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Objective To investigate the infection of Chlamydia pneumoniae and mycoplasma pneumoniae in adults and their association with atherosclerosis,and to provide theoretical guidance for the prevention of such diseases. Methods A case-control study was used to collect 362 patients who were diagnosed with atherosclerosis from January 2019 to December 2021 in Department of Sichuan Bazhong Central Hospital, and 370 cases who were admitted to the hospital during the same period of physical examination without any cardiovascular disease were selected as the control group, and whole blood samples of the two groups of study subjects were collected, and the infection of Chlamydia pneumoniae and mycoplasma pneumoniae was detected by PCR. Results The infection rate of Chlamydia pneumoniae was 35.49%, the infection rate of mycoplasma was 40.37%, and the co-infection rate was 11.37%；The infection rate of Chlamydia pneumoniae in the control group was 12.04%, the infection rate of mycoplasma was 15.83%, and the coinfection rate was 3.14%, and the difference between the two groups was statistically significant ( χ2=10.926, P=0.023). The effects of mycoplasma, chlamydia, and co-infection on atherosclerotic patients have sex differences, mainly manifested as higher infection rates in men; In addition, the effects of mycoplasma, chlamydia, and co-infection on atherosclerosis patients varied by age, mainly in the 55-70 years age group (P<0.05). Multivariate logistic regression results showed that Chlamydia pneumoniae infection was a risk factor for atherosclerosis (OR=1.303, 95%CI: 1.043-1.677) in the whole population, and chlamydia pneumoniae (OR=1.472, 95% CI: 1.037-1.556), mycoplasma (OR=2.003, 95%CI: 1.637-3.842) and co-infection in men (OR=1.937, 95%CI: 1.380-2.184) were risk factors for atherosclerosis, while co-infection in women (OR=1.699, 95%CI: 1.263-1.765) was a risk factor for atherosclerosis. Conclusion Chlamydia pneumoniae and mycoplasma infection are risk factors for atherosclerosis, and their impact on male groups is greater, and more attention needs to be paid to them.
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Aim To discover the potential active compounds and possible mechanisms in rheumatoid arthritis (RA) treatment with Zhi-Huang-Zhi-Tong powder (ZHZTP) by using network pharmacology and in vitro study. Methods The active ingredient targets and disease targets of Zhihuang Zhitong Powder were searched and screened by database; they intersected to get a common target; and the "drug-component-target" relationship network diagram was constructed for GO and KEGG enrichment analysis of the overlapping genes; then the core components were docked with the core targets. Finally, based on the inflammation model of HUVECs in vitro, the efficacy and mechanism of Zhihuang Zhitong powder were verified by MTT method, plate scratch test and Western blot. Results Active compounds involved in RA treatment were screened in the present study, and the top two were ursolic acid and emodin, all playing crucial roles in RA treatment with ZHZTP. Additionally, the key target was AKTA, TNF and IL-6. GO and KEGG enrichment analysis revealed that ZHZTP regulated BP, MF and CC, and also focused on regulating AKTA, TNF and IL-6 signaling pathway. Molecular docking showed that interactions between key active compounds and key targets were stable. In vitro ZHZTP significantly inhibited cell viability and migration of TNF-a-stimulated HUVECs, and the involved mechanism may be associated with PI3K/AKT/m-TOR signaling. Conclusions The present study reveals that the potential active compounds of ZHZTP are ursolic acid and emodin, and moreover, the involved mechanisms of ZHZTP for RA treatment are associated with PI3 K/AKT/m-TOR signaling.
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Heart failure is the final stage of heart disease caused by a variety of etiologies and has a high morbidity， mortality， and disability rate， making it a major challenge in the field of medicine. Cardiomyocytes， the most basic unit of the heart， are irreversible in nature and can be damaged or necrotic in various ways in the presence of heart failure. Myocardial cell injury is also an important cause of cardiac dysfunction and affects the prognosis and quality of life of patients. Therefore， reducing the level of myocardial cell damage and delaying the process of cell death can help patients with heart failure lessen the extent of cardiac damage and improve their prognosis， thereby lowering the incidence of death and disability and times of hospitalization. Ferroptosis is a new form of cell death that has been widely concerned in recent years， with studies confirming its occurrence in cardiac myocytes. As a modifiable form of cell death， interfering with ferroptosis can modulate the extent of injury and death in cardiac myocytes. Studies have shown that the inhibition of iron death has a protective effect on cardiomyocytes， thereby alleviating heart failure. Chinese medicine has been widely used in the clinical treatment of heart failure， and has the advantages of multiple approaches and entry points， with significant therapeutic effects， low side effects， and low medical costs. It also reduces the clinical side effects of western medicine， with good clinical results. The use of Chinese medicine to modulate ferroptosis may be a new direction for the future treatment of heart failure. This paper briefly elaborated on the mechanism of ferroptosis， investigated the role of ferroptosis in heart failure， and discussed the current status of research on ferroptosis in Chinese medicine interventions in heart failure， to provide references for further improving the efficacy of Chinese medicine in the treatment of heart failure.
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Glaucoma is a chronic optic neuropathy that affects the retinal ganglion cells, characterized by optic disc atrophy, visual field defects, and visual acuity loss. Since glaucoma is a chronic disease, long-term use of topical intraocular pressure-lowering medications often leads to ocular surface diseases, thus reducing medication adherence and ultimately affecting treatment efficacy. Currently, topical intraocular pressure-lowering medications include prostaglandin derivatives, β-adrenergic blockers, α-adrenergic agonists, topical carbonic anhydrase inhibitors, and cholinergic drugs. This article provides a comprehensive review of the effects and related mechanisms of these five antiglaucoma medications on the ocular surface of glaucoma patients and offers preventative measures for the protection of ocular surface in glaucoma patients.
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A case of IgG4-related hypertrophic pachymeningitis was reported. The patient was an elderly female, with the course of disease more than 8 years. Clinical manifestations included recurrent headache, vision and hearing loss, exophthalmos and thyroid dysfunction. Finally, she was diagnosed as IgG4-related disease and IgG4-related hypertrophic pachymeningitis by PET-CT and dural biopsy. After treatment with methylprednisolone and mycophenolate mofetil, the patient′s clinical symptoms improved.
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Objective:To explore the effects of frailty syndrome on activities of daily living and its associated risk for adverse outcomes among elderly residents in China.Methods:Using open data from "China Health and Retirement Longitudinal Survey", the 2011 baseline survey was conducted on general information, health risk factors, chronic disease, data obtained from various ability assessments and Fried frailty criteria assessments for community elderly aged 60 years and over.The follow-up data were used to analyze the adverse outcomes of frailty syndrome using a covariation-adjusted Logistic regression model.Results:Among the 5 630 people in the baseline population, 34.9%(1 963/5 630 cases)were non-frailty, 57.4%(3 236 cases)were pre-frailty, and 7.7%(431 cases)were frailty.The frailty group had higher rates of falls, hip fractures, hospitalizations, and death than the pre-frail and non-frail groups at the 3rd, 5th, and 8th years of follow-up.At follow up to 2015, the covariate-adjusted analysis of the study population showed that as compared with the non-frail group, the frail group had increased risks of falling( OR=1.738, 95% CI: 1.292-2.338, P<0.001), increased risks of hip fracture( OR=2.672, 95% CI: 1.365-5.233, P=0.004), increased risks of hospitalization( OR=1.670, 95% CI: 1.224-2.277, P=0.001), increased risk of death( OR=1.599, 95% CI: 1.256-2.035, P<0.001), increased risks of declined upper limb activity( OR=2.769, 95% CI: 2.101-3.650, P<0.001), of declined instrumental activity of daily living( OR=2.567, 95% CI: 1.941-3.395, P<0.001), and of declined basic activities of daily living( OR=2.790, 95% CI: 2.110-3.689, P<0.001). Conclusions:Frailty syndrome increases the risk of decreased ability to live, falls, hip fractures, hospitalization and death in older adults.Frailty screening is an effective tool for predicting the risk of adverse outcomes in elderly community populations.
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Objective:To establish and validate a prognosis prediction model of gall bladder cancer after surgery based on the albumin-bilirubin (ALBI) grade.Methods:The clinicopathological data of 161 patients with gallbladder cancer undergoing radical surgery in the First Hospital of Jiaxing between March 2011 to January 2020 were retrospectively analyzed, including 44 males and 117 females, aged (65±9) years old. The patients were grouped by the levels of ALBI score. The survival data were obtained through telephone or outpatient review. The Kaplan-Meier method was used to draw the survival curve. Multivariate analysis was performed using the Cox regression analysis model. The time-dependent receiver operating characteristic (ROC) curve was plotted to compare the prognostic value of the scoring system. A nomogram based on ALBI grade was established and its predictive performance was evaluated.Results:The 1, 3, 5 years overall survival (OS) rates of patients with gallbladder cancer were 76.7%, 52.5%, and 41.9%, respectively. The time-dependent ROC curves revealed that the area under the curve (AUC) values of ALBI grade were 0.659, 0.597 and 0.599 for 1, 2 and 3 years, showing a good prognostic performance. Multivariate regression analysis showed that poorer tumor differentiation ( HR=2.890, 95% CI: 1.816-4.600, P<0.001), TNM Ⅲ/Ⅳ stage ( HR=2.832, 95% CI: 1.781-4.503, P<0.001), ALBI grade 2 ( HR=1.595, 95% CI: 1.017-2.500, P=0.042), and ALBI grade 3 ( HR=3.938, 95% CI: 1.375-11.278, P=0.011) were independent risk factors for OS. The nomogram established with the independent risk factors such as ALBI grade showed a good predictive value for OS. The ROC curve results showed that the AUC values for 1, 3 and 5 years were 0.796, 0.806 and 0.799, respectively. The calibration plots and clinical decision curve analysis (DCA) showed the clinical feasibility of this nomogram. Conclusion:The nomogram model based on ALBI grading has a good predictive value for gallbladder cancer after surgery, which could guide the prognosis and individualized treatment decision-making.
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Objective:To explore the accuracy of artificial intelligence (AI) system based on deep learning in evaluating bone age of children with abnormal growth and development.Methods:The positive X-ray films of the left wrist of children with abnormal growth and development who were treated at the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2021 were collected retrospectively. A total of 717 children were collected, including 266 males and 451 females, aged 2-18 (11±3) years. Based on Tanner Whitehouse 3 (TW 3)-RUS (radius, ulna, short bone) and TW3-Carpal (carpal bone) method, bone age was measured by 3 senior radiologists, and the mean value was taken as reference standard. The bone ages were independently evaluated by the AI system (Dr.Wise bone age prediction software) and two junior radiologists (physicians 1 and 2). The accuracy within 0.5 year, the accuracy within 1 year, the mean absolute error (MAE) and the root mean square error (RMSE) between the evaluation results and the reference standard were analyzed. Paired sample t-test was used to compare MAE between AI system and junior physicians. Intraclass correlation coefficient (ICC) was used to evaluate the consistency between AI system, junior physician and reference standard. The Bland-Altman diagram was drawn and the 95% consistency limit was calculated between AI system and reference standard. Results:For TW3-RUS bone age, compared with the reference standard, the accuracy within 0.5 year of AI system, physician 1 and physician 2 was 75.3% (540/717), 62.1% (445/717) and 66.2% (475/717), respectively. The accuracy within 1 year was 96.9% (695/717), 86.3% (619/717) and 89.1% (639/717), respectively. MAE was 0.360, 0.565 and 0.496 years, and RMSE was 0.469, 0.634 and 0.572 years, respectively. For TW3-Carpal bone age, compared with the reference standard, the accuracy within 0.5 year of AI system, physician 1 and physician 2 was 80.9% (580/717), 65.1% (467/717) and 71.7% (514/717), respectively. The accuracy within 1 year was 96.0% (688/717), 87.3% (626/717) and 90.4% (648/717), respectively. MAE was 0.330, 0.527 and 0.455 years, and RMSE was 0.458, 0.612, 0.538 years, respectively. Based on TW3-RUS and TW3-Carpal bone age, the MAE of AI system were lower than those of physician 1 and physician 2, and the differences were statistically significant ( P all<0.001). The evaluation results of AI, physician 1 and physician 2 were in good agreement with the reference standard (ICC all>0.950). The Bland-Altman analysis showed that the 95% agreement limits of AI system for assessing TW3-RUS and TW3-Carpal bone age were -0.75-1.02 years and-0.86-0.91 years, respectively. Conclusion:The accuracy of AI system in evaluating the bone age of children with abnormal growth and development is close to that of senior doctors, better than that of junior doctors, and in good agreement with senior doctors.
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Diabetic ketoacidosis (DKA), a serious acute complication of diabetes mellitus, mainly manifests as hyperglycemia, ketosis, and acidosis. It is a metabolic syndrome resulting from insulin deficiency and increased insulin-antagonistic hormone levels. While type 2 diabetes mellitus complicated by DKA is relatively uncommon, secondary pneumomediastinum in DKA is extremely rare. Following alveolar rupture, air can travel through various routes to reach the hilum, causing anterior, middle, or posterior pneumomediastinum or even leading to intracranial epidural pneumatosis. The diagnosis of pneumomediastinum is mainly dependent on chest computed tomography findings. After the successful treatment of DKA, pneumomediastinum usually resolves spontaneously within 5-10 days with a good prognosis. One DKA patient admitted to Dege County People's Hospital developed Kussmaul respirations, followed by an increase in intra-alveolar pressure, an elevation in intra and extra-alveolar pressure difference, and protein decomposition in the alveolus wall, which promoted alveolar rupture and induced mediastinal emphysema. After rapid fluid replacement, blood glucose control with insulin, and maintenance of acid-base balance (correction DKA), the mediastinal emphysema was spontaneously absorbed. Through the analysis of the clinical data of this case, the purpose is to improve the clinicians' internal understanding of the relationship between mediastinal emphysema and DKA, avoid over-examination and over-treatment, and provide strategies for correct diagnosis and treatment.
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Objective:To investigate the expression and significance of programmed death ligand 1 (PD-L1) and programmed death 1 (PD-1) in colorectal cancer complicated by schistosomiasis.Methods:A total of 134 patients with colorectal cancer who received treatment in Xuancheng People's Hospital during 2014-2021 were included in this study. These patients consisted of 74 patients with colorectal cancer combined with schistosomiasis (patient group) and 60 patients with only colorectal cancer (control group). The expression of PD-L1 and PD-1 in colorectal cancer tissue was detected by an immunohistochemical method. The differences in PD-L1 and PD-1 expression were compared between the two groups. The relationships between PD-L1 and PD-1 expression and clinical pathological characteristics were determined.Results:The positive expression rates of PD-L1 and PD-1 in cancer cells and interstitial lymphocytes were 55.4% and 60.8% respectively in the patient group and they were 35.0% and 40.0% respectively in the control group. The positive expression rates of PD-L1 and PD-1 were significantly higher in the patient group than the control group ( χ2 = 5.55, 5.74, both P < 0.05). The expressions of PD-L1 and PD-1 in the patient group were correlated with lymph node metastasis and high tumor-node-metastasis stage ( P < 0.05). Conclusion:PD-L1 and PD-1 are highly expressed in colorectal cancer complicated by schistosomiasis and are related to their invasive behavior. PD-1/PD-L1 singaling pathway may be involved in the molecular mechanism underlying the occurrence and development of colorectal cancer complicated by schistosomiasis. Blocking PD-1/PD-L1 signaling pathway may be a new strategy for immunotherapy of colorectal cancer complicated by schistosomiasis.
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Objective:To improve the critical thinking ability of interns in nephrology department based on electronic "Spot" mind mapping teaching method.Methods:In the control group, the traditional clinical teaching method was adopted. Each kidney disease unit was divided into 3 courses. ①The clinical practice teacher dictated or demonstrated his/her experience to the student in the first class. ②Students could exchange questions and answers in the second class. ③In the third class, according to the homework situation, the teacher presided over the discussion, guided the students to express their difficulties and help them solve the problems. The research group adopted the electronic "Spot" mind mapping teaching method: ①Grouping: the students were divided into groups, 6 to 8 people in each group, a total of 16 groups. ②Preparation: each group established a WeChat group, and teachers guided them download the Mindmanager software and learn its mapping method. ③In class: each kidney disease unit was divided into 3 sessions. In the first class, based on what the instructor taught, the students summarized the contents and drew a mind map, and then explain their understanding according to the map. In the second class, "Spot" in the group was conducted based on standards, reading each other in the group, actively discussing with each other, further improving and reconstructing the core knowledge points of the chapter, and encouraging each student to actively participate in enhancing their subjective initiative in learning. In the third class, teachers evaluated students according to their learning situation, and students filled in the gaps according to their opinions, perfected their mind maps, and finally posted to the WeChat group. ④Review: the final versions were sent to the WeChat groups as review materials, which was convenient for learning together. SPSS 24.0 was used for Chi-square test.Results:There was no significant difference between the two groups before study ( P>0.005). After the research, the scores of theory test ( t=2.52, P=0.015), clinical skill test ( t=2.22, P=0.034) and total score ( t=3.53, P=0.003) in the experimental group were significantly higher than those in the control group ( P<0.05). There was no significant difference in the scores of critical thinking ability between the two groups before research ( P>0.05). Six months after research, the total scores of critical thinking ability in the experimental group were significantly higher than those in the control group ( P<0.05). Conclusion:The introduction of electronic "Spot" mind mapping teaching method into clinical practice teaching can realize the cross-linking of related knowledge points and systematize the knowledge. At the same time, it is interesting and can stimulate students' learning interest, and is helpful to cultivate the clinical critical thinking ability of students.
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The reversible and precise temporal and spatial regulation of histone lysine methyltransferases(KMTs)is essential for epigenome homeostasis.The dysregulation of KMTs is associated with tumor initiation,metastasis,chemoresistance,invasiveness,and the immune microenvironment.Therapeutically,their promising effects are being evaluated in diversified preclinical and clinical trials,demonstrating encouraging outcomes in multiple malignancies.In this review,we have updated recent understandings of KMTs'functions and the development of their targeted inhibitors.First,we provide an updated overview of the regulatory roles of several KMT activities in oncogenesis,tumor suppression,and im-mune regulation.In addition,we summarize the current targeting strategies in different cancer types and multiple ongoing clinical trials of combination therapies with KMT inhibitors.In summary,we endeavor to depict the regulation of KMT-mediated epigenetic landscape and provide potential epigenetic targets in the treatment of cancers.
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Objective:To analyze the diagnostic value of Michigan nerve screening Scale (MNSI), pain, touch and temperature detection combined with vibratory perception threshold (VPT) in diabetic peripheral neuropathy (DPN).Methods:A total of 500 patients with type 2 diabetes mellitus (T2DM) who received inpatient treatment in Xinhua Hospital Chongming Branch Affiliated of Shanghai Jiao Tong University School of Medicine from January to December 2018 were selected. Sixty four patients with DPN were enrolled in the DPN group, and the remaining 436 patients were enrolled in the no-DPN group. The clinical data and the results of MNSI scale, pain, touch and temperature detection thresholds and VPT of the two groups were compared. Receiver operating characteristic (ROC) curve was drawn to analyze the clinical value of single and combined examination indicators in the diagnosis of DPN.Results:MNSI symptom questionnaire score and MNSI physical examination score in DPN group were higher than those in no-DPN group: (3.00 ± 1.35) scores vs. (1.69 ± 0.52) scores, (1.57 ± 0.50) scores vs. (1.01 ± 0.24) scores; the proportion of touch regression, pain regression and temperature regression was significantly higher than that in no-DPN group; and the levels of VPT in the DPN group was higher than that in the no-DPN group: (26.34 ± 5.03) V vs. (17.97 ± 6.82) V, there were statistical differences ( P<0.01). When the single index was diagnosed, the area under the curve (AUC) value of VPT was the highest (0.825), and significantly higher than the pain, touch and temperature detection ( P<0.01). The AUC value of VPT + MNSI in combined diagnosis was the highest (0.738), and the sensitivity and specificity of DPN diagnosis were 51.56% and 96.10%, respectively. Conclusions:Compared with MNSI scale score, sensory detection such as pain, touch and temperature, VPT has the best diagnostic efficiency for DPN, while combined with MNSI, the specificity can be further improved, but the sensitivity decreases, which is worthy of clinical attention.
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There is growing evidence that the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased risks of psychiatric sequelae. Depression, anxiety, cognitive impairments, sleep disturbance, and fatigue during and after the acute phase of COVID-19 are prevalent, long-lasting, and exerting negative consequences on well-being and imposing a huge burden on healthcare systems and society. This current review presented timely updates of clinical research findings, particularly focusing on the pathogenetic mechanisms underlying the neuropsychiatric sequelae, and identified potential key targets for developing effective treatment strategies for long COVID. In addition, we introduced the Formosa Long COVID Multicenter Study (FOCuS), which aims to apply the inflammation theory to the pathogenesis and the psychosocial and nutrition treatments of post-COVID depression and anxiety.
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BACKGROUND@#Patients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) in differentiating MFP from PDAC.@*METHODS@#A literature search was performed in the PubMed, EMBASE (Ovid), Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Weipu (VIP), and WanFang databases to identify original studies published from inception to August 20, 2021. Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included. The meta-analysis was performed with Stata 15.0 software. The outcomes included the pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CEUS and CECT. Meta-regression was conducted to investigate heterogeneity. Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.@*RESULTS@#Twenty-six studies with 2115 pancreatic masses were included. The pooled sensitivity and specificity of CEUS for MFP were 82% (95% confidence interval [CI], 73%-88%; I2 = 0.00%) and 95% (95% CI, 90%-97%; I2 = 63.44%), respectively; the overall +LR, -LR, and DOR values were 15.12 (95% CI, 7.61-30.01), 0.19 (95% CI, 0.13-0.29), and 78.91 (95% CI, 30.94-201.27), respectively; and the area under the SROC curve (AUC) was 0.90 (95% CI, 0.87-92). However, the overall sensitivity and specificity of CECT were 81% (95% CI, 75-85%; I2 = 66.37%) and 94% (95% CI, 90-96%; I2 = 74.87%); the overall +LR, -LR, and DOR values were 12.91 (95% CI, 7.86-21.20), 0.21 (95% CI, 0.16-0.27), and 62.53 (95% CI, 34.45-113.51), respectively; and, the SROC AUC was 0.92 (95% CI, 0.90-0.94). The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC (relative DOR 1.26, 95% CI [0.42-3.83], P > 0.05).@*CONCLUSIONS@#CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC, and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.
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Humanos , Medios de Contraste , Teorema de Bayes , Tomografía Computarizada por Rayos X/métodos , Neoplasias Pancreáticas/diagnóstico por imagen , Carcinoma Ductal Pancreático/diagnóstico por imagen , Sensibilidad y Especificidad , Pancreatitis/diagnóstico por imagen , Ultrasonografía/métodosRESUMEN
OBJECTIVE@#To observe the effects of acupuncture at "Kongzui" (LU 6) and "Yuji" (LU 10) on the latent period of inducing asthma, pulmonary function and the expression of endothelin-1 (ET-1) and metallothionein-2 (MT-2) in asthma rats, and to explore the possible mechanism of acupuncture in alleviating airway smooth muscle spasm and improving the acute attack of asthma.@*METHODS@#A total of 40 male SD rats of SPF-grade were randomly divided into a normal group, a model group, a medication group and an acupuncture group, 10 rats in each group. Except for the normal group, ovalbumin sensitization method was used to establish the asthma model in the other 3 groups. Salbutamol nebulization was adopted in the medication group, while acupuncture was applied at bilateral "Kongzui" (LU 6) and "Yuji" (LU 10) in the acupuncture group. The intervention was given once a day for 14 days in the two groups. The latent period of inducing asthma and pulmonary function were observed, the levels of ET-1 and tumor necrosis factor (TNF)-α in serum and bronchoalveolar lavage fluid (BALF) were detected by ELISA method, the morphology of the airway was observed by Masson staining, the ultrastructure of the airway smooth muscle was observed by transmission electron microscopy, the mRNA and protein expression of ET-1 and MT-2 in lung tissue was detected by real-time PCR and Western blot methods.@*RESULTS@#Compared with the normal group, in the model group, the latent period of inducing asthma was shortened (P<0.01); the airway resistance (RL) was increased while the dynamic compliance (Cdyn) was decreased (P<0.01, P<0.05); the levels of ET-1 and TNF-α in serum and BALF were increased (P<0.01); collagen fibers and collagen depositions were found around the bronchi, airway smooth muscle was thickened, the cell damage was severe and mitochondria were swollen; the mRNA and protein expression of ET-1 was increased while the mRNA and protein expression of MT-2 was decreased (P<0.01). Compared with the model group, in the acupuncture group, the latent period of inducing asthma was prolonged (P<0.05), the RL was decreased while the Cdyn was increased (P<0.01, P<0.05). Compared with the model group, in the medication group and the acupuncture group, the levels of ET-1 and TNF-α in serum and BALF were decreased (P<0.01, P<0.05); collagen fibers and collagen depositions around the bronchi were reduced, the thickened airway smooth muscle was lightened, the cell damage was improved; the mRNA and protein expression of ET-1 was decreased while the mRNA and protein expression of MT-2 was increased (P<0.01). Compared with the medication group, the mRNA expression of MT-2 was increased in the acupuncture group (P<0.05).@*CONCLUSION@#Acupuncture at "Kongzui" (LU 6) and "Yuji" (LU 10) can improve the pulmonary function and alleviate the airway smooth muscle spasm in rats with asthma. Its mechanism may be related to the down-regulation of ET-1 expression and up-regulation of MT-2 expression.
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Ratas , Masculino , Animales , Factor de Necrosis Tumoral alfa/metabolismo , Ratas Sprague-Dawley , Pulmón , Asma/metabolismo , Terapia por Acupuntura , Espasmo , ARN Mensajero/metabolismoRESUMEN
【Objective】 To explore the efficacy of modified prostate tip separation technique combined with laparoscopic radical prostatectomy based on propensity score matching (PSM) in the treatment of prostate cancer. 【Methods】 A total of 74 prostate cancer patients treated during Jan.2019 and Dec.2022 with modified prostate tip separation technique combined with laparoscopic radical prostatectomy were included in the combined group, and another 63 prostate cancer patients treated during the same period with laparoscopic radical prostatectomy were selected as the control group. Altogether 58 pairs of patients were matched with PSM. The perioperative indicators, incidence of complications, urinary control function and sexual function before and one month after surgery between the two groups after matching were compared. 【Results】 There were no statistically significant differences in general data between the two groups (P>0.05). One month after operation, the scores of the International Urinary Incontinence Questionnaire (ICIQ-SF) and International Erectile Function Questionnaire (IIEF-5) in both groups decreased, while the Expanded Prostate Cancer Index Composite (EPIC-UIN) and International Prostate Symptom Score (IPSS) in both groups increased (P<0.05). The scores of ICIQ-SF [(9.02±1.98) vs. (11.38±2.04)] and IPSS [(19.67±4.19) vs. (21.68±4.23)] were lower in the combined group than in the control group (P<0.05), while the scores of EPIC-UIN [(70.49±6.82) vs. (63.34±6.48)] and IIEF-5 [(18.17±1.73) vs. (16.72±1.58)] were higher in the combined group than in the control group (P<0.05). Compared with the control group, the combined group had shorter catheter retention time [(7.38±1.97) d vs. (5.11±1.82) d] and hospital stay [(13.18±2.23) d vs. (11.74±2.09) d], lower incidence of complications (22.41% vs. 6.90%), and higher positive rate of incision margin (8.62% vs. 20.69%) (P<0.05). 【Conclusion】 PSM can balance the differences between groups. The modified prostate tip separation technique combined with laparoscopic radical prostatectomy can improve the urinary control function, have little impact on sexual function, and cause fewer postoperative complications. However, the risk of positive incision margin is high, and further modification is needed to achieve the best therapeutic effects.
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【Objective】 To construct and validate a risk prediction model for cognitive impairment after stroke based on demographic, clinical, and neuroimaging characteristics. 【Methods】 Through the medical record system, we collected all data of the patients. We finished cognitive function testing three months after the indexed stroke. The Mini-Mental State Examination Scale score≤26 was defined as cognitive dysfunction. Optimal subset regression analysis was used to screen variables, Logistic regression analysis was used to construct a predictive model for cognitive impairment, and C-index, calibration chart and clinical decision curve analyses were used to evaluate the discrimination, consistency, and clinical availability of the model. And nomograms were used to express the performance of the model. 【Results】 Seven variables were selected: cognitive function before stroke, age, years of education, National Institutes of Health Stroke Scale score at admission, history of ischemic heart disease, the number of old lacunar infarct lesions, and medial temporal lobe atrophy scale. The prediction model had a C-index of 0.845 (95% CI: 0.805-0.885). The clinical decision curve showed that the model had a positive net benefit when the threshold probability was 9.0%-90.0%. 【Conclusion】 The predictive model of cognitive impairment in stroke patients has good predictive efficiency and provides an effective assessment tool for screening high-risk cases of cognitive impairment in patients with stroke of various subtypes.
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【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.
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Objectives To explore and compare the clinical characteristics and risk factors for mortality between patients with artificial quartz stone silicosis and those with classic silicosis. Methods A total of 48 patients with artificial quartz stone silicosis (experiment group) and 98 patients with classic silicosis (control group) were recruited as the research subjects using the convenience sampling method. Data of clinical symptoms, laboratory tests, high-resolution computed tomography (HRCT), and pulmonary pathology of the research subjects were retrospectively analyzed. The Cox proportional hazards regression model was used to analyze the influencing factors on the survival time of silicosis patients. Results Patients in the experiment group had shorter years of dust exposure, latency period and time since last exposure than those in the control group (all P<0.01). The positive rate of anti-nuclear antibodies and the expression of neuron-specific enolase in the experiment group were higher than those in the control group (39.6% vs 10.2%, median： 28.44 vs 16.25, both P<0.01). The PaO2 levels in the experiment group were lower than those in the control group (median： 66.0 vs 89.0, P<0.01). The patients in the experiment group had lower vital capacity, inspiratory reserve volume, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and carbon monoxide diffusion capacity compared to the control group (all P<0.05), but the maximal expiratory flow in 75% vital capacity was higher than the control group (P<0.05). Compared with the control group, patients in the experiment group had the presence of ground-glass opacity (GGO) in both lungs, aggregation and fusion of subpleural nodules, and gradual formation of progressive massive fibrosis (PMF), with higher potential of pneumothorax. Within 5 years after diagnosis, the mortality of patients in the experiment group was higher than that in the control group (27.1% vs 4.1%, P<0.01). The Cox regression model analysis results showed that patients with nodule aggregation on lung HRCT images had a higher risk of mortality than those without nodule aggregation, and lower lung function including vital capacity, FVC, FEV1 and maximum expiratory flow in 25% vital capacity had higher risk of reduced survival time (all P<0.05). Conclusion Compared with patients with classic silicosis, patients with artificial quartz stone silicosis have higher level of serum neuron-specific enolase, increasing the risk of autoimmune diseases. Pulmonary imaging features in patients with artificial quartz stone silicosis include GGO, PMF and susceptibility to pneumothorax, and rare calcification of mediastinal lymph nodes, leading to a higher mortality rate within 5 years after diagnosis.