicity in manipulating, microinvasiveness, less time-consuming, less complication, higher rate of tumor resection though the rates of gross tumor resection might be of no significant difference.</p><p><b>CONCLUSIONS</b>Modified subtemporal transpetrosal apex approach has obvious advantages compared with the transpetrous presigmoid approach. Some complications need to be solved by practice and modification of the approach as well as the accumulation of the experiences.</p>
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Meningioma , Patología , Cirugía General , Procedimientos Neuroquirúrgicos , MétodosRESUMEN
Objective To carry out quantitative investigation on application of emulational trunk dummy (ETD) in evaluating the opening shock of life saving parachute and provide a more reliable test method for further development. Method ETD equipped with parachute was tested in the impact experiment, where a 63.4 kg impact block was dropped from the height of 0.20 m,0.40 m,0.60 m,0.80 m respectively to simulate different opening shocks. The opening shocks were deducted by measured forces on harness and acceleration loads at the center of dummy's thorax. For comparison, 5 rigid trunk dummies (RTD) were tested under the equivalent impacts. As the contrast test, 24 male healthy subjects were also exposed under such impacts with standing and sitting posture respectively. Results Under the same impact, the peak impact value on harness exhibited maximum on RTD, minimum on subjects with sitting posture, and medium on ETD. There were significant differences between each experimental group (P<0.01). With different impact loads, the peak impact value on ETD was 2 795,3 873,4 816 and 5 736 N respectively, which was correspondingly close to that of subjects with standing posture(2 541,3 042,3 720 and 4250 N). Conclusions The result of opening shock gathered from ETD is closer to that from RTD due to ETD’s viscoelasticity, which shall certainly influence the measured opening shock. Therefore, ETD is suggested to be used in the development of live saving parachute.
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<p><b>OBJECTIVE</b>To investigate the effect and mechanism of Qingxuan Tiaoya Recipe (QXTYR) on depressing blood pressure in menopausal women with hypertension.</p><p><b>METHODS</b>Patients were randomly assigned to two groups, the 44 patients in the test group were administered with perindopril tablet and QXTYR granule, while the 43 in the control group were administered with the same program, but a simulator of QXTYR was used to replace for the real one. The treatment course for them all was 2 months. Before and after treatment, the ambulatory blood pressure (ABMP), heart rate, related clinical symptoms, blood lipids, serum estradiol (E2), high-sensitivity C-reactive protein ( Hs-CRP), homocysteine (HCY) and angiotensin II (Ang II) were measured.</p><p><b>RESULTS</b>The treatment in the test group showed an effect better than that in the control group in terms of reducing blood pressure variability and night-time blood pressure decrease rate (P <0.05), with the total effective rate and markedly effective rate in lowering blood pressure superior to the control group (P<0.05), alleviating symptoms as headache, soreness and weakness of the waist and knees, and insomnia (P <0.05), and decreasing levels of heart rate, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), Hs-CRP and Ang II (P <0.05), The plasma level of endogenous E2 was elevated after treatment in the test group (P< 0.05), but showed no statistical difference in the control group.</p><p><b>CONCLUSIONS</b>QXTYR shows favorable effect in depressing blood pressure of menopausal women with hypertension, it can reduce blood pressure variability, improve the symptoms of the menopause syndrome, blood lipid metabolism and plasma levels of Hs-CRP, E2, and Ang II in patients, suggesting that its mechanism may be related to the functional regulation of sympathetic-vagus nerve and neuro-endocrine-immune system, and also the inhibition on the circulatory renin-angiotensin-aldosterone system activity.</p>
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Adulto , Femenino , Humanos , Persona de Mediana Edad , Medicamentos Herbarios Chinos , Usos Terapéuticos , Hipertensión , Quimioterapia , Menopausia , Fitoterapia , Resultado del TratamientoRESUMEN
Double antibody sandwich-type ELISA was used to detect rhG-CSF in serum to study the pharmacokinetics of rhG-CSF, PEG-rhG-CSF and rHSA-hG-CSF in mice and to confirm that PEGlyation and albumin fusion of rhG-CSF technology can prolong half-life of G-CSF. Pharmacokinetic parameters were calculated with 3P87 software. T1/2 s of rhG-CSF, PEG-rhG-CSF and rHSA-hG-CSF are 2. 1 , 14.2 and 10. 6 h, respectively. T1/2 s of PEG- rhG-CSF and rHSA-hG-CSF are 7, 5 times than T1/2 s of rhG-CSF, respectively. Tpeak s of PEG-rhG-CSF and rHSA-hG-CSF are 15, 13 times than Tpeak of rhG-CSF, respectively. The result of ELISA indicates that PEGlyation and albumin fusion of rhG-CSF technology can prolong half-life of G-CSF.