Analysis of risk factors and a predictive model of malnutrition in disabled stroke patients / 中华物理医学与康复杂志

Objective:To analyze the risk factors for malnutrition among disabled stroke survivors and devise a prediction model.Methods:A total of 373 disabled stroke survivors treated in the Department of Rehabilitation Medicine, the First Affiliated Hospital of Zhengzhou University in 2021 formed a control group ( n=102) and a malnutrition group ( n=271) according to their nutritional status. Univariate correlation analysis and multivariate logistic regression were used to analyze the risk factors for malnutrition and their predictive value. Results:Age, dysphagia, pulmonary infection, disability score and feeding style were found to be related significantly to the occurrence of malnutrition. Multivariate logistic regression confirmed that age, pulmonary infection, dysphagia, low total intake and a low Barthel index were useful predictors of malnutrition in such persons. Moreover, patients who had received nasogastric tube feeding were at much higher risk of malnutrition than those with intermittent oroesophageal tube feeding. The area under the receiver operating characteristics curve of the Barthel index combined with dysphagia to predict malnutrition was 0.84. The critical value was 0.67 with a sensitivity of 88% and a specificity of 72.5%.Conclusions:Age, pulmonary infection, dysphagia, feeding method, total intake and disability score are risk factors for malnutrition in disabled stroke survivors. The Barthel index combined with dysphagia has good predictive power for the occurrence of malnutrition in such persons.

Effects of hypoxia preconditioning on hematology-related indexes through hypoxia inducible factor-1α/ stromal cell-derived factor-1 pathway in rats / 解剖学报

[Abstract] Objective To study the role of hypoxia inducible factor-1α (HIF-1α) / stromal cell-derived factor-1 (SDF-1) pathway in high altitude hypoxia preconditioning in rat. Methods Seventy-six adult male SD rats, which through fed in low-pressure oxygen chamber (altitude 5000 m) and Xining (altitude 2260 m) to establish the rat model of hypoxia preconditioning. Rats randomly divided into 6 groups: control group (Ctrl), high altitude hypoxic preconditioning 1 day group (HHP-1d), high altitude hypoxic preconditioning 4 days group (HHP-4d), high altitude hypoxic preconditioning 15 days group (HHP-15d), high altitude hypoxic preconditioning 30 days group (HHP-30d), medium altitude hypoxic preconditioning group (MHP). 7. 0 T small animal MRI was used to observe the intracranial structure, diameter of basilar artery and cerebral blood flow in the hippocampus and brainstem regions by the sequences of T2 weighted images (T2WI) and arterial spin labeling (ASL) in the groups of Ctrl, HHP-4d, HHP-30d and MHP. In each group, blood routine was tested, the concentrations of HIF-1α, SDF-1 in serum, platelet activating factor (PAF)and P-selectin (SELP) in plasma were detected by the method of ELISA. Results In the hypoxia preconditioning groups, intracranial structure and diameter of basilar artery had no significant difference, while cerebral blood flow in the regions of brainstem and hippocampus increased significantly (P<0. 05). Meanwhile, red blood cell and white blood cell increased significantly, while platelet decreased significantly in the groups of hypoxia preconditioning (P<0. 05). Red blood cell and platelet in MHP group were closer to Ctrl group. The concentrations of HIF-1α and SDF-1 (except HHP-1d group) increased significantly in hypoxia preconditioning groups (P<0. 05).The concentrations of PAF and SELP increased significantly in HHP-1d and HHP-15d groups. The concentration of PAF decreased significantly in the HHP-4d and HHP-30d groups, and SELP decreased significantly in HHP-4d group (P<0. 05). Conclusion Hypoxia preconditioning can increase oxygen storage and immune defense capacity, improve brain reserve capacity and play the effect of brain protection through HIF-1α/ SDF-1 pathway. The best effect preconditioning was feed at medium altitude (altitude 2260 m) for 30 days.

Meroterpenoids from Rhododendron nivale / 中国中药杂志

To elucidate the chemical material basis of Rhododendron nivale, this study comprehensively used various chromatographic techniques to isolate and obtain five new meroterpenoid enantiomers(1a/1b-5a/5b) from the ethyl acetate extract of R. nivale. A variety of spectral analytical methods, such as high-resolution mass spectrometry(HRMS), nuclear magnetic resonance spectroscopy(NMR), and infrared(IR) spectrum, were used to evaluate the structure, combined with the measurement and calculation of electronic circular dichroism(ECD). The new compounds 1a/1b-4a/4b were named as(±)-nivalones A-B(1a/1b-2a/2b) and(±)-nivalnoids C-D(3a/3b-4a/4b), along with one known enantiomer(±)-anthoponoid G(5a/5b). Human neuroblastoma cells(SH-SY5Y cells) induced by hydrogen peroxide(H_2O_2) were used as oxidative stress models to evaluate the protective activity of the isolated compounds against oxidative damage to nerve cells. It was found that compounds 2a and 3a had a certain protective effect on nerve cells against H_2O_2-induced oxidative damage at concentrations of 50 μmol·L~(-1), which increased the cell survival rate from 44.02%±2.30% to 67.82%±1.12% and 62.20%±1.87%, respectively. Other compounds did not show a significant ability to protect cells from oxidative damage. These findings enrich the chemical constituents of R. nivale and provide valuable information for identifying the structure of its meroterpenoids.

The application of intermittent oro-esophageal tube feeding in cerebral hemorrhage patients undergoing tracheotomy / 中华物理医学与康复杂志

Objective:To explore the effects of intermittent oral-esophageal tube feeding (IOE) on cerebral hemorrhage (CH) survivors receiving a tracheotomy.Methods:A total of 126 CH patients undergoing tracheotomy were randomly divided into an IOE group ( n=65) and a nasogastric tube feeding (NGT) group ( n=61). The feeding continued for 4 weeks along with medication and thorough rehabilitation interventions (including hemiplegic limb training, swallowing training, and pulmonary function training). Before and after the treatment, the body mass index, hemoglobin, albumin, proalbumin, creatinine height index, extubation rate and intubation time of the tracheotomy, as well as the incidence of complications were evaluated for both groups. Both groups were also assessed using the clinical pulmonary infection scale (CPIS) and National Institutes of Health stroke scale (NIHSS). Results:After the 4 weeks the nutrition indexes, average extubation rate (90.76%) and intubation time [(15.96±3.86)d], CPIS score (3.00±1.69), NIHSS score (11.86±4.08) and the overall incidence of complications in the IOE group were all significantly better than the NGT group′s averages.Conclusions:Where feasible, intermittent oro-esophageal tube feeding is superior to nasogastric tube feeding of cerebral hemorrhage patients undergoing tracheotomy. It reduces the risk of pulmonary infection and other complications, resulting in early removal of the tracheotomy cannula and quicker recovery.

Factors influencing the extubation of patients in a vegetative state after tracheotomy / 中华物理医学与康复杂志

Objective:To explore the factors influencing the extubation time of patients in a persistent vegetative state (PVS) after tracheotomy so as to provide a theoretical basis for early extubation for such patients.Methods:Clinical data were collected on PVS patients after a tracheotomy. The cases were divided into an extubation group and a difficult extubation group according to whether the extubation was successful or not. Version 22.0 of the SPSS software was used to evaluate univariate and multivariate logistic regressions analyzing the factors influencing the success of extubation.Results:The single-factor analysis revealed significant differences between the groups in terms of average age, nursing level, nutrition, swallowing function, hypoalbuminemia and incubation time. Gender, brain injury, stroke, ischemic anoxic encephalopathy and lung infection were not, however, significant predictors. The multivariate logistic regression analysis highlighted nutritional mode, swallowing function, intubation time, pulmonary infection, full-time care and age as independent predictors of extubation success.Conclusions:Intermittent oral to esophageal tube feeding and full-time care are protective factors for extubation of patients in a PVS after a tracheotomy. Swallowing disorders, intubation for more than 30 days, pulmonary infection and greater age are risk factors for unsuccessful extubation. Nutritional support, swallowing function training and intensive nursing can effectively improve the success rate of extubation.

Effects of intermittent oro-esophageal tube feeding on functional recovery from severe brain injury / 中华物理医学与康复杂志

Objective:To explore the effect of intermittent oro-esphageal tube feeding (IOE) on functional recovery from severe brain injury complicated by tracheotomy.Methods:A total of 98 patients with severe brain injury and tracheotomy were randomly divided into an observation group and a control group. All received neurotrophic and anti-infection medication, physical therapy, acupuncture and exercise. The observation group was also given intermittent oro-esophageal tube feeding, while the control group was given nasogastric tube feeding for 4 weeks. Before and after the treatment, each patient′s nutritional status, extubation time and extubation rate of the tracheotomy, and Glasgow Coma Scale score was evaluated as well as the incidence of complications.Results:After the 4 weeks the average hemoglobin, albumin and pre-albumin levels of the observation group and its average body mass index were all significantly better than the control group′s averages. It also had a significantly better overall incidence of complications, average extubation rate, average extubation duration and average GCS score.Conclusions:Where feasible, intermittent oro-esphageal tube feeding is superior to nasogastric tube feeding for improving the nutritional status and consciousness level of patients with severe brain injury. It promotes early removal of the tracheotomy cannula, which inhibits complications.

Terpinen-4-ol inhibits proliferation, migration and invasion and promotes apoptosis of glioma U87 and U251 cells / 中国药理学通报

Aim To investigate the effect of T40 on malignant biological behavior of glioma U87 and U251 cells and its mechanism. Methods U87 and U251 cells were treated with T40 at different concentrations (0,1,2 and 4 p,mol • L"1). Changes of cell proliferation, clonal formation, apoptosis, migration and invasion in each group were detected by CCK-8, cloning plate, flow cytometry, scratch and transwell experi-ments. Bioinformatics was used to explore T40 targets and analyze the relationship between targets and glioma progression. The protein expression levels of PTPN1, PTPN2, Bcl-2, Bax, pro-caspase-3 , cleaved caspase- 3, MMP-2 and MMP-9 in each group were detected by Western blot. Results T40 significantly inhibited U87 and U251 proliferation, clone formation, migration and invasion and promoted apoptosis ( P < 0. 05 ) ; T40 had 37 targets, among which the expression levels of PTPN1 and PTPN2 were negatively correlated with the overall survival rate of glioma patients; T40 signifi cantly reduced the expression of PTPN1, PTPN2, Bcl- 2, MMP-2 and MMP-9 in U87 and U251 cells, and increased the expression of Bax and cleaved caspase-3 (P < 0. 05). Conclusions T40 inhibits the proliferation , migration and invasion of glioma U87 and U251 cells and promotes their apoptosis, and its mechanism may be related to the reduction of PTPN1 and PTPN2 expression.

Preliminary study on cerebrospinal fluid proteomics of Erxian Decoction against neurogenesis impairment in late-onset depression / 中国中药杂志

This study aims to elucidate the underlying mechanism of Erxian Decoction(EXD) against neurogenesis impairment in late-onset depression(LOD) rats based on cerebrospinal fluid(CSF) proteomics. A total of 66 20-21-month-old male Wistar rats were randomized into naturally aged(AGED) group, LOD group, and EXD group. All rats received chronic unpredictable mild stress(CUMS) for 6 weeks for LOD modeling except for the AGED group. During the modeling, EXD group was given EXD(ig, twice a day at 4 g·kg~(-1)) and other groups received equivalent amount of normal saline(ig). After modeling, a series of behavioral tests, such as sucrose preference test(SPT), open-field test(OFT), forced swimming test(FST), and Morris water maze test(MWMT) were performed. Immunofluorescence method was used to detect the number of Ki-67/Nesti-positive cells and BrdU/DCX-positive cells in the hippocampal DG area of each group. High-concentration corticosterone(CORT) was combined with D-galactose(D-gal) to simulate the changes of LOD-related stress and aging and the proliferation and differentiation of primary neural stem cells of hippocampus in each group were observed. Data independent acquisition(DIA)-mass spectrometry(MS) was used to analyze the differential proteins in CSF among groups and bioinformatics analysis was performed to explore the biological functions of the proteins. Behavioral tests showed that sucrose consumption in SPT, total traveling distance in OFT, and times of crossing the platform in MWMT were all reduced(P<0.01) and the immobility time in FST was prolonged(P<0.01) in the LOD group compared with those in the AGED group, suggesting that LOD rats had developed depression symptoms such as anhedonia, decreased locomotor activity ability, and cognitive dysfunction. Behavioral abnormalities were alleviated(P<0.01, P<0.05) in the EXD group as compared with those in the LOD group. Immunofluorescence results demonstrated that Ki-67/Nesti-positive cells and BrdU/DCX-positive cells in the hippocampal DG area were fewer(P<0.05) in LOD group than in the AGED group, and the positive cells in the EXD group were more(P<0.05) than those in the LOD group. In vitro experiment showed that the proliferation and differentiation of primary hippocampal neural stem cells under the CORT+D-gal treatment were reduced(P<0.01). The proliferation rate of neural stem cells decreased(P<0.05) in CORT+D-gal+LOD-CSF group but increased(P<0.01) in CORT+D-gal+EXD-CSF group compared with that in the CORT+D-gal group. A total of 2 620 proteins were identified from rat CSF, with 135 differential proteins between the LOD group and AGED group and 176 between EXD group and LOD group. GDF11, NrCAM, NTRK2, and GhR were related to neurogenesis and 39 differential proteins were regulated by both LOD and EXD. EXD demonstrated obvious anti-LOD effect, as it improved the locomotor activity ability and cognitive function of LOD rats and protected the proliferation and differentiation of hippocampal neural stem cells. EXD exerts anti-LOD effect by regulating the proteins related to neurogenesis in CSF, such as GDF11, NrCAM, NTRK2, and GhR and maintaining hippocampal neurogenesis.

Acupuncture adjuvant treatment for dysphagia in patients with Parkinson's disease: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture on swallowing function and nutritional status of patients with Parkinson's disease (PD) dysphagia.@*METHODS@#A total of 56 patients with PD dysphagia were randomly divided into an observation group and a control group, 28 cases in each one. Both groups were given conventional treatment and swallowing function rehabilitation training.On the basis, the observation group was treated with acupuncture (filiform needling and tongue picking acupuncture). The acupoints of filiform needling were Lianquan (CV 23), Shanglianquan (Extra), Yifeng (TE 17), etc.; and the tongue picking acupuncture was applied at Jinjin (EX-HN 12), Yuye (EX-HN 13) and posterior pharyngeal wall. Rehabilitation training and acupuncture were performed once a day for 5 consecutive days a week, 2 weeks as a course of treatment, 3 courses in total. The swallowing function [oral transit time (OTT), swallowing response time (SRT), pharyngeal transit time (PTT), laryngeal closure duration (LCD)] and nutritional indexes [body mass index (BMI), serum albumin (ALB), serum prealbumin (PA), hemoglobin (Hb)] in the two groups were evaluated before and after treatment, and the clinical effects were compared.@*RESULTS@#After treatment, the paste and liquid OTT, SRT, PTT, LCD in the two groups were shorter than those before treatment (@*CONCLUSION@#Acupuncture-assisted rehabilitation training can improve the swallowing function and nutritional status in patients with Parkinson's disease swallowing disorders.

Intermittent oro-esophageal tube feeding for dysphagia patients with cerebral small vessel disease / 中华物理医学与康复杂志

Objective:To observe the effect of intermittent oro-esophageal tube feeding (IOE) on dysphagia patients with cerebral small vessel disease.Methods:Sixty such patients were randomly divided into an experimental group ( n=30) and a control group ( n=30). In addition to the routine basic treatment and swallowing function training, the control group was given nasogastric tube feeding, while the experimental group was provided with IOE. Before and after two weeks of the treatment the swallowing function and nutritional status of both groups were evaluated along with the incidence of pneumonia, ability in the activities of daily living and general quality of life. Results:Before the intervention, there were no significant differences between the two groups in any of the measurements. Afterward significant improvements were observed in all of the measurements in both groups, but the experimental group had improved significantly more than the control group in terms of each measure.Conclusions:IOE is superior to NG in improving the nutrition and swallowing function of patients with dysphagia and cerebral small vessel disease. It betters their ability in daily life activities and their quality of life.

Effect of electroacupuncture on rehabilitation of knee joint movement after anterior cruciate ligament reconstruction / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on the rehabilitation of knee joint function after anterior cruciate ligament (ACL) reconstruction.@*METHODS@#A total of 140 patients with ACL reconstruction were randomly divided into an observation group (58 cases recruited, 12 cases dropped out) and a control group (65 cases recruited, 5 cases dropped out). The patients in the control group were treated with routine rehabilitation treatment. The patients in the observation group, on the basis of the treatment in the control group, were treated with EA at Fengshi (GB 31), Futu (ST 32), Zusanli (ST 36), Shangjuxu (ST 37), Fenglong (ST 40), Xuanzhong (GB 39), Diji (SP 8) and Sanyinjiao (SP 6) on the affected side (2 Hz/100 Hz of dilatational wave, 2-5 mA). Each EA treatment lasted 20-30 min, twice a day for 7 days. The swelling degree (d), pain visual analogue scale (VAS), knee joint range of motion (ROM), scores of International Knee Documentation Committee (IKDC) subjective short form and scores of Lysholm were observed in the two groups 1 day, 1 month, 3 months, 6 months and 1 year after operation.@*RESULTS@#One month and 3 months after operation, the swelling degree (d) and VAS scores in the observation group were lower than those in the control group (0.05). One month, 3 months, 6 months and 1 year after operation, the ROM of the knee joint in the observation group was higher than that in the control group (<0.05), the IKDC score and Lysholm score were higher than those in the control group (<0.05). Within one year, there were no relaxations, fractures and other related complications in the two groups. The pivot shift test, anterior drawer test and the Lachman test were all negative.@*CONCLUSION@#EA combined with routine rehabilitation training could obviously reduce the pain of knee joint, improve the swelling degree, increase the ROM of knee joint, promote the functional recovery in patients with ACL reconstruction, which are superior to rehabilitation training alone.

Effect of Interleukin-1β Silence on Expression of Vimentin in Rats with Spinal Cord Contusion / 中国康复理论与实践

Objective To observe the expression of vimentin (Vim) after silence of interleukin-1β (IL-1β) in rats with spinal cord contusion (SCC). Methods The model of SCC was established in 30 Sprague-Dawley rats with Allen's method. The rats were randomized into vector group (n=15) and silence group (n=15), which were injected blank lentivirus vector and vector of IL-1β siRNA, respectively; and divided in three, seven and 28 days subgroups. The relationship between IL-1βand Vim was predicted with GeneMANIA bioinformatics. The expression of Vim protein and mRNA in spinal cord was detected with immunohistochemistry and real-time quantitative polymerase chain reaction. Results GeneMANIA bioinformatic analysis indicated that there was some direct and indirect relationship between IL-1β and Vim. The Vim protein and mRNA expressed in the spinal cord, and was less in the silence group than in the vector group (t>2.875, P<0.05). Conclusion Silence of IL-1β can inhibit the expression of Vim in SCC rats, which may promote the recovery of spinal cord function.

Application of modified traction method on endoscopic submucosal dissection / 中华消化内镜杂志

Objective To discuss the safety and clinical efficacy of modified traction method using endoloop and clip for endoscopic submucosal dissection(ESD).Methods Fifty patients who underwent ESD at Renmin Hosptial of Wuhan University between August 2016 and February 2017 were randomly divided into two groups, including 25 patients in modified ESD group and 25 patients in conventional ESD group as control. The therapeutic conditions, dissection time and incidence of complications were compared between the two groups. Results In the modified ESD group, the dissection time of submucosal exposure to the full dissection (19. 9±6. 5 min VS 26. 4±9. 2 min, P＝0. 001), total dissection time (27. 5±8. 1 min VS 35. 1± 10. 7 min, P＝0. 003), and dissection time per unit area (2. 4±1. 1 min/cm2VS 3. 3±1. 3 min/cm2, P＝0. 009) were significantly shorter compared with those in the control group. There were 1 case of delayed bleeding in the modified group and 2 cases in the control group with no significant difference ( P＝0. 248). No perforation occurred. Conclusion The modified traction method using endoloop and clip for ESD is safe and effective with a shorter operation time.

Up-regulation of miR-22 through Wnt pathway suppresses proliferation, migration and invasion in human gastric MGC803 cells by DADS / 中国药理学通报

Aim To investigate the up-regulation of miR-22 through Wnt pathway inhibits the proliferation,migration and invasion in human gastric MGC803 cells induced by diallyl disulfide(DADS).Methods The effects of proliferation,migration,and invasion of gastric cancer cells were evaluated by MTT,wound-healing and invasion assays.Online prediction software was applied to search the target gene of miR-22.Luciferase report gene assay was used to assess the target genes Wnt-1 of miR-22.The expressions of Wnt-1,β-catenin and TCF-4 were tested by qRT-PCR and Western blot,respectively.Results MTT showed that DADS and miR-22 notably decreased the proliferation compared with control group(P<0.05).Wound-healing assay showed that DADS and miR-22 could significantly inhibit the migration of MGC803 cells compared with the control group, especially in miR-22+DADS(P<0.05). Invasion assay showed that DADS and miR-22 could markedly inhibit the invasion of MGC803 cells compared with the control group, especially in miR-22+DADS(P<0.05). Online prediction software to search the target gene exhibited that Wnt-1 may be a target gene of miR-22. Luciferase report gene assay disclosed that Wnt-1 was identified as a direct target of miR-22. Qrt-PCR showed that the expression of Wnt-1 Mrna was respectively down-regulated by DADS and miR-22 compared withcontrol group, especially in miR-22+DADS(P<0.05). Western blot exhibited that DADS and miR-22 obviously suppressed the expressions of Wnt-1, β-catenin and TCF-4 proteins, especially in miR-22+DADS(P<0.05).Conclusion Up-regulation of miR-22 through Wnt pathway can remarkably suppress the proliferation, migration and invasion in MGC803 cells by DADS.

Therapeutic effect of the pre-purse-string suture on gastric lesions of external growth under endoscopy / 中华消化内镜杂志

Objective To investigate the clinical effect of "pre-purse-string" suture on submucous gastric lesions of external growth type in endoscopic patients. Methods Clinical data of 27 patients with gastric lesions of external growth type admitted to the digestive endoscopy center of Renmin Hospital of Wuhan University from August 2016 to October 2016 for endoscopic submucosal dissection ( ESD ) were analyzed. Patients were randomly divided into two groups, the experiment group receiving the "pre-purse-string" suture, the control group receiving purse-string suture after ESD. Mean size of the lesions, procedure time, withdrawal time of gastric decompression, and hospitalization time were compared. Results In the 15 patients of the experiment group, there were 3 cases whose lesions were located in gastric antrum, 6 in gastric body and 6 in gastric fundus. In the 12 cases of the control group, 3 lesions were located in gastric antrum, 5 in gastric body and 4 in gastric fundus. All procedures were successfully completed in endoscopy. No obvious postoperative complications occurred. The mean size of lesions was 2. 5 cm × 3. 2 cm in the experiment group,and 2. 4 cm×3. 0 cm in the control group (P=0. 63). The operation time was 28. 0-43. 0 min (35. 8±6. 1 min) in the experiment group, and 45. 6-68. 8 min (48. 8±5. 3 min) in control group ( P<0. 01) . Conclusion "Pre-purse-string" technique is of clinical effect on gastric submucosal tumor of external growth.

Therapeutic effect of the pre-purse-string suture on gastric lesions of external growth under endoscopy / 中华消化内镜杂志

Objective To investigate the clinical effect of "pre-purse-string" suture on submucous gastric lesions of external growth type in endoscopic patients. Methods Clinical data of 27 patients with gastric lesions of external growth type admitted to the digestive endoscopy center of Renmin Hospital of Wuhan University from August 2016 to October 2016 for endoscopic submucosal dissection ( ESD ) were analyzed. Patients were randomly divided into two groups, the experiment group receiving the "pre-purse-string" suture, the control group receiving purse-string suture after ESD. Mean size of the lesions, procedure time, withdrawal time of gastric decompression, and hospitalization time were compared. Results In the 15 patients of the experiment group, there were 3 cases whose lesions were located in gastric antrum, 6 in gastric body and 6 in gastric fundus. In the 12 cases of the control group, 3 lesions were located in gastric antrum, 5 in gastric body and 4 in gastric fundus. All procedures were successfully completed in endoscopy. No obvious postoperative complications occurred. The mean size of lesions was 2. 5 cm × 3. 2 cm in the experiment group,and 2. 4 cm×3. 0 cm in the control group (P=0. 63). The operation time was 28. 0-43. 0 min (35. 8±6. 1 min) in the experiment group, and 45. 6-68. 8 min (48. 8±5. 3 min) in control group ( P<0. 01) . Conclusion "Pre-purse-string" technique is of clinical effect on gastric submucosal tumor of external growth.

Stellate ganglion block treatment of OSAS combined curative effect observation of patients with high blood pressure / 重庆医学

Objective To observe the stellate ganglion block (SGB) on obstructive sleep apnea syndrome (OSAS) combined the curative effect of sleep respiration and blood pressure control in patients with hypertension.Methods Incorporating meets the criteria for the OSAS patients with high blood pressure in hospital order randomly assigned into normal group and experimental group and routine group was given antihypertension drugs,adjustment in lifestyle,continuous positive airway pressure (CPAP) treatment,the experimental group on the basis of conventional treatment at the same time give SGB to intervene.Using t test on admission and intervention were compared after a period of treatment in patients with sleep apnea and blood pressure control,using 2 test comparison blood pressure control rates of two groups patients.Results Compared with normal group,the experimental group after intervention in a course of apnea hypoventilation index (AHI),SaO2 and 24 h mean arterial pressure were obviously improved,the difference was statistically significant (P＜0.05).Conclusion SGB as a new treatment method,not only can improve clinical symptoms in patients with OSAS,but also make the patients get better control of blood pressure.

Expressions of GLP-1R and CK17 in papillary thyroid cancer and clinical significance / 重庆医学

Objective To investigate the expressions of glucagon-like peptide-1 receptors (GLP-1R) and cytokeratin17 (CK17) in papillary thyroid cancer tissue and clinicopathological significance.Methods The immunohistochemistry and immunoblotting method were employed to detect the expressions of GLP-1R and CK17 in normal thyroid tissues (control group,50 cases) and papillary thyroid cancer tissue (observation group,80 cases).Then the correlation between the expressions of GLP-1R and CK17 with pathological factors of thyroid cancer was analyzed.Results Low expression of GLP-1R was found in 22 cases (44.00 ％) of the control group,while GLP-1R was expressed in 77 cases(96.25 ％) of the observation group,and the difference between both groups was statistically significant(P＜0.01).The expression of CK17 was positive in 8 cases(16.00％) of the control group,while 77 cases(96.25 ％) in the observation group were CK17 expression positive,and the difference between both groups was statistically significant(P＜0.01).The difference between GLP-1 positive expression and clinicopathologic factors had no statistical significance(P＞0.05).The difference between CK17 expression with sex and age had no statistical significance (P＞0.05),and was obviously related with the tumor diameter,clinical stages and cervical node metastasis of thyroid neoplasms(P＜0.05).Conclusion GLP-1R and CK17 all are highly expressed in papillary thyroid cancer tissue and CK17 expression is obviously related with the tumor diameter,clinical stages and cervical node metastasis of papillary thyroid cancer.

Account for Clinical Heterogeneity in Assessment of Catheter-based Renal Denervation among Resistant Hypertension Patients: Subgroup Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Catheter-based renal denervation (RDN) is a novel treatment for resistant hypertension (RH). A recent meta-analysis reported that RDN did not significantly reduce blood pressure (BP) based on the pooled effects with mild to severe heterogeneity. The aim of the present study was to identify and reduce clinical sources of heterogeneity and reassess the safety and efficacy of RDN within the identified homogeneous subpopulations.</p><p><b>METHODS</b>This was a meta-analysis of 9 randomized clinical trials (RCTs) among patients with RH up to June 2016. Sensitivity analyses and subgroup analyses were extensively conducted by baseline systolic blood pressure (SBP) level, antihypertensive medication change rates, and coronary heart disease (CHD).</p><p><b>RESULTS</b>In all patients with RH, no statistical differences were found in mortality, severe cardiovascular events rate, and changes in 24-h SBP and office SBP at 6 and 12 months. However, subgroup analyses showed significant differences between the RDN and control groups. In the subpopulations with baseline 24-h SBP ≥155 mmHg (1 mmHg = 0.133 kPa) and the infrequently changed medication, the use of RDN resulted in a significant reduction in 24-h SBP level at 6 months (P = 0.100 and P= 0.009, respectively). Subgrouping RCTs with a higher prevalent CHD in control showed that the control treatment was significantly better than RDN in office SBP reduction at 6 months (P < 0.001).</p><p><b>CONCLUSIONS</b>In all patients with RH, the catheter-based RDN is not more effective in lowering ambulatory or office BP than an optimized antihypertensive drug treatment at 6 and 12 months. However, among RH patients with higher baseline SBP, RDN might be more effective in reducing SBP.</p>

Practice and Ethical Issues of Long Term Care Mode that Combined Medicine with Pension in Henan Province / 中国医学伦理学

Through an overview of the development of long-term care mode that combined medicine and pen-sion and the existing ethical issues, this paper pointed out that the future long-term care mode should strengthen the enthusiasm of public hospitals to participate in, reduce multiple management by government departments, es-tablish perfect laws and regulations and medical insurance system, enhance the responsibility of the practitioners and the general public, meanwhile, actively practice the principle of humanity and respect, fairness and efficiency, honesty and reliability in ethics, to provide new ideas and directions for the development of this model.