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@#The experience of famous and veteran physicians in traditional Chinese medicine （TCM） is a supplement to the cognition of industry groups and a high-quality learning resource. Digital inheritance of the experience of famous and veteran TCM physicians refers to the use of digital technology to record， organize， protect， spread， share and innovate the knowledge， skills and experiences of famous and veteran TCM physicians， which helps to overcome the inefficiency of traditional experience inheritance and realize the inheritance and development of TCM culture. Digital inheritance has certain advantages in accessibility， loss resistance， accuracy， innovation ability and effectiveness， which can assist the digital preservation， analysis and excavation of the experience of famous and veteran TCM physicians， and is an important supplement to the traditional way of learning from teachers. Digital inheritance is usually divided into the following steps： building a database of TCM knowledge， building a database of experienced medical records of famous and veteran TCM physicians， discovering laws by data mining， and assisting clinical decision-making with machine learning. The digital inheritance of famous and veteran TCM physicians is not only the use of experience information， but also the process of innovation and productization based on experience， which may become a new service model of TCM diagnosis and treatment.
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The experience of famous and veteran physicians in traditional Chinese medicine （TCM） is a supplement to the cognition of industry groups and a high-quality learning resource. Digital inheritance of the experience of famous and veteran TCM physicians refers to the use of digital technology to record， organize， protect， spread， share and innovate the knowledge， skills and experiences of famous and veteran TCM physicians， which helps to overcome the inefficiency of traditional experience inheritance and realize the inheritance and development of TCM culture. Digital inheritance has certain advantages in accessibility， loss resistance， accuracy， innovation ability and effectiveness， which can assist the digital preservation， analysis and excavation of the experience of famous and veteran TCM physicians， and is an important supplement to the traditional way of learning from teachers. Digital inheritance is usually divided into the following steps： building a database of TCM knowledge， building a database of experienced medical records of famous and veteran TCM physicians， discovering laws by data mining， and assisting clinical decision-making with machine learning. The digital inheritance of famous and veteran TCM physicians is not only the use of experience information， but also the process of innovation and productization based on experience， which may become a new service model of TCM diagnosis and treatment.
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Primary hemifacial spasm is a motor disorder of facial muscles related to facial nerve. During the attack, the facial muscles present irregular and involuntary clonus, which can be induced or aggravated by emotional excitement, mental tension and random facial movement, seriously affecting daily work and life. The pathogenesis, diagnosis, differential diagnosis and treatment of the primary hemifacial spasm have been studied extensively in recent years. This article reviews the progress in these aspects.
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Objective:To investigate the clinical effects of health and safety management in elderly patients receiving gastroenteroscopy under sedation.Methods:From February 2018 to November 2019, 126 elderly patients admitted to the cadre medicine and gerontology department of our hospital to undergo gastroenteroscopy under sedation were included as research subjects.According to the digital random number method, they were divided into the control group and the test group(n=63, each group). The control group was given routine management, while the test group was given routine management plus health and safety management.Clinical effects and safety were analyzed and compared between the two groups.Results:There was no significant difference in scores of the Hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD)between the two groups before intervention.After intervention, the scores of HAMA and HAMD were lower in the test group than in the control group[(39.2±3.1)scores vs.(48.6±2.1)scores, (40.1±4.1)scores vs.(52.6±5.5)scores, t=19.926 and 14.463, both P=0.000]. The incidence of postoperative complications was lower in the test group than in the control group(7.94% or 5/63 vs.19.05% or 12/65, χ2=14.209, P=0.002). The differences between maximum and minimum values of heart rate(HR), diastolic blood pressure(DBP), respiratory rate(RR)and systolic blood pressure(SBP)were lower in the test group than in the control group(all P<0.05). The length of the procedure was shorter and the anesthetic dose was lower in the test group than in the control group(9.11±2.56 min vs.13.56±3.05 min, 15.35±2.66 ml vs.21.67±6.15 ml, t=8.870 and 7.486, both P=0.000). Patient satisfaction was higher in the test group than in the control group( χ2=16.383, P=0.014). Conclusions:Health and safety management can improve emotional health, stabilize vital signs and enhance satisfaction in elderly patients undergoing gastroenteroscopy under sedation.
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Objective To establish a modified dual liver transplantation rat model. Methods Based on the classic donor Y-shaped double iliac vein recanalization of bilateral liver grafts and portal vein and bile duct of the recipients, the dual liver transplantation rat model was modified by increasing the rat body mass, increasing the right lower lobe of the right graft, appropriate bile duct length, trimming Y-shaped blood vessels, and "triangular" anastomosis. The operation time, cold ischemia time, warm ischemia time and anhepatic phase of dual liver transplantation were recorded. The incidence of postoperative complications of the recipients was observed. The survival rates of the recipients at postoperative 7 and 30 d were calculated. Results The operation time of dual liver transplantation in rat was (114±7) min, the cold ischemia time was (36±3) min, the warm ischemia time was (9.7±1.6) min, and the anhepatic phase was (19.9±2.2) min, respectively. The incidence of postoperative complications in the recipient rats was 31% (5/16) including 2 cases of peritoneal effusion, 1 case of hemorrhage, 1 case of bile leakage and 1 case of respiratory obstruction. The postoperative 7- and 30-d survival rates of the recipient rats were 81%(13/16)、56%(9/16), respectively. Conclusions The modified technique can establish a stable dual liver transplantation rat model, which deserves widespread application.
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Mitochondria-associated membranes (MAMs) are highly specialized subcellular regions composed of the endoplasmic reticulum and mitochondrial outer membrane connected by proteins. They participate in several important cell events such as calcium homeostasis maintenance, cell apoptosis, lipid synthesis and utilization, and cell autophagy, and also provide a platform for antiviral signal transduction and Nod-like receptor protein-3 (NLRP3) inflammasome assembly. Thus, MAMs play an important role in resisting pathogen infection. However, pathogens have evolved different coping strategies such as targeting MAMs to escape or antagonize host immune response, or regulating the functions of MAMs to facilitate infection. The most common reason of inflammatory response is pathogen infection. The disorder of acute inflammatory response usually leads to a series of chronic inflammatory diseases. This review summarized the relationship between the functions of MAMs and pathogen-induced inflammatory response.
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Objective:To investigate the clinical features and prognosis of acute myocardial infarction with or without cardiovascular risk factors.Methods:22 780 patients with acute myocardial infarction registered with the National Health Commission from November 2015 to December 2018 were analyzed. After excluding 3 432 patients, the patients were divided into two groups according to whether there were cardiovascular risk factors. The control group (2 840 cases) had no cardiovascular risk factors, and the observation group (16 508 cases) had cardiovascular risk factors. The clinical characteristics, cardiac function indexes, complications and prognosis were observed between the two groups.Results:There were significant differences in age, symptoms, blood pressure, heart rate, blood glucose, creatinine, total cholesterol, triglyceride, high density lipid-cholesterol (HDL-C) and low density lipid-cholesterol (LDL-C) between the two groups ( P<0.05). The results of coronary angiography showed that there were significant differences in single vessel disease, left main or multiple vessels, left anterior descending branch, left circumflex branch, right coronary artery and left main artery between the two groups ( P<0.05). There was no difference in mortality (2.6% vs 3.1%, P=0.450) and complications (20.6% vs 20.0%, P=0.647) between the observation group and the control group. One year later, the clinical results showed that the all-cause mortality of the control group was 2.0% (57/2 840) and that of the observation group was 1.3% (215/16 508), with statistically significant difference ( P=0.031). Conclusions:Even without cardiovascular risk factors, elderly patients are prone to acute myocardial infarction. Therefore, patients without any cardiovascular risk factors still need to be given full monitoring.
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The anoikis resistance confers the ability of cancer cells to survive and metastasize in the blood circulation without adhesion,but its effect and mechanism in intrahepatic and distant metastasis of hepatocellular carcinoma has not been fully elucidated.Recent studies have shown that certain factors or drugs may inhibit anoikis of hepatoma cells through some signaling pathways.These signaling pathways are not completely separated,they are interconnected to promote metastasis of hepatocellular carcinoma.Liver is the metabolic center of many substances,and many related factors can promote metastasis of hepatocellular carcinoma through inhibiting anoikis.In this review,we summarized the signaling pathways of anoikis resistance of hepatocellular carcinoma.
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Objective To analyze the influence of liraglutide intervention combined percutanous coronary intervention(PCI) therapy on acute myocardial infarction( AMI) with type 2 diabetes( T2DM) patients'myocardial injury, ventricular remodeling( VR), and cardiac function. Methods Eighty patients with AMI and T2DM were included in the study, and they were randomly divided into observation group and control group according to the random number table, each with 40 patients. The patients in the control group received metformin and conventional insulin combined PCI treatment, and the patients in the observation group received metformin and liraglutide combined PCI treatment. The changes in the values of ventricular remodeling indexes, cardiac function and serum related indexes were compared after 3 months treatment between the two groups. Results ( 1) The body weight and fasting blood glucose levels of the observation group were significantly lower than those of the control group( P＜0.05), and fasting insulin levels were significantly higher than those of the control group(P＜0.01). (2)The levels of N-terminal-pro-B- type natriuretic peptide ( NT-proBNP ), creatine kinase isoenzymes-MB ( CK-MB), and troponin I ( TnI) in the observation group 3 months after treatment were significantly lower than those in the control group(P＜0.05). (3)The levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group 3 months after treatment( P＜0. 05). ( 4) The values of left ventricular end systolic diameter ( LVESD ), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness ( IVST), left ventricular posterior wall thickness ( LVPWT), left ventricular mass index ( LVMI), left ventricular end systolic volume ( LVESV), and left ventricular end diastolic volume(LVEDV) in the observation group were lower than those in the control group; the values of left ventricular fraction shortening(LVFS), left ventricular ejection fraction(LVEF), and mitral valve early diastolic blood flow rate (VE)/atrial systolic flow velocity ( VA), all were higher than those of the control group ( P＜0. 05). Conclusion Lraglutide intervention combined with PCI therapy on AMI with T2DM patients may reduce myocardial injury, induce ventricular remodeling, enhance cardiac function, and improve prognosis.
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Objective To explore the correlation between the level of glucagon like peptide-1 (GLP-1) and the extent of coronary lesions in coronary heart disease (CHD).Methods One hundred and ninety-two CHD patients included in the study were divided into simple CHD group (n =60),CHD accompanied with impaired glucose tolerance(IGT) group (n =67),and CHD accompanied with type 2 diabetes mellitus (T2DM) group (n =65).48subjects were used as controls.The levels of GLP-1 in all the patients were analyzed by ELISA.Oral glucose tolerance test (OGTF) was performed.Blood glucose,insulin,and C-peptide levels were measured.The area under curves of insulin(AUCINS),C-peptide (AUCC-P),glucose (AUCGlu),and GLP-1 (AUCGLP-1) were calculated.All the patients underwent coronary angiography and the extent of coronary lesions was analyzed by total amount of coronary narrow degree integral.The association of GLP-1 level with coronary narrow degree was analyzed by correlation analysis and multivariate linear stepwise regression analysis.Results The levels of blood glucose and AUCGlu during OGTT in CHD accompanied with T2DM group were significantly higher than those in CHD with IGT group (P＜0.01),while the levels of insulin and C-peptide,AUCINS,and AUCC-P were decreased (P＜0.05).The levels of blood glucose,insulin,C-peptide,AUCGlu,AUCINs,and AUCC-P in CHD accompanied with IGT group were significantly higher than those in control group and simple CHD group (P＜0.01).Compared with simple CHD group and CHD accompanied with IGT group,GLP-1 level in CHD accompanied with T2DM group was markedly decreased(P＜0.01) while coronary artery narrow degree was raised(P＜ 0.05).Compared with simple CHD group,CHD accompanied with IGT group showed lower GLP-1 level and higher coronary artery narrow degree(P＜0.01).Correlation analysis revealed that GLP-1 level was negatively correlated with the coronary artery narrow degree in CHD patients (P ＜ 0.01).Multivariate linear regression analysis showed that systolic blood pressure,high density lipoprotein-cholesterol,fasting C-peptide and GLP-1 had a predictive effect on the coronary narrow degree integral in CHD patients.Conclusion The level of GLP-1 is closely correlated with the coronary artery narrow degree in CHD patients,especially in patients accompanied by hyperglycemia.
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Shortage of donors is a major obstacle for liver transplantation.Lee innovated dual graft living donor liver transplantation in 2001,obtained graft from two donors,and it was conducted in various parts of the world.At present,South Korea has the biggest numbers in operation,China,Japan,and Germany.Turkey,Romania,and other countries are relatively less;current clinical liver donor liver transplantation is mainly based on single graft living donor liver transplantation,and in some complicated cases,single graft liver transplantation cannot be completed due to various factors,at this situation dual grafts living donor liver transplantation can complete the treatment.Although dual donor liver transplantation can only be carried out in a few areas due to complex surgical procedures,it can enrich the treatment of liver transplantation and promotes the development of liver transplantation.
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Objective To investigate the change of the error positivity(Pe)of event-related poten-tial(ERP)under Flanker task in adolescents with smoking addiction. Method The signals of ERP during the Flanker task in fifteen adolescents with smoking addiction were compared with that of 15 non-smoking ad-olescents. Results The Pe amplitude in adolescents with smoking addiction((3.575±2.299)μV)was sig-nificantly lower than that of non-smokers((5.865 ± 4.290)μV)(F=5.324,P=0.029),and the reaction time of the Flanker task in smoking addiction adolescent group((440.754± 36.051)ms)was significantly higher than that in the control group((422.850±20.194)ms)(F=0.620,P<0.05).The Pe amplitude in ado-lescents with smoking addiction was positively correlated with smoking index(pack-years)(r=0.599,P=0.018). Conclusion The adolescents with smoking addiction may exit worse ability of error monitoring dur-ing the Flanker task.
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Objective To systematically evaluate the effect of different administration methods of hydrocortisone on blood glucose in patients with septic shock. Methods The Cochrane Library, PubMed, Web of Science, Embase, CNKI, CBM, Wanfang, and VIP databases were searched from foundation to December 31st, 2017 for the randomized controlled trials (RCTs) about hydrocortisone on blood glucose of different drug-deliver ways in patients with septic shock. In addition, the citation retrievals were performed by the literature references. Then the quality evaluation and data extraction was conducted by two researchers independently according to the Cochrane systematic review methods. RevMan 5.3 software was utilized to perform meta-analysis on the influences of the two different administration methods of the continuously pumping hydrocortisone group (experimental group) vs. the intermittently dripping hydrocortisone group (control group) on the mean blood glucose (MBG), largest amplitude of glycemic excursion (LAGE), glucose variability (GV), hyperglycemia time window in patients with septic shock. Results 1 203 relevant articles were preliminarily searched. Then the duplications were removed, reviews, and non-RCTs and articles evidently not accordant with the inclusion criteria were excluded by titles and abstracts. Eventually a total of 5 well-designed RCTs (404 cases) were incorporated, including 201 cases in the experimental group and 203 cases in the control group. The results of meta-analysis showed that compared with the control group, MBG was significantly decreased in the experimental group [mean difference (MD) = -0.99, 95% confidence interval (95%CI) = -1.53 to -0.45, P < 0.05], LAGE was decreased (MD = -5.66, 95%CI =-6.92 to -4.41, P < 0.05), GV was reduced (MD = -0.67, 95%CI = -0.82 to -0.53, P < 0.05), and hyperglycemia time window was shortened (MD = -7.68, 95%CI = -9.03 to -6.33, P < 0.05). The funnel chart revealed that there was publication bias in the MBG, hyperglycemia time window of the articles, and the publication bias was lower in the LAGE and GV. Conclusion Compared with intermittent administration method, the continuous pumping hydrocortisone method can stabilize the blood glucose of septic shock patients, shorten the duration of hyperglycemia and reduce the peak value of blood glucose.
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Cholangiocarcinoma is a malignant tumor originating from bile duct epithelial cells, among which hilar cholangiocarcinoma is the most common, accounting for about 58％-70％ of cholangiocarcinoma. Due to its atypical clinical features, special anatomical site, low radical resection rate, high recurrence rate and poor prognosis, the 5-year survival rate of hilar cholangiocarcinoma was only 14.7％-33.8％. Hence, the most effective method of hilar cholangiocarcinoma lies in early diagnosis and radical resection. Good perioperative management can improve the rate of radical resection of hilar cholangiocarcinoma and contribute a lot to prognosis of the patients. The perioperative management of hilar cholangiocarcinoma is described as follows.
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Primary sclerosing cholangitis (PSC) is a common autoimmune liver disease,and the diversity of its treatment methods has been hotly discussed by scholars in various countries.As the best treatment,end-stage liver transplantation (LT),due to the related diseases,such as postoperative complications greatly limits its wide application in clinical practice.Early assessment and intervention can reduce the risk of concomitant disease and reduce the occurrence of postoperative complications.In this paper,the status of LT indications,timing and related disease management,postoperative complications and other aspects of PSC patients were reviewed.
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Objective To detect the plasma concentration of tacrolimus and the survival time of rats after small-volume liver transplantation,and to investigate the criteria for immunological rejection after small-volume liver transplantation.Methods Lewis rats and Brown Norway rats were used to establish a small volume and normal liver volume transplantation model,which were divided into 7 groups:whole liver transplantation group (WI),small volume allogeneic liver transplantation group (SI),and whole liver allograft group (WA),small volume allogeneic liver transplantation group (SA),whole liver allograft immunotherapy group (WAT),small volume allogeneic liver transplantation immunotherapy group (SAT),small volume allogeneic liver transplantation immunotherapy modulation group (SATa).Morphological and functional changes of liver tissue were studied postoperatively,AST and tacrolimus plasma concentrations were detected,and survival was recorded.Results Compared with the WA group,the inflammatory cells infiltrated in the portal area of the SA group,the inflammatory changes of the sinusoidal endothelial cells,and the proportion of TCRpositive lymphocytes increased.Four days after transplantation,peripheral blood tests showed that CD4+CD25+ double positive lymphocytes were significantly lower in the allograft group than in the allograft group,and the positive expression rate in the SA group (0.6％) was significantly lower than that in the WA group (1.8％).The differences were statistically significant (P＜0.05).In the SAT group,the blood concentration of tacrolimus was significantly higher than that in the WAT group at each time point (P＜0.05).The blood concentration of tacrolimus in the SATa group was relatively stable,and the plasma concentration of the SATa group was stable.And AST was significantly lower than the SAT group,the differences were statistically significant (P＜0.05).Compared with WAT group,the proliferation and apoptosis rate of hepatocytes in SAT group and SATa group were significantly increased.The proliferation of hepatocytes in SATa group was significantly higher than that in SAT group (P＜0.05).Survival analysis showed that the cumulative survival rate of the WA group was 85.7％,which was significantly higher than that of the SAT group (28.6％).The difference was statistically significant (P＜0.05).The cumulative survival rate of the SATa group was 51.7％.The survival time of WAt group was (57.4±25.0) days,SAT group was (28.0±29.10) days,SATa group was (39.7± 29.0) days,which were longer than untreated groups.The ratio of proliferation to apoptosis (PRA) increased with increasing time of tacrolimus.Regardless of blood concentration,tacrolimus plasma concentration was positively correlated with AST (R =0.758,P＜0.05),indicating RPA was inversely correlated with AST (R=-0.962,P＜0.05).Conclusion The use of tacrolimus significantly prolonged the survival time of small-volume allogeneic liver transplantation rats.Adjusting the amount of tacrolimus under the guidance of tacrolimus plasma concentration and AST serum value equation TD =-0.494TC-0.0035AST+ 260.487 to make the blood concentration relatively stable,it can further extend the allogeneic liver transplantation rat time to live.
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Polyhydroxyalkanoates are polyesters of hydroxyalkanoates synthesized by many bacteria and haloarchaea as carbon and energy storage materials. There are more than 150 types of polyhydroxyalkanoate monomers reported, resulting in a variety of Polyhydroxyalkanoates with diverse properties. The material variability, nonlinear optical properties, piezoelectric properties, gas barrier properties, thermoplasticity, biodegradability, and biocompatibility allow polyhydroxyalkanoates to be used for plastic packaging, chiral chemicals generation, medicine, agriculture and bio-energy fields. This review introduces the current applications and future development of polyhydroxyalkanoates.
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Objective To observe the changes of electroencephalogram (EEG) signal during the resting state in adolescents with smoking addiction.Methods Spectral analysis during the resting state was used to observe and analyze the EEG signals between adolescents with smoking addiction (n=21) and nosmoking control group (n=21) by using Brain Vision Analyzer software.Results Compared with the nosmoking control group,adolescents with smoking addiction showed increased alpha band signals in 3 brain regions (including left-anterior,right-anterior and midline-anterior regions,P＜0.05),and decreased delta band signals in 3 brain regions (including right-posterior,midline-anterior and midline-posterior regions,P＜0.05).Moreover,the signals in these brain regions were positively correlated with pack-years (alpha band:left-anterior(r=0.648,P=0.003),right-anterior (r=0.629,P=0.004),midline-anterior (r=0.456,P=0.043);delta band:right-posterior (r=0.602,P =0.005),midline-anterior (r =0.533,P=0.019),midline-posterior (r=0.692,P=0.001))in adolescents with smoking addiction.Conclusion The changes of EEG signals during the resting state in adolescents with smoking addiction may be associated with cumulative effects of smoking.
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Objective To investigate the association between matrix metalloproteinase 9(MMP 9) and type 2 diabetic macroangiopathy and explain the mechanism of Simvastatin protective effects on blood vessel.Methods The serum MMP 9 was determined by ELISA in 40 healthy controls and 80 type 2 diabetes(including 40 type 2 diabetic macroangiopathy and 40 type 2 diabetes without complications) before and after Simvastatin treatment.Results The serum MMP 9 in type 2 diabetic macroangiopathy was higher than that in type 2 diabetes without complications and healthy controls.Serum MMP 9 was correlated positively with TC,LDL C,Ox LDL and blood pressure and correlated negatively with HDL C. After Simvastatin treatment,the levels of serum MMP 9 were reduced and serum TC,LDL C and Ox LDL were also decreased.Conclusion MMP 9 may play an important role in the development and progression of type 2 diabetic macroangiopathy.The protective effects of Simvastatin on blood vessel partly attribute to its lowering of serum MMP 9.