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OBJECTIVE To investigate the effects of renally inappropriate medication （RIM） on the frailty of elderly patients with diabetes. METHODS The data of elderly patients with diabetes mellitus admitted to a third-grade class A hospital in Yunnan province from January to December 2022 were collected， and Beers criteria （2019 edition） and Chinese version of FRAIL scale were used to evaluate RIM and the frailty of the patients； the patients were divided into the trial group （with RIM） and the control group （without RIM） according to whether there was RIM. The propensity score matching was used to balance confounding factors between two groups， and the influence of RIM on the frailty of elderly diabetic patients was analyzed by the Logistic regression model. RESULTS Among the 367 patients， 80 patients （21.80%） had RIM， the drugs involved RIM were spironolactone （82.56%）， rivaroxaban （13.95%） and gabapentin （3.49%）. After reaching the balance between groups using the propensity score matching method， the incidence of frailty was 77.94% in trial group and 27.94% in control group （P＜0.001）； the difference was not statistically significant in other confounding factors between the two groups （P＞0.05）. Results of Logistic regression analysis showed that the risk of frailty in the experimental group was 3.118 times that of the control group （odds ratio was 3.118，95% confidence interval was 1.758-5.530， P＜0.001）. CONCLUSIONS RIM is a risk factor for the frailty of elderly patients with diabetes， which can be considered as an indicator for early identification and screening of the frailty of elderly diabetes patients.
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AIM: To study the perception of first-order grating acuity and second-order spatial contrast sensitivity in patients with monocular anisometropia amblyopia.METHODS:A total of 715 children(715 eyes)diagnosed as monocular anisometropia amblyopia in our hospital from January 2018 to December 2022 were collected as amblyopia group, and 745 children(745 eyes)with normal corrected visual acuity were collected. The best corrected visual acuity(BCVA), first-order grating acuity and/or second-order spatial contrast sensitivity were measured, repectively. The perception ability of amblyopia patients to first-order grating acuity and second-order spatial contrast sensitivity were analyzed.RESULTS:There were significant differences between amblyopia group and normal control group in the perception of first-order grating acuity(11.58±6.10 vs. 20.27±3.47, P<0.001)and second-order spatial contrast sensitivity(0.33±0.16 vs 0.12±0.04, P<0.001). And there were significant differences between mild-to-moderate amblyopia and severe amblyopia patients in first-order grating acuity(12.10±6.23 vs. 8.13±3.70, P<0.001)and second-order spatial contrast sensitivity(0.32±0.16 vs. 0.37±0.17, P<0.05).CONCLUSION: The first-order and second-order visual pathway of the cerebral cortex in children with monocular anisometropia amblyopia have different degrees of damage. The injury of severe amblyopia is more serious than that of mild-to-moderate amblyopia.
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ObjectiveTo investigate the effect and mechanism of Shenqi Tangluo pill （SQTLP） on oxidative stress injury of skeletal muscle of type 2 diabetes mellitus （T2DM） mice based on nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）/NAD（P）H quinone oxidoreductase 1 （NQO1） pathway. MethodA total of 60 7-week-old male db/db mice ［specific pathogen-free （SPF） grade］ were selected and fed for one week for adaption. They were divided into the model control group， SQTLP low-， medium- and high-dose （19， 38， and 76 g·kg-1） groups and metformin group （0.26 g·kg-1） by gavage. Each group consisted of 12 mice. Twelve male db/m mice of the same age were selected as the blank group. The intervention was implemented continuously for 8 weeks. Fasting blood glucose （FBG） was detected. Fasting serum insulin （FINS） levels were detected by enzyme-linked immunosorbent assay （ELISA）， and the homeostasis model assessment-insulin resistance （HOMA-IR） index and the homeostasis model assessment-insulin sensitivity index （HOMA-ISI） were calculated. Oral glucose tolerance test （OGTT） and insulin tolerance test （ITT） were conducted. The activities of superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） and the contents of malondialdehyde （MDA） and reduced nicotinamide adenine dinucleotide phosphate （NADPH） in skeletal muscle tissues were detected by biochemical kits. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in skeletal muscle tissues. The levels of reactive oxygen species （ROS） and 4-hydroxynonenal （4-HNE） in skeletal muscle tissue were detected by immunofluorescence （IF）. The expression levels of Nrf2， HO-1， NQO1 and glutamate-cysteine ligase catalytic subunit （GCLC） proteins in skeletal muscle tissues were detected by Western blot. ResultCompared with those in the blank group， FBG， FINS and HOMA-IR in the model group were significantly increased （P<0.05）， while HOMA-ISI was decreased （P<0.05）. The results of OGTT and ITT showed that blood glucose was significantly increased at all time points （P<0.05）， and glucose tolerance and insulin tolerance were significantly impaired. SOD and GSH-Px activities in skeletal muscle tissues were significantly decreased （P<0.05）， and MDA and NADPH contents were significantly increased （P<0.05）. In skeletal muscle tissues， the arrangement of muscle fibers was loose， the nucleus was disordered， and inflammatory cells were infiltrated. The expression levels of ROS and 4-HNE in skeletal muscle tissues were significantly increased （P<0.05）. The protein expression levels of Nrf2， HO-1， NQO1 and GCLC in skeletal muscle tissues were significantly decreased （P<0.05）. Compared with those in the model group， FBG， FINS and HOMA-IR in the metformin group were significantly decreased （P<0.05）， while HOMA-ISI was increased （P<0.05）. The results of OGTT and ITT showed that blood glucose in the metformin group was significantly decreased at all time points （P<0.05）. The activities of SOD and GSH-Px in skeletal muscle tissues were significantly increased （P<0.05）， while the contents of MDA and NADPH were significantly decreased （P<0.05）. No obvious abnormality was found in the skeletal muscle tissue of the metformin group. The expressions of ROS and 4-HNE in skeletal muscle tissues were decreased （P<0.05）. The protein expression levels of Nrf2， HO-1， NQO1 and GCLC in skeletal muscle tissues were significantly increased （P<0.05）. Compared with those in the model group， FBG， FINS and HOMA-IR in the SQTLP medium- and high-dose groups were significantly decreased （P<0.05）， while HOMA-ISI was increased （P<0.05）. The results of OGTT and ITT showed that the glucose tolerance and insulin tolerance of mice were improved in each dose group of SQTLP. The GSH-Px activity in the SQTLP low-dose group was significantly increased （P<0.05）， and the NADPH content was decreased （P<0.05）. The activities of SOD and GSH-Px in the SQTLP medium- and high-dose groups were significantly increased （P<0.05）， while the contents of MDA and NADPH were significantly decreased （P<0.05）. The skeletal muscle tissue injury of mice in each dose group of SQTLP was ameliorated to different degrees. In the SQTLP medium- and high-dose groups， the expressions of ROS and 4-HNE were decreased （P<0.05）， and the protein expression levels of Nrf2， HO-1， NQO1 and GCLC were significantly increased （P<0.05）. Compared with those in the SQTLP low-dose group， FBG and HOMA-IR in the SQTLP high-dose group were significantly decreased （P<0.05）， while HOMA-ISI was increased （P<0.05）. The results of OGTT and ITT showed that the SQTLP high-dose group significantly improved the glucose tolerance and insulin tolerance of mice. The activities of SOD and GSH-Px in skeletal muscle tissues were significantly increased （P<0.05）， while the contents of MDA and NADPH were significantly decreased （P<0.05）. No obvious abnormality was found in the skeletal muscle tissue， the expressions of ROS and 4-HNE were decreased （P<0.05）， and the protein expression levels of Nrf2， HO-1， NQO1 and GCLC were significantly increased （P<0.05） in the skeletal muscle tissue of the SQTLP high-dose group. ConclusionSQTLP can significantly improve IR in T2DM mice， and the mechanism is related to SQTLP activating the Nrf2/HO-1/NQO1 signaling pathway， promoting the expression of antioxidant enzymes， and thus improving the oxidative stress injury in the skeletal muscle.
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Objective To explore six-degree-of-freedom (6-DF) registration methods between planning and cone beam computed tomography (CBCT) during image-guided radiation therapy (IGRT) in esophageal cancer.Methods Thirty pairs of CBCT images acquired before radiation and the corresponding planning computed tomography (CT) images of esophageal cancer were selected for further investigation.Registration markers for 6-DF image registration were determined and contoured in those images.The results of registration as well as time cost were compared among different registration methods of bone match, gray value match, manual match, and bone plus manual match.Results Contouring bone and spinal canal posterior to the target volume of esophageal carcinoma as registration marker could make 6-DF registration quick and precise.Compared with manual match, set-up errors of v rotation in bone plus manual match (-0.55° vs.-0.88°, t=2.55, P=0.020), of x-axis and v rotation in bone match (0.12 mm vs.-2.33 mm, t=5.75, P=0.000; -0.35° vs.-0.88°, t=3.00, P=0.007), and of x-axis and w rotation in gray value match (7.20 mm vs.-2.33 mm, t=3.10, P=0.006; -0.10° vs.-0.59°, t=2.81, P =0.011) were significantly different.Compared with manual match, the coincidence rate of bone plus manual match was the highest (85.55%), followed by bone match and gray value match (74.45% and 74.45%).The time cost of each registration method from longest to shortest was:6.00 -10.00 minutes for manual match, 1.00 - 5.00 minutes for bone plus manual match, 0.75 - 1.50 minutes for gray value match, and 0.50 - 0.83 minutes for bone match.Conclusions Registration marker is useful for image registration of CBCT and planning CT in patients with esophageal cancer.Bone plus manual match may be the best registration method considering both registration time and accuracy.
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Objective To choose optimal concentration and volume of Gd-DTPA solution as a oral gastrointestinal negative contrast agent for MRCP.To evaluate the role of Gd-DTPA solution in improving image quality of MRCP.Methods In vitro experiment:Gd-DTPA solution was made with different concentrations.T1WI,T2WI,two-dimensional single slice fast spin echo sequence and three-dimensional half-fourier acquisition single-shot fast spin echo sequence were performed to measure the signal intensity of these contrast agents respectively,so Gd-DTPA solution with the optimal concentration can be decided as oral negative gastrointestinal contrast agent on MRCP.Clinical study:The Gd-DTPA solution with optimal concentration and volume was regarded as an oral negative gastrointestinal contrast agent of MRCP.Twenty-four patients were performed with MRCP before and after (5--10 minutes and 10--15 minutes)administration of oral negative gastrointestinal contrast agent and image quality was analyzed.Statistical analysis was performed using analysis of variance with SPSS 10.0.Results When the concentration of Gd-DTPA solution was ≤0.01 mol/L,the contrast agent was hyperintense on T1WI.On T2WI,when the concentration was ≥0.015 mol/L,it was as hypointense as basic ground; On 2D FSE MRCP images,controls were hyperintense and the contrast agent with concentration ranging from 0.0025 mol/L to 0.03 moL/L was hypointense.On 3D HEAST MRCP image,controls were hyperintense and when the eoncentration of Gd-DTPA was ≥0.01 mol,the contrast agent was hypointense.The Gd-DTPA solution with the concentration of 0.01 mol/L and the volume of 100 ml was chosen as MRCP oral negative gastrointestinal contrast agent.On MRCP images after oral administration of the contrast agent,in 10-15 minutes,the average grade scores within 24 patients of the intrahepatic bile duct,the common hepatic bile duct,the gall bladder,the common bile duct and pancreatic duct(the average grade scores were respectively 3.63,3.46,3.08,3.71,3.87,3.88,3.79,3.71,3.50) were somehow higher than in 5--10 minutes(the average grade scores were respectively 3.54,3.46,3.00,3.79,3.96,3.87,3.71,3.67,3.54),but showed no statistical difference(P>0.05).However,the scores of the third branch of the intrahepatic bile duct,the common bile duct and pancreatic duct after oral administration of the contrast agent were significantly higher than those before administration of oral contrast agent(the average grade scores were respectively 2.79,3.71,3.50,3.42,3.25) (F=4.36,4.75,7.86,8.05,7.55,P<0.05).Conclusion The0.01 mol/L oral Gd-DTPA contrast agent is optimal because it can suppress the high signal from the retention of the stomach and duodenum completely.It can be regarded as MRCP oral negative gastrointestinal contrast agent.After oral contrast administration,the image quality of MRCP is improved obviously and the pancreaticobiliary tree is clear 5-10 minutes later.
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Temporal and spatial expressions of ?-catenin investigated in the hair follicle and epidermis of the hoof periphery in bovine embryonic development. IHC (immunohistochemical method) was applied to qualitatively detect the temporal and spatial expressions of ?-catenin. ?-catenin was detected in suprabasal, epidermal basal layer, placode, hair bud in early phase(E68～93),and expressed strongly in epidermal basal layer, placode, and hair bud, in suprabasal expressed less strongly; in metaphase(E94～184), ?-catenin was detected in epidermis, hair peg, and in suprabasal, epidermal basal layer, hair follicle bulge, inner root sheath, outer root sheath, follicular infundibulum expressed less strongly; in late phase(E184～225), ?-catenin expressed weakly in epidermal basal layers, while expressed strongly in epidermal keratinocytes. The result suggested that ?-catenin plays an important role in hair follicle morphogenesis in the periphery of bovine hoof in bovine embryos.
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Objective To study the MRI characteristics of osteoblastoma and to discuss its diagnostic value. Methods Nine patients with osteoblastoma proved by pathology were examined with T_2WI, nonenhanced T_1WI and Gd-DTPA enhanced T_1WI MR imaging before operation MR finding were analyzed. Results Of nine patients, tumor originated from spine in five patients, from skull in three patients and from pelvis in one patient. Of these patients, benign osteoblastoma were in six patients and malignant were in three patients. On MRI, the tumor was an expanded osteolytic lesion, osteoid production formation was low or equal signal intensity on T_1WI and medial or high signal intensity on T_2WI. MRI showed low signal intensity of the calcification or ossification in osteoblastoma on T_2WI, and low or equal signal intensity on T_1WI. The ossified ring of tumor was low signal intensity on both T_1- and T_2WI. The adjacent soft tissue masses were showed on MRI. All patients given gadolinium showed enhancement within the osteoid production and the adjacent soft tissue mass, and no enhancement with ossification and calcification, cystoid and the ossified ring on MRI. The boundary of malignant osteoblastoma was obscure, and adjacent tissue could be invaded.Conclusion MR imaging can show all the characteristics of osteoblastoma well . It is of important value in diagnosis, operative orientation and staging of osteoblastoma, especially for the lesion originated from spine and skull.
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0.05). Conclusion DSA is highly valuable for the evaluation of collateral pathways of ICA stenosis or occlusion, and it is necessary for preoperative examination. MRA is a non-invasive angiographic method and can evaluate collateral circulation in both morphology and function, and can be the preferred method for the disease.
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25%, TCI of vecuronium was started at a target blood concentration of 0.3 ?g.ml-1 .Vecuronium was administrated by a specific TCI system incorporating the pharmacokinetic parameter set of Ruppy. Vecuronium target blood concentration was titrated to maintain T1/T2. at 25% .Results The average degree of NMB was 14.0%?2.2% in control group and 22.9%? 1.8% in TCI group. The difference was statistically significant ( P
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Objective To investigate the effects of propofol on nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) levels in blood and lung during endotoxic shock in rats.Methods Seventy-two male Wistar rats weighing 180-220 g were randomly divided into thiee groups :group Ⅰ control (C) ( n = 8) ; group Ⅱ endotoxic shock (L) ( n = 32) and group Ⅲ propofol + endotoxic shock (P) ( n = 32) . The animals were anesthetized with 3% pentobarbital 25 mg?kg-1 , tracheostomized and mechanically ventilated . Carotid and pulmonary artery were cannulated for MAP and MPAP monitoring. In group Ⅱ (L) and Ⅲ (P) endotoxin 10 mg?kg-1 was injected intraperitoneally. In group P 10 min before endotoxin administration subcutaneous propofol infusion was started at a rate of 20 mg?kg-1?h-1 . In control group normal saline(NS) was given ip instead of endotoxin. Venous blood samples were taken at 30, 90, 180 and 360 min after intraperitoneal endotoxin or NS injection. In group L and P 8 animals were killed at each time point respectively and in control group the 8 animals were killed at 360 min after ip NS injection. The lungs were immediately removed. Blood and lung NO and MDA levels and RBC SOD content were measured.Results The serum and lung NO concentration measured at all 4 time points were significantly lower in group Ⅲ than those in group n (P