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Objective:To screen plasma exosomal protein molecular markers in patients with spinal cord injury (SCI) by applying Label-Free quantification and bioinformatics analysis.Methods:Fifty plasma specimens from the First Affiliated Hospital of Nanjing Medical University (from January 2021 to June 2022) were collected from SCI patients and healthy people, respectively. Plasma exosomes were isolated using ultracentrifugation and identified by transmission electron microscopy, nanoparticle tracking analysis and western blot. Plasma exosomal differentially expressed proteins (DEPs) were analyzed using Label-Free quantitative proteomics, and DEPs were characterized, annotated, and enriched based on Gene Ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) databases. The screened DEPs were validated by western blot and enzyme linked immunosorbent assay (ELISA) using plasma exosomal specimens.Results:According to the spinal cord injury classification of the American Spinal Injury Association, 14 cases were grade A, 19 cases were grade B, 12 cases were grade C, and 5 cases were grade D. Plasma exosomes of SCI patients and control groups showed typical cup-like morphology, with diameters mainly ranging from 30-200 nm. A total of 493 exosomal proteins were identified by Label-Free quantification, and 126 proteins were screened for differential expression, of which 38 were up-regulated and 88 were down-regulated. GO annotation revealed that DEPs were mainly involved in functions such as protein activation cascade, complement activation and immune response. KEGG pathway analysis revealed that DEPs were involved in biological pathways such as complement and coagulation cascade reactions, proteasome and neurodegenerative disease pathways. Two candidate proteins, APOB and S100A9, were initially screened based on quantitative results from proteomics and bioinformatics analyses. Western blot results showed that the relative expression of S100A9 protein in plasma exosomes of 30 SCI patients (1.62±0.19) was elevated compared with that of 30 control groups (0.86±0.24), and the difference was statistically significant ( t=8.55, P<0.001), while the relative expression of APOB protein (1.06±0.13 and 1.02±0.23) were not statistically significant ( t=0.46, P=0.653). The results of ELISA analysis showed that the expression of S100A9 in plasma exosomes of patients with different degrees of SCI (grade A 197.7±11.7 pg/ml, grade B 151.7±15.2 pg/ml, grade C 136.3±14.7 pg/ml) had statistical significance ( F=69.94, P<0.001), the higher the severity of SCI, the higher the expression of S100A9 in plasma exosomes (A vs. B, q=13.11, P<0.001; A vs. C, q=15.66, P<0.001; B vs. C, q=4.19, P=0.005). Conclusion:S100A9 is a potentially valid plasma exosomal molecular marker for assessing the severity of SCI.
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There is still a serious challenge of the measurement of critical quality attributes (CQAs) related to clinical efficacy for Chinese materia medica manufacturing. To overcome this challenge, an integrated strategy of biosensor and ultra-performance liquid chromatography/tandem mass spectrometry (UPLC-MS/MS) was proposed using Tongren niuhuang qingxin pills as a trial. Firstly, an original biosensor was created using a semiconductor chip material high electron mobility transistor (HEMT) as the transducer and the macrophage migration inhibitory factor (MIF) as the identification element. By this MIF-HEMT biosensor, the efficacy on stoke of different components from Tongren niuhuang qingxin pills was measured. It was clear that all three components of Tongren niuhuang qingxin pills had strong therapeutic effects on stroke, especially the section A, the KD of which reached to 8.722×10-10 g·mL-1. Furthermore, MIF-HEMT biosensor integrated UPLC-MS/MS was introduced to identify the efficacy CQAs of different components of Tongren niuhuang qingxin pills. As a result, 19 potential CQAs, such as albiforin, paeoniflorin, and prim-O-glucosylcimifugin, were measured as the efficacy CQAs of Tongren niuhuang qingxin pills on stroke treatment by MIF. These results provided vital measurement techniques and methodological guidance for the CQAs study of Tongren niuhuang qingxin pills intervention in MIF-induced stroke treatment. This also provided an essential guideline for the efficient utilization and quality control measurement of high-quality classical recipes.
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The impact of plateau environment on cerebral venous thrombosis (CVT) is more complex and diverse than in plain areas. This article reviews the epidemiological characteristics, affected sites, and especially the pathogenesis of CVT in plateau areas.
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Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.
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ObjectiveTo observe the inhibitory effect of modified Xiao Xianxiongtang on epithelial-mesenchymal transition (EMT) of human gastric cancer MGC803 cells and its relationship with secretory glycoprotein Wnt/β-catenin pathway. MethodThe BALB/c nude mice were implanted with human gastric cancer MGC803 cell suspension in the heterotopic subcutaneous position for inducing tumor. After successful modeling, they were randomly divided into the model group, low-, medium-, and high-dose (16.0,32.0,and 64.0 g·kg-1) groups of modified Xiao Xianxiongtang, and capecitabine (400 mg·kg-1) group, with eight mice in each group, and gavaged with the corresponding drugs, once per day, for 28 consecutive days. Those in the capecitabine group received one-week discontinuation after every two weeks of treatment. The general state and body weight of the nude mice were observed, and the transplanted tumor volume was measured. After being killed, they were weighed and the tumor inhibition rate was calculated. Hematoxylin-eosin (HE) staining was carried out for observing the pathological changes in transplanted tumor tissues. The gene and protein expression levels of Wnt1 and β-catenin were detected by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot, followed by the determination of matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor (VEGF), N-cadherin, E-cadherin, Vimentin, and Snail protein expression by Western blot. The expression levels of cyclooxygenase 2 (COX2) and prostaglandin E2 (PGE2) were detected by enzyme-linked immunosorbent assay (ELISA). ResultIt was found that the transplanted tumor in each group showed different growth trends with time, with the most obvious growth observed in the model group. Compared with the model group, the low-, medium-, and high-dose modified Xiao Xianxiongtang groups exhibited reduced tumor volume and slowed growth to varying degrees over time. After medication for days 7,14,21,and 28, the tumor volumes in the low- and high-dose modified Xiao Xianxiongtang groups and capecitabine group declined (P<0.05, P<0.01), and that in the medium-dose Xiao Xianxiongtang group was also remarkably reduced after medication for days 14,21,and 28 (P<0.01). Compared with the model group, the high-dose modified Xiao Xianxiongtang group and capecitabine group showed a significant reduction in the relative tumor volume after treatment for days 7,14,21,28 (P<0.01), and the low- and medium-dose modified Xiao Xianxiongtang groups also presented with decreased relative tumor volume after treatment for days 14,21,28 (P<0.05, P<0.01). Compared with the model group, the modified Xiao Xianxiongtang at low, medium, and high doses and capecitabine all increased the tumor inhibition rate to varying degrees (P<0.01), down-regulated the mRNA and protein expression levels of Wnt1 and β-catenin in tumor tissue (P<0.05, P<0.01) and protein expression levels of MMP-9, VEGF, N-cadherin, Vimentin, and Snail (P<0.05, P<0.01), up-regulated E-cadherin protein expression (P<0.05, P<0.01), and reduced COX2 and PGE2 contents (P<0.05, P<0.01). ConclusionModified Xiao Xianxiongtang inhibits the EMT of human gastric cancer MGC803 cell-transplanted tumor, which may be related to Wnt/β-catenin pathway.
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@#Objective To investigate the relationship between the expression of serum galectin-3 and matrix metalloproteinase-9 (MMP-9) and neurological deficit after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods The clinical data of 100 patients with AIS who received intravenous thrombolytic therapy in the hospital were retrospectively analyzed.The neurological deficit (NIHSS) of all patients after thrombolytic therapy was evaluated.They were divided into severe group (NIHSS score≥15,71 patients) and mild to moderate group (NIHSS score 0~14,29 patients),and the relationship between the levels of serum galectin-3 and MMP-9 and the neurological deficit after intravenous thrombolytic therapy of AIS patients was analyzed.Results The serum galectin-3 and MMP-9 levels of severe group high than mild to moderate group (P<0.05).The high expression of serum galectin-3 and MMP-9 before thrombolysis may be the risk factors of severe neurological deficit after thrombolysis in AIS patients (OR=1.385、1.166,P<0.001、=0.002,95%CI1.160~1.653、1.060~1.282).Besides,they can predict the risk of severe neurological deficit in patients with AIS after thrombolytic therapy (AUC=0.781、0.718).Conclusion The levels of serum galectin-3 and MMP-9 in patients with AIS before thrombolysis are related to the neurological deficit after thrombolysis.Their overexpression may increase the risk of severe neurological deficit.
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Spinal cord injury is a common clinical disease secondary to spinal cord fractures that causes patients with motor and sensory dysfunction or even paralysis. In recent years, exosomes have participated in the occurrence and development of various diseases as nanometer-sized cell particles, and have received extensive attention. Exosomes derived from spinal cord tissue cells during spinal cord injury affect the injury process and tissue repair. In addition, exosomes as a new treatment for spinal cord injury have been widely studied. The authors document the mechanisms of various exosomes from spinal cord tissue and the repair effects of various cell-derived exosomes in spinal cord injury, in order to deepen the understanding of the role of exosomes in spinal cord injury and provide new ideas for studying the course and treatment of spinal cord injury.
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The Solanaceae plants distributed in China belong to 105 species and 35 varietas of 24 genera. Some medicinal plants of Solanaceae are rich in tropane alkaloids(TAs), which have significant pharmacological activities. In this paper, the geographical distribution, chemical components, traditional therapeutic effect, pharmacological activities, and biosynthetic pathways of TAs in Solanaceous plants were summarized. Besides, the phylogeny of medicinal plants belonging to Solanaceae was visualized by network diagram. Fourteen genera of Solanaceae plants in China contain TAs and have medical records. TAs mainly exist in Datura, Anisodus, Atropa, Physochlaina, and Hyoscyamus. The TAs-containing species were mainly concentrated in Southwest China, and the content of TAs was closely related to plant distribution area and altitude. The Solanaceae plants containing TAs mainly have antispasmodic, analgesic, antiasthmatic, and antitussive effects. Modern pharmacological studies have proved the central sedative, pupil dilating, glandular secretion-inhibiting, and anti-asthma activities of TAs. These pharmacological activities provide a reasonable explanation for the traditional therapeutic efficacy of tropane drugs. In this paper, the geographical distribution, chemical components, traditional therapeutic effect, and modern pharmacological activities of TAs-containing species in Solanaceae were analyzed for the first time. Based on these data, the genetic relationship of TAs-containing Solanaceae species was preliminarily discussed, which provided a scientific basis for the basic research on TAs-containing solanaceous species and was of great significance for the development of natural medicinal plant resources containing TAs.
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Vias Biossintéticas , Filogenia , Plantas Medicinais , Solanaceae/genética , TropanosRESUMO
Objective: To explore the clinical value of quantitatively assessment of left ventricular strain in patients with coronary chronic total occlusion (CTO) by cardiac magnetic resonance imaging (CMR)-feature tracking (CMR-FT) technique. Methods: In this retrospective and observation study, patients with single CTO, who underwent CMR examination in Beijing Anzhen Hospital from November 2014 to January 2019, were selected as case group (CTO group), and those without cardiovascular diseases defined by echocardiography, electrocardiogram (ECG) and clinical history and with normal CMR results were selected as healthy control group (control group). General clinical data including age, gender, discharge diagnosis, and the examination results of echocardiography and ECG were obtained from the electronic medical record system. Two-dimensional CMR-FT was applied to measure left ventricle (LV) global peak radial, circumferential, and longitudinal strains (GPRS, GPCS and GPLS, respectively), and the regional myocardial strain in the target vessel area of CTO was analyzed. Grayscale thresholds of 5 standard deviations (SDs) were used to quantify late gadolinium enhancement (LGE). Patients with CTOs were divided into infract size>10% group and infarct size≤10% group, and left ventricular ejection fraction (LVEF)≥50% group and LVEF<50% group, respectively. The differences between various groups were compared. Results: There were 52 patients in CTO group (34 males, age (54.1±11.7) years, body mass index (BMI) (26.2±2.5)kg/m2) and 30 patients in control group (14 males, age(51.6±12.3)years, BMI (25.6±3.3)kg/m2). There was no significant difference in age, gender, and BMI between the two groups (all P>0.05). LVEF, GPRS, GPCS and GPLS were significantly lower in CTO group than in control group (all P<0.05), left ventricular volume (LVEDV) was similar between the two groups (P>0.05). Among the patients with CTO, there were 26 patients with infarct size>10% and 26 patients with infarct size≤10%. GPRS, GPCS and GPLS were significantly lower (all P<0.05), while LVEF and LVEDV were similar in CTO patients with infarct size≤10% as compared to control group (both P>0.05). LVEF, GPRS, GPCS and GPLS were significantly lower (all P<0.05), while LVEDV was similar in CTO patients with infarct size>10% (P>0.05) as compared to control group. GPRS and GPCS were significantly lower (both P<0.05), while LVEF, LVEDV and GPLS were similar in CTO patients with infarct size>10% as compared to infarct size≤10% group. There were 40 subjects in LVEF≥50% group and 12 subjects in LVEF<50% group. Compared with the control group, GPCS and GPLS of CTO patients were significantly lower in LVEF≥50% group and LVEF<50% group (all P<0.01), LVEF and LVEDV was similar in CTO patients with LVEF≥50% (both P>0.05), but LVEF was lower and LVEDV was larger in LVEF<50% group (both P<0.05). The GPRS, GPCS, GPLS and LVEF of CTO patients in LVEF ≥ 50% group were higher than those in LVEF<50% group (all P<0.0l), and the myocardial infarction size was smaller than that in LVEF reduced group (P<0.0l), but there was no significant difference in LVEDV between the two groups (P=0.07). In the CTO group, there were 21 patients with left anterior descending artery (LAD) occlusion and 126 segments supplied by the target vessels. The peak radial strain (PRS), circumferential strain (PCS) and longitudinal strain (PLS) in the blood supply area were lower than those in the control group (all P<0 01). In 7 patients with left circumflex artery (LCX) occlusion, the number of myocardial segments supplied by the target vessels was 35, and the PRS, PCS and PLS in the target vessel supply area were lower than those in the control group (all P<0 05). In 24 patients with right coronary artery (RCA) occlusion, the number of myocardial segments supplied by the target vessels was 120, and the PRS, PCS and PLS in the target vessel supply area were lower than those in the control group (all P<0.01). Among the 126 segments in 21 patients with LAD CTO, 91 (72.2%) segments had infarct size≤25%, 17 (13.5%) segments had infarct size between 26%-50%, 11 segments (8.7%) had infarct size between 51%-75%, and 7 (5.6%) segments had infarct size between 76%-100%. Among the 35 segments in 7 patients with LCX CTO, 31 (88.6%) segments had infarct size≤25%, and 4 (11.4%) segments had infarct size between 26%-75%. Among the 120 segments in 24 patients with RCA CTO, 96 (80.0%) segments had infarct size≤25%, 11 (9.2%) segments had infarct size between 26%-50%, 8 (6.7%) segments had infarct size between 51%-75%, and 5 segments (4.2%) had infarct size between 76%-100%. Conclusions: In this study with single CTO, although the LVEF is preserved in the majority of the patients, the left ventricular global and regional strain values are significantly decreased. The larger the infarct size, the greater the impact on radial and circumferential motion, reflecting the early impairment of left ventricular function in these patients.
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Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Meios de Contraste , Oclusão Coronária/diagnóstico por imagem , Gadolínio , Ventrículos do Coração/diagnóstico por imagem , Espectroscopia de Ressonância Magnética , Intervenção Coronária Percutânea , Estudos Retrospectivos , Volume Sistólico , Função Ventricular EsquerdaRESUMO
Microglia cells are activated after ischemic stroke, and polarized phenotypes of M1 and M2. Some drugs, such as fingolimod, 3-N-butylphthalide, curcumin, sildenafil, exendin-4, celastrol, omega-3 fatty acids, malibatol A, salidroside, etc., can transfer the polarization from M1 to M2, and may benefit the outcome of ischemic stroke.
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This paper explores Mongolian medicine processing methods and the use regularity of excipient by text mining techniques. Relevant books of Mongolian medicine processing were consulted to collect data on Mongolian medicine processing methods and excipient, and select data based on processing methods and excipient noun frequency statistics. Microsoft Excel 2010 software was used for statistical analysis and mining for the usage regularity of different types of Mongolian medicinal materials in different periods. And Cytoscape 3.6.1 software was used for visual presentation. The topological analysis showed the top five processing methods were net production, development, frying, calcining and cooking, and the top five processing excipient were fresh milk, wine, urine, cream and mineral borax. Frequency analysis showed that the plant medicinal materials were mostly recorded in the 18~(th) and 21~(st) centuries, especially in the 21 st century; the processing methods mostly contained water processing, repair processing and other methods. The mineral medicinal materials were mostly recorded in the 18~(th), 19~(th) and 21~(st) centuries; most of the processing methods were the fire processing method. The animal medicinal materials were recorded in the 18~(th), 19~(th) and 21~(st) century; the fire processing method occupied a major position, and the repair processing and the grinding processing were markedly increased in the 21~(st) century. In the use of excipient, liquid excipient were mostly used in plant medicines. Solid excipient were most commonly used in the 18~(th) century. Animal excipient were mostly used during the processing in the 18~(th) century. The use of liquid excipient gradually increased in the 19~(th) and 21~(st) centuries. This study summarizes the traditional processing methods of Mongolian medicine and the usage regularity of excipient, defines the characteristics of Mongolian medicine processing methods and excipient, and the characteristics of the combination of medicinal materials and excipient, so as to provide reference for the clinical use of Mongolian medicine.
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Mineração de Dados , Excipientes , Medicina Tradicional da Mongólia , Registros , SoftwareRESUMO
Mongolian medicine is an indispensable part in developing traditional Mongolian medicine. This study is aimed to provide a basis for the formulation of clinical and Mongolian medicinal materials standards by clarifying the original plant and species collation of Mongolia medicine of "saradma". Mongolian herbal medicine, as an important part of Mongolian medicine, is needed to study the authentic Mongolian medicine, in order to exert the best therapeutic effect in the application. The Mongolian medicine of "saradma" is a kind of medicinal material for diuresis, reinforcing kidney, and eliminating edema, for which comes from the roots, stems, leaves, flowers, fruits, seeds and other parts of medicinal plant. The ancient books of Mongolian medicine are the most important reference the research of Mongolian medicine varieties. This review adopts the method of inductive comparison of ancient books in order to summarize the conclusion of Mongolian medicine of "saradma". According to the investigations, Mongolian medicine of "saradma" type is mainly Leguminosae plant, Oxytropis latibracteata, Hedysarum multijugum, Thermopsis barbata, Astragalus membranaceus, Vicia amoena, O. caerulea, Astragalus bhotanensis, Hedysarum sikkimense. Compared with modern works, it is found that the drug has a wide range of resources distribution and application. It can be used for the treatment of cold edema, hot edema, nephrogenic edema, edema, swelling and likes caused by different diseases. Based on the research of Mongolian medicine of "saradma" varieties, it was found that the most commonly used varieties in Inner Mongolia were cayan saradma, xara saradam and sira saradma all of which are all top-grade drugs that reduce swelling.
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Livros , China , Medicamentos de Ervas Chinesas , Medicina Tradicional da Mongólia , Fitoterapia , Plantas MedicinaisRESUMO
OBJECTIVE@#To evaluate the effectiveness of integrative medicine (IM) on patients with coronary artery disease (CAD) and investigate the prognostic factors of CAD in a real-world setting.@*METHODS@#A total of 1,087 hospitalized patients with CAD from four hospitals in Beijing, China were consecutively selected between August 2011 and February 2012. The patients were assigned to two groups based on the treatment: Chinese medicine (CM) plus conventional treatment, i.e., IM therapy (IM group); or conventional treatment alone (CT group). The endpoint was major adverse cardiac events [MACE; including cardiac death, myocardial infarction (MI), and revascularization].@*RESULTS@#A total of 1,040 patients finished the 2-year follow-up. Of them, 49.4% (514/1,040) received IM therapy. During the 2-year follow-up, the total incidence of MACE was 11.3%. Most of the events involved revascularization (9.3%). Cardiac death/MI occurred in 3.0% of cases. For revascularization, logistic stepwise regression analysis revealed that age ⩾ 65 years [odds ratio (OR), 2.224], MI (OR, 2.561), diabetes mellitus (OR, 1.650), multi-vessel lesions (OR, 2.554), baseline high sensitivity C-reactive protein level ⩾ 3 mg/L (OR, 1.678), and moderate or severe anxiety/depression (OR, 1.849) were negative predictors (P<0.05); while anti-platelet agents (OR, 0.422), β-blockers (OR, 0.626), statins (OR, 0.318), and IM therapy (OR, 0.583) were protective predictors (P<0.05). For cardiac death/MI, age ⩾ 65 years (OR, 6.389) and heart failure (OR, 7.969) were negative predictors (P<0.05), while statin use (OR, 0.323) was a protective predictor (P<0.05) and IM therapy showed a beneficial tendency (OR, 0.587), although the difference was not statistically significant (P=0.218).@*CONCLUSION@#In a real-world setting, for patients with CAD, IM therapy was associated with a decreased incidence of revascularization and showed a potential benefit in reducing the incidence of cardiac death or MI.
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença da Artéria Coronariana , Tratamento Farmacológico , Medicina Integrativa , Modelos Logísticos , Medicina Tradicional Chinesa , PrognósticoRESUMO
OBJECTIVE@#To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China.@*METHODS@#A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia.@*RESULTS@#Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05).@*CONCLUSIONS@#The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.
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Humanos , Recém-Nascido , Asfixia Neonatal , Epidemiologia , China , Incidência , Estudos RetrospectivosRESUMO
Neoadjuvant chemoradiotherapy is the current standard of care for locally advanced rectal cancer. However, this modality is facing more and more challenges. The research progress on this issue around the world can be summarized into three aspects. The first is to increase the intensity of treatment to obtain better tumor regression, such as adding a second drug during the neoadjuvant chemoradiotherapy, prolonging the interval and receiving sufficient chemotherapy before surgery. Current research data are not sufficient to support strategies for adding drugs or receiving sufficient chemotherapy before surgery, but it may be worth looking forward to adding irinotecan during neoadjuvant chemoradiotherapy, and an appropriate extension of the interval before surgery may also be a good option. Secondly, we can reduce the intensity of treatment to improve the quality of life of patients with a non-inferior clinical outcome, such as non-surgical approach, local excision rather than total mesorectal excision and removal of preoperative radiotherapy. The data of the International Watch & Wait Database (IWWD) suggest that patients with a Watch & Wait strategy have similar long-term survival outcomes as those who have undergone surgery and have pathologic complete response, meanwhile the data are still inadequate to support using local excision instead of total mesorectal excision, or removal of preoperative radiotherapy strategies. Finally, to achieve a precise individual treatment, some potential biomarkers are investigated via genomics, metabolomics and radiomics. But so far, there is no recognized biomarker for clinical treatment in the field of neoadjuvant therapy for rectal cancer. This article summarizes the clinical research progress of locally advanced rectal cancer in recent years from the above three aspects.
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Objective To observe the clinical efficacy of modified Huanglian Wendan Decoction for treatment of tic disorder (TD) children with syndrome of wind stirring due to phlegm-heat; To detect its effects on peripheral-blood miR-429 expression. Methods Eighty cases of TD children were randomly divided into treatment group and control group,with 40 cases in each group.In the treatment group,children were treated with modified Huanglian Wendan Decoction, one dosage a day, twice a day, orally. In the control group, TD children were treated with haloperidol, 0.03 mg/(kg?d), orally, according to the symptom to adjust dose, and the maximum amount did not exceed 0.08 mg/(kg?d). 30 d was a treatment course for both groups. The treatment lasted for three courses. Before and after 3 months of clinical observation, the severity of disease was evaluated by TCM syndrome and Yale Global Tic Severity Scale (YGTSS) score. Clinical efficacy and TCM syndrome efficacy were evaluated; the level of miR-429 in peripheral blood was detected; the adverse reactions were observed. Results The total effective rate of clinical efficacy was 82.5% (33/40) in treatment group and 80.0% (32/40) in the control group, without statistical significance (P>0.05); The total effective rate of TCM syndrome efficacy was 92.5% (37/40) in treatment group and 75.0% (30/40) in the control group, with statistical significance (P<0.05). Compared with before treatment, the YGTSS score and TCM syndrome score significantly decreased after treatment (P<0.01), and the TCM syndrome score in the treatment group was much lower than the control group after treatment (P<0.05). Compared with before treatment, miR-429 level in both groups increased obviously after treatment (P<0.01), and the miR-429 level in the treatment group was much higher than the control group after treatment (P<0.05). There were mild constipation (1 cases), diarrhea (2 cases), and anorexia (2 cases) in the treatment group, and obvious lethargy (3 cases) and dizziness (3 cases) in the control group. Conclusion Modified Huanglian Wendan Decoction shows obvious effects for treating TD, and can up-regulate miR-429 of peripheral-blood.
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OBJECTIVE@#To evaluate the level of blood pressure control in patients with coronary heart disease (CHD) of China in order to provide guidance for the prevention and treatment of CHD.@*METHODS@#The patients with CHD were retrospectively collected from 2011~2014 in PLA General Hospital and Hainan Branch Hospital. Then analyzed the difference of blood pressure compliance rate between different surgical methods percutaneous coronary intervention (PCI), coronary artery bypass grafting(CABG), secondary preventive drugs(aspirin, clopidogrel, nitrates, trimetazidine, nicorandil, hypotensor, hypoglycemic, lipid-lowering drugs) and lifestyle(smoking, drinking, exercise).@*RESULTS@#①Effects of surgical methods on blood pressure:Male's systolic blood pressure (SBP) and diastolic blood pressure(DBP) in the CABG group were lower in the PCI group and control group, and female's DBP in the CABG group were lower in the PCI group. ②Usage rate of secondary prevention drugs:usage rate of trimetazidine, calcium antagonist, β-blockers, angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor antagonist (ARB) in hypertension group were higher than in normal blood pressure group. ③ Lifestyle condition:compliance rate of blood pressure in the smoking group was lower than that in the non smoking group. And there was no significant difference in blood pressure compliance rate among whether drinking and doing exercise or not.@*CONCLUSIONS@#Blood pressure control in patients with CHD was still not satisfied. Compared with PCI, CABG may be more beneficial in the control of blood pressure in patients with CHD. Smoking cessation and improving the usage rate of secondary preventive drugs are still the main means of blood pressure control.
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Feminino , Humanos , Masculino , Pressão Sanguínea , China , Ponte de Artéria Coronária , Doença das Coronárias , Tratamento Farmacológico , Cirurgia Geral , Estilo de Vida , Intervenção Coronária Percutânea , Estudos Retrospectivos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To study the effects of low?intensity pulsed ultrasound (LIPUS) in promoting repair of cyclophosphamide (CTX)?induced ovarian injury in female rats.</p><p><b>METHODS</b>Fifty female SD rats were subjected to intraperitoneal injection of cyclophosphamide at 30 mg/kg for 5 consecutive days to induce premature ovarian failure. Successful modeling was achieved in 43 rats, which were then randomized into model group (21 rats) and treatment group (22 rats), with another 13 rats without any injections serving as the normal control group. The rats in the treatment group received low?intensity pulsed ultrasound treatment, and those in the other two groups received no interventions. The estrous cycle of the rats was monitored during the experiment, and all the rats were sacrificed 7 days after the treatment for analysis of serum estradiol (E), follicle stimulating hormone (FSH), anti?Mullerian hormone (AMH), morphological changes of the ovary and the number of follicles.</p><p><b>RESULTS</b>Compared with those in the normal control group, the rats in the model group showed disorders in the estrous cycle, reduced number of follicles at all levels, significantly decreased serum Eand AMH, and increased serum FSH following CTX injection (P=0.01). Ultrasound treatment obviously promoted the recovery of estrous cycle, significantly increased the number of follicles and serum E(P=0.01), and decreased FSH (P=0.01) in the rats with CTX?induced ovarian injury, but AMH showed no significant changes after ultrasound treatment (P=0.50).</p><p><b>CONCLUSION</b>Low?intensity pulsed ultrasound can promote the repair of the CTX?induced ovarian injury in SD rats.</p>
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Objective To investigate the short-term clinical efficacy of Jack vertebral dilator kyphoplasty bone grafting combined with minimally invasive fixation in the treatment of thoracolumbar fracture.Methods A retrospective case series analysis was made on 34 patients with thoracolumbar fracture treated by minimally invasive transpedicular bone grafting and fixation in the injury vertebrae with Jack vertebral dilator from December 2014 to December 2015.There were 20 males and 14 females,and their age was 25-27 years (mean,46.7 years).According to the AO classification,there were 16 cases of type A1 and 18 type A3.The injured levels were at T11 in one case,at T12 in 6,at L1 in 15,at L2 in 9 and at L3 in 3.The operation time,blood loss,fluoroscopy frequency,incision length,and postoperative hospital stay duration were recorded.The visual analogue scale (VAS),Oswestry disability index (ODI),height ratio of vertebrae,Cobb angle,and complications were evaluated at follow-up.Results The operation time was (91.2 ±9.8) minutes,blood loss was (42.4 ±4.3) ml,incision length was (7.2 ± 0.4) cm,intraoperative fluoroscopy frequency were five,postoperative hospital stay was (3.9 ± 0.5) days,and follow-up time was (13.8 ± 1.7) months.All the patients showed complete healing in the injury vertebra.The VAS was (6.4 ± 0.9) points preoperatively,(4.1 ± 0.8) points,(1.2 ± 0.4) points,and (1.2 ± 0.5) points at 7 days,3 months and 12 months postoperatively.The ODI was (39.2 ± 2.3) points preoperatively,(24.5 ± 1.9) points,(13.0 ± 3.0) points,and (12.3 ± 2.0) points at 7 days,3 months and 12 months postoperatively.At postoperative 7 days,the VAS and ODI were significantly decreased compared with those preoperatively (P < 0.05) and further declined at postoperative 3 months (P < 0.05),while there was no significant difference between 3 months and 12 months postoperatively (P > 0.05).The height ratio of vertebrae was 47.8 ± 12.2 preoperatively,83.6 ±4.9,82.5 ±4.8,and 81.7 ±4.7 at 7 days,3 months and 12 months postoperatively.The Cobb angle was respective (22.4 ± 4.7) °preoperatively,(3.6 ± 2.4) °,(4.6 ± 2.6) °,and (5.0 ± 2.8) ° at 7 days,3 months and 12 months postoperatively.At postoperative 7 days,the height ratio of vertebrae was increased and Cobb angle was decreased significantly compared to those preoperatively (P < 0.05),while there was no significant difference in the indicators at 3 days,3 months and 12 months postoperatively (P > 0.05).No looseness or breakage of internal fixation was found at follow-up and all patients had fracture union at the last follow-up.Conclusion Jack vertebral dilator kyphoplasty bone grafting combined with minimally invasive fixation is safe and effective for treatment of thoracolumbar fractures,as the procedure can quickly relieve the pain,improve the function disability,effectively maintain the height of the vertebral body and restore the sagittal balance of spine.
RESUMO
OBJECTIVE: To investigate the toxic effects of four different kinds of aluminum compounds in rat adrenal-derived pheochromocytoma cell PC12. METHODS: PC12 cells at logarithmic growth phase were treated with four different kinds of aluminum compounds: aluminum maltolate( concentration was 0. 0,0. 1,0. 2,0. 4,0. 8 mmol / L),aluminum chloride( concentration was 0. 0,1. 0,2. 0,4. 0,8. 0 mmol/L),aluminum citrate( concentration was 0. 0,1. 0,2. 0,4. 0,8. 0mmol / L) and aluminum lactate( concentration was 0. 0,2. 0,4. 0,8. 0,16. 0 mmol / L) for 24 hours,respectively. The cell viability was determined with CCK-8 assay,and the apoptotic rate was detected by flow cytometry. RESULTS: All of the aluminum compounds suppressed the cell viability and increased apoptosis( P < 0. 01). Most of the effects were in a dose dependent manner. Comparing with the control,the minimum effective concentration of aluminum maltolate,aluminium chloride,aluminum citrate and aluminum lactate were 0. 2,2. 0,2. 0 and 4. 0 mmol / L,respectively,in cell viability( P < 0. 05); and 0. 1,2. 0,1. 0 and 2. 0 mmol/L in cell apoptosis( P < 0. 05). The 24 hours 50% inhibitory concentration of the above four aluminum compounds were( 0. 45 ± 0. 01),( 4. 02 ± 0. 39),( 5. 37 ± 0. 88) and( 6. 31 ±0. 58) mmol / L,respectively. CONCLUSION: Treatment of all four aluminum compounds had reduced cell viability and increased the percentage of cell apoptosis in a dose-dependent manner in PC12 cells. The best dose-response relation was observed in aluminum maltolate treatment group,and a relatively low dose of it was required in in-vitro toxicology study.Therefore,aluminum maltolate posed to be better reagent than the other three for in-vitro aluminum toxicity study.