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ObjectiveTo explore the evolution principles of symptoms including deficiency， phlegm and blood stasis， and of the functional near-infrared spectroscopy （fNIRS） cerebral hemodynamic characteristics at various stages in patients of Alzheimer's disease. MethodsA total of 497 patients with complaint of memory loss were included， and were divided into subjective cognitive decline （SCD） group （198 participants）， mild cognitive impairment （MCI） group （228 participants） and dementia （AD） group （71 participants）. Neuropsychological evaluation， traditional Chinese medicine （TCM） syndrome investigation， and fNIRS data collection of prefrontal cortex were performed in each group. Descriptive statistics were used to analyze the distribution of TCM syndromes and the difference of TCM syndrome scores in each group； logistic regression was used to analyze the influence of TCM syndromes on the incidence of the patients； association rules were used to analyze the TCM syndromes of the patients； the hemodynamic characteristics of fNIRS in the prefrontal cortex of each group were compared. ResultsKidney essence deficiency syndrome was the dominant syndrome in all stages of AD. There were statistically significant differences in the distribution frequency of kidney essence deficiency， phlegm turbidity obstructing orifices， blood stasis obstructing collaterals， qi and blood deficiency， heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes among the three groups （P＜0.01）， and the scores of kidney essence deficiency syndrome among the three groups were statistically significant （P＜0.01）. Logistic regression analysis showed that kidney essence deficiency， and qi and blood deficiency syndromes were the main risk factors for the SCD group （P＜0.05）， phlegm turbidity obstructing orifices syndrome was the main risk factor for the MCI group （P＜0.05）， and heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes were the main risk factors for the AD group （P＜0.05）. The association rule analysis showed that the combination of kidney essence deficiency plus phlegm turbidity obstructing orifices had the highest support （33.33%） in the SCD group， and the combination of kidney essence deficiency plus blood stasis obstructing collaterals had the highest support （32.90% and 52.13%） in both the MCI and AD group. The prefrontal fNIRS results showed that the mean ∆HbO2 concentration in the left dorsolateral prefrontal cortex （LDLPFC） decreased sequentially among the three groups （P＜0.05）， and the mean ∆HbO2 concentration in the LDLPFC was negatively correlated with the MoCA score among the three groups （r = -0.142， P＜0.05）. Further analysis showed that the mean ∆HbO2 concentration in the LDLPFC of patients with kidney essence deficiency syndrome were statistically significant differences among the three groups （P＜0.05）. ConclusionKidney deficiency is the basis of the pathogenesis of AD， and the key brain area damaged is the LDLPFC. Turbid pathogens such as phlegm and blood stasis are the pathological factors that aggravate the disease， and the syndromes of AD show the evolution law of deficiency and excess as “kidney deficiency→phlegm turbidity→blood stasis→turbid toxin”. The changes in prefrontal hemodynamics based on fNIRS are consistent with the changes in the characteristics of symptoms， which can be used to assess the degree of cognitive impairment in AD patients.
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Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.
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Objective:To evaluate the effect of stroke volume variation (SVV)-guided fluid therapy on perioperative haemodynamics and tissue perfusion in the patients with end-stage renal disease (ESRD) undergoing parathyroidectomy.Methods:One hundred and twenty-one patients of either sex, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅲ, with body mass index of 18-28 kg/m 2, with ESRD undergoing elective parathyroidectomy, who received haemodialysis treatment within 24 h before surgery, were enrolled in this study. The patients were divided into standard restrictive fluid therapy group (group SRT, n=61) and goal-directed fluid therapy group (group GDT, n=60) using a random number table method. Group SRT received restrictive fluid therapy, with a continuous infusion of 0.9% normal saline at a rate of 4 ml·kg -1·h -1. Group GDT received goal-directed fluid therapy guided by SVV, and when the SVV≥10% lasted for 5 min, the 0.9% normal saline 3 ml/kg was infused within 5 min until SVV<10%. Systolic blood pressure (SBP) was maintained at ≥90 mmHg or mean arterial pressure(MAP) at ≥65 mmHg throughout the perioperative period in both groups. The intraoperative volume of fluid infused, usage rate and consumption of intraoperative vasoactive drugs were recorded, and arterial blood lactate (Lac) level, MAP, heart rate, cardiac output, and inferior vena cava collapse index (IVC-CI) after removal of endotracheal tube at the end of surgery were measured. MAP was continuously recorded within 12 h after surgery, and MAP variability (CV MAP) was calculated. The occurrence of cardiovascular and cerebrovascular events within 30 days after operation was also recorded. Results:Compared with group SRT, the intraoperative volume of fluid infused was significantly increased, the usage rate of ephedrine and norepinephrine was decreased, the consumption of ephedrine was reduced, and the percentage of postoperative IVC-CI<50% and cardiac output were increased, the percentage of Lac≥2.0 mmol/L and CV MAP were decreased ( P<0.05), and no significant change was found in the incidence of cardiovascular and cerebrovascular events within 30 days after surgery in group GDT ( P>0.05). Conclusions:Compared with restrictive fluid therapy, SVV-guided fluid therapy can optimize the perioperative hemodynamics and tissue perfusion in the patients with ESRD undergoing parathyroidectomy.
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Objective To evaluate the BALB/c murine infective effects in different concentrations and different aerosol challenge times by Bordetella pertussis.Methods Four experiment groups according to different concentrations and different aerosol challenge times were designed.BALB/c murines were challenged by aerosol way.Group 1: 1010cfu/mL Bordetella pertussis challenge 15 min, group 2: 1010cfu/mL challenge 30 min, group 3: 109cfu/mL challenge 30 min, group 4: 1011cfu/mL challenge 30 min, using the normal saline challenge 30 min as control.At 0d,3d,7d,14d and 21d after challenge, the WBCs of all groups were measured and lung tissues were homogenized to calculate the bordetella pertussis clone in lung.Results After 3 days of challenge, WBCs in all groups were slightly increased.The WBCs of group 1, group 2, group 3 and group 4 were significantly increased after 7 days, with the average numbers of 8.52×109 per/L, 1.74×1010per/L, 1.15×1010per/L and 5×1010per/L, respectively.After 14 days, they were 1.77×1010per/L, 1.67×1010per/L, 1.27×1010per/L and 3.84×1010per/L respectively.WBCs in all groups were dramatically declined after 21 days.The WBC of negative control group had no obvious change during the whole process with the stable number of 3.4~7.0×109per/L.Bordetella pertussis were detected in lung of all experimental groups in each sampling point.The CFU in lung wase at peak at 7d or 14d after challenge, which was obviously decreased at 21d.Conclusion This aerosol challenge method can establish a bordetella pertussis infection mouse model successfully.
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Shape memory polymer (SMP) is a new type of functional materials.SMP has lots of advantages such as low density,light weight,high shape-recovery rate and low cost,but its stiffness is low and shape recovery force is small.Therefore,the reinforced SMP composite has become a hot research focus.The latest progress of reinforced SMP composite is reviewed,with the emphasis placed on the analysis of the influence of reinforced materials on SMP properties including short fibers,particles and the mixture of fibers and particles.Finally,problems exist in the study and the prospect of reinforced SMP composite are discussed briefly.
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<p><b>OBJECTIVE</b>To explore the impact on neutrophil-to-lymphocyte ratio (NLR) and the quality of life (QOL) in the patients of non-small-cell lung cancer (NSCLC) treated with wheat-size moxibustion therapy.</p><p><b>METHODS</b>Seventy patients of NSCLC were randomized into an observation group and a control group, 35 cases in each one. Finally, 33 cases were participated in the observation group and 32 cases in the control group for statistical analysis. In the observation group, Zusanli (ST 36) and Feishu (BL 13) were selected for grain-size moxibustion, 9 moxa cones on each acupoint, once a day. There was the follow-up visit without any treatment applied in the control group. The trial lasted for 6 weeks. The changes in NLR and the QOL score before and after treatment were observed in the patients of the two groups and the differences were compared between the two groups.</p><p><b>RESULTS</b>Compared with the condition before treatment, in the observation group, NLR was reduced apparently (P< 0.05), the general health state/life quality field, physical functioning, emotional functioning, cognitive functioning, fatigue, pain, short breath, insomnia and anorexia were improved apparently (all P < 0.05). In the control group, the differences were not significant in NLR, the general health states/life quality field, physical functioning, emotional functioning, cognitive functioning, role functioning, social functioning, fatigue, pain, short breath, insomnia and anorexia before and after treatment (all P > 0.05). In comparison of the two groups, NLR was reduced apparently in the observation group as compared with that in the control group after treatment (P < 0.05). The scores of the general health state/life quality field, physical functioning, emotional functioning and cognitive functioning were increased apparently as compared with those in the control group after treatment (all P < 0.05). The scores of fatigue, pain, short breath, insomnia and anorexia in the observation group were reduced apparently as compared with those in the control group after treatment (all P < 0.05).</p><p><b>CONCLUSION</b>The wheat-size moxibustion therapy reduces NLR and improves the immune function and quality of life in the patients of NSCLC.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Pulmón de Células no Pequeñas , Alergia e Inmunología , Terapéutica , Neoplasias Pulmonares , Alergia e Inmunología , Terapéutica , Linfocitos , Alergia e Inmunología , Moxibustión , Neutrófilos , Alergia e Inmunología , Calidad de VidaRESUMEN
BACKGROUND: RT-Q medical biomembrane, the novel copolymer synthesized from lactic acid and hyaluronic acid, not only possesses the advantages of hyaluronic acid, such as multiple biological functions, excellent flexibility and biocompatibility, but also has the merits of polylactic acid fragments to be easily processed and transformed to membrane when encountering water. OBJECTIVE: To investigate the hemostatic effect of RT-Q medical biomembrane in rat external jugular vein hemorrhage model, and to evaluate its histocompatibility by locally applying it to rat muscle. DESIGN: Randomized controlled animal trial.SETTING: Department of Pharmacology, Department of Pharmacognosy, West China School of Pharmacy, Sichuan University.MATERIALS: 130 male Wistar rats aged 6 weeks, weighing 170-210 g, were selected. Eighty rats were used for evaluation of hemostatic effect, and the other fifty were used in biocompatibility experiment. Animal intervention met the animal ethical standard. RT-Q aerosol composed of DL-lactic acid and hyaluronic acid, α-cyanoacrylate, acetone (solvent), freon (propellant) and excipient aerosol composed of acetone and freon (propellant) (Batch number 20050311) were provided by Department of Pharmaceutics, West China School of Pharmacy, Sichuan University.α-cyanoacrylate medical adhesive(SUNCON medical adhesive) (Batch number 20050930) was produced by Beijing Suncon Medical Adhesive Science and Technology Development Co., Ltd. METHODS: Haemostatic effect: Eighty male rats were randomly divided into four groups, served as RT-Q, SUNCON (positive control), excipient group and non-treatment group (negative control), twenty in each group. After anesthesia was induced, external jugular vein of rats was exposed, and an approximately 0.6 cm incision was made to create hemorrhage. The bleeding areas were blotted by antiseptic gauze. After removing the gauze, the bleeding surfaces were immediately treated with RT-Q aerosol in the RT-Q group, excipient aerosol in the excipient group, 0.15 mL SUNCON medical adhesive in the SUNCON group, or no agent in non-treatment group, respectively. Then, injury surfaces were covered by gauze. In the non-treatment group, bleeding was left to naturally stop. Bleeding time and blood loss (gauze weight after hemostasia - that before hemostasia) were determined. Local histocompatibility: Rats were divided into A and B groups. Incision was made in rat post-leg muscle after anesthesia was induced. Left bleeding surfaces were treated with excipient aerosol, and right bleeding surfaces were treated with RT-Q aerosol in group A (n=30). The same incision as the group A was made, but no intervention was performed in the group B (n=20). Tissues were possessed and HE-stained for pathological observation under light microscope at days 1, 2, 3, 4, 5, 6, 7, 15, 23, 30 after the surgery. Effect of biomembrane on wound healing, degradation and toxicity to tissues surrounding injuries were observed. MAIN OUTCOME MEASURES: Bleeding time and blood loss in hemostatic experiment; wound healing, biodegradation and toxicity to tissues surrounding injuries in local histocompatibility experiment. RESULTS: 130 rats were involved in the result analysis. Histopathologic examination showed RT-Q membrane had no effect of promoting or delaying wound healing. Membrane formed by RT-Q aerosol began to degrade on the 15th day, absorbed completely during 3-4 weeks, and had no toxicity to surrounding tissues. Bleeding time and blood loss were reduced in the RT-Q group than in the non-treatment group and the excipient group (P < 0.01). There was no significant difference between the RT-Q group and the SUNCON group (P > 0.05).CONCLUSION: RT-Q medical biomembrane as α-cyanoacrylate medical adhesive has significant hemostatic effects on topical bleeding, and possesses good histocompatibility.