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Objective:To analyze the association between visceral fat area (VFA) and fatty liver based on quantitative CT (QCT) in people receiving health examination with normal body mass index (BMI).Methods:A cross-sectional study. A total of 1 305 physical examiners who underwent chest CT and QCT examination in the Department of Health Management of Henan Provincial People′s Hospital from January to December 2021 were retrospectively selected as subjects. The physical components at the central level of the lumbar two cone were measured with QCT, including subcutaneous fat area (SFA), VFA and liver fat content (LFC). And the metabolic indexes, such as blood lipids and blood glucose, were collected. The t-test and χ2 test were used to analyze the correlation between the detection rate of fatty live and LFCr and age and gender. According to level of VFA (<100 cm 2, 100-150 cm 2 and≥150 cm 2), the subjects were divided into three groups, and one-way ANOVA and χ2 test were used in comparison between groups. Multiple linear regression was used to analyze the correlation between VFA and metabolic indexes and LFC. Results:Of the 1 305 subjects, there were 634 males and 671 females. The detection rate of fatty liver in normal BMI population was 65.67%, and it was 72.71% and 59.02% respectively in men and women ( χ2=27.12, P<0.001), and the detection rate of fatty liver and LFC increased with age (both P<0.05). With the increase of VFA, the age, BMI, SFA, LFC, total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), alanine aminotransferase (ALT), blood uric acid and prevalence of fatty liver increased (all P<0.05), and the low-density lipoprotein cholesterol (HDL-C) decreased ( P<0.001). Multiple linear regression analysis showed that after adjustment for age factors, regardless of male or female, LFC was independently positively related with VFA, BMI, and ALT (male β=0.206, 0.145, 0.174, female β=0.194, 0.150, 0.184; all P<0.05). FBG was positively correlated with male independently ( β=0.134; P<0.001). The indicators related to female independently were TC, TG, and blood uric acid ( β=-0.121, 0.145, 0.141, all P<0.05) Conclusion:In the population receiving health examination with normal BMI, the VFA measured by QCT technique is closely related to fatty liver.
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Objective:To establish a high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of voliconazole (VRC), posaconazole (PCZ), and linazolam (LNZ) in human serum.Methods:This study is a methodological validation by LC-MS/MS. The blood concentration results of VRC, PCZ, and LNZ in our hospital′s anti-infection patients were collected. Voriconazole, Posaconazole, and Linezolid were accurately weighed and prepared. Linezolid-[2H3] was used as the internal standard. After gradient elution on the ACE PFP column, the residuals were analyzed by LC-MS/MS in the positive electrospray ionization mode and multiple reaction monitor (MRM) mode. The method′s linearity, precision, lower limit of detection, and recovery rate were validated according to standard guidelines.Results:The linear correlation coefficient ( r) of the standard curve was above 0.99 ( r>0.99). The linear range of VRC and PCZ were 0.10 mg/L~10.00 mg/L, and the lower limit of detection were 0.01 mg/L. The linear range of LNZ was 0.50 mg/L~50.00 mg/L, and the lower limit of detection was 0.05 mg/L. The recoveries of VRC, PCZ and LNZ were 90.96%-103.18%, 91.84%-99.17%, and 97.04%-100.41%, respectively. Intra-and inter-batch precision (% CV) for VRC were less than 8.30%. Intra-and inter-batch precision (% CV) for PCZ was less than 9.78%. Intra-and inter-batch precision (% CV) for LNZ was less than 7.14%. Drug concentrations in 155 cases of VRC, 44 cases of PCZ, and 59 cases of LNZ were detected. Conclusion:We have established an LC-MS/MS method for the rapid, accurate, highly specific determination of VRC, PCZ, and LNZ concentrations in human serum. This method is suitable for analyzing large clinical sample sets.
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The SARS-COV-2 virus, which causes the COVID-19, is rapidly accumulating mutations to adapt to the hosts. We collected SARS-COV-2 sequence data from the end of 2019 to April 2022 to analyze for their evolutionary features during the pandemic. We found that most of the SARS-COV-2 genes are undergoing negative purifying selection, while the spike protein gene (S-gene) is undergoing rapid positive selection. From the original strain to the alpha, delta and omicron variant types, the Ka/Ks of the S-gene increases, while the Ka/Ks within one variant type decreases over time. During the evolution, the codon usage did not evolve towards optimal translation and protein expression. In contrast, only S-gene mutations showed a remarkable trend on accumulating more positive charges. This facilitates the infection via binding human ACE2 for cell entry and binding furin for cleavage. Such a functional evolution emphasizes the survival strategy of SARS-COV-2, and indicated new druggable target to contain the viral infection. The nearly fully positively-charged interaction surfaces indicated that the infectivity of SARS-COV-2 virus may approach a limit.
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Objective: The characteristics of 3D-FLAIR MRI images of the inner ear of patients with vestibular neuritis were preliminarily studied to explore the possible pathogenesis of vestibular neuritis, and the correlation analysis was conducted in combination with vestibular function to provide a basis for accurate diagnosis of vestibular neuritis. Methods: A total of 36 patients with vestibular neuritis (VN) from December 2019 to October 2020 were collected from the Vertigo Department of Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University. There were 36 cases (18 females, 18 males) with unilateral acute vestibular neuritis, 17 cases of left ear and 19 cases of right ear. According to the results of 3D-FLAIR MRI in the inner ears, the patients were divided into the enhanced group and the non-enhanced group (the health side served as the normal control group). The results of vestibular function examination in the two groups were compared. SPSS19.0 software was used for statistical processing to analyze the relationship between the vestibular function and the characteristics of 3D-FLAIR imaging in the inner ears. Results: Abnormal enhancement of 3D-FLAIR was found in 31 cases (86.1%) of the 36 cases, including 14 cases of both vestibular nerve and vestibular terminal organ enhancement, eight cases of superior vestibular nerve enhancement alone, seven cases of vestibular terminal organ enhancement alone, and two cases of cochlear enhancement alone. Observation of abnormal reinforcement of vestibular nerve showed: twenty-one cases of superior vestibular nerve reinforcement, one case of superior and inferior vestibular nerve reinforcement. No abnormalities were found in 3D-FLAIR of inner ear in 5 cases. According to the analysis of vestibular function results, there were 19 cases (52.8%) with total vestibular involvement, sixteen cases (44.4%) with superior vestibular involvement alone, and one case (2.8%) with inferior vestibular involvement alone. Comparison of vestibular function between the five cases (non-enhancement group) and the 31 cases (enhanced group) in the 3D-FLAIR group of the inner ears showed that the CP values of caloric tests in the enhanced group were higher (60.81±3.49 vs 34.12±7.37), with statistically significant difference (t=-2.898, P<0.01). Conclusion: In patients with vestibular neuritis, 3D-FLAIR MRI scan of the inner ear provides visual imaging evidence for clinical practice, considering that the lesion site of vestibular neuritis is not only in the vestibular nerve, but also in the vestibular end organ. Patients with 3D-FLAIR enhanced in the inner ear may have more significant vestibular function damage.
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Female , Humans , Male , Caloric Tests , Imaging, Three-Dimensional/methods , Magnetic Resonance Imaging/methods , Vestibular Neuronitis/diagnosis , Vestibule, LabyrinthABSTRACT
Objective:This study aimed to explore the feasibility and clinical value of monitoring the progression of early kidney injury in type 2 diabetic patients by assessment of the urinary C-terminal agrin fragment (uCAF) with enzymatic chemiluminescence immunoassay.Methods:A total of 251 patients with type 2 diabetes, who attended the Second Affiliated Hospital of Wenzhou Medical University from October 2018 to March 2020, were included in this retrospective analysis. One hundred and fifty-six participants undergoing health check-up at the Second Affiliated Hospital of Zhejiang University School of Medicine in February 2021 served as controls. Basic clinical information, glycosylated hemoglobin type A 1c and serum creatinine values were recorded, and urine specimens were collected for urinary creatinine, urinary α 1 microglobulin(uα 1M), urinary immunoglobulin G (uIgG), urinary albumin, urinary N-Acetyl-B-D-glycosaminidase (uNAG) and uCAF measurements. Based on the estimated glomerular filtration rate (eGFR), 251 patients were classified into G1~G5 stage groups with 116, 22, 28, 55 and 30 patients in each group. One hundred and sixty-six patients with early diabetic kidney disease (stage G1-G3) were divided into subgroups A1 (79), A2 (48) and A3 (39) according to the urinary albumin/creatinine ratio (UACR), the uα1M levels were divided into uα1M subgroup 1 (83 cases), uα1M subgroup 2 (42 cases), and uα1M subgroup 3 (41 cases), and uIgG subgroup 1 (83 cases), uIgG subgroup 2 (42 cases), and uIgG subgroup 3 (41 cases) according to uIgG levels. The Spearman method was used to analyze the correlation between uCAF levels and eGFR, UACR, uα1M and uIgG levels. Results:(1) The linear range of the uCAF detected by enzymatic chemiluminescence immunoassay was 3.97-2 000.00 ng/ml, with a detection limit of 2.28 ng/ml, intra-batch coefficients of variation of 1.15% and 1.57%, inter-batch coefficients of variation of 1.63% and 5.78%, and a biological reference interval of <95.35 μg/g Cr. (2) The uCAF level and positive rate (UACR≥30 mg/g) increased with the decrease of eGFR from G1-G3, uCAF level was negatively correlated with eGFR value ( r=-0.543, P<0.000 1), and the positive rate increased from 24.14% (28/116) to 85.71% (24/28) from G1-G3. The uCAF level and positivity rate decreased with the decrease of eGFR from G4 to G5. uCAF level was positively correlated with eGFR value ( r=0.495, P<0.001), and the positivity rate decreased from 30.91% (17/55) to 23.33% (7/30) from G4 to G5. (3) In patients with early diabetic kidney disease, uCAF levels and positivity rates increased gradually with the increase of UACR. uCAF levels were positively correlated with UACR values ( r=0.602, P<0.001), and the uCAF positivity rate reached 21.52% (17/79) in the A1 subgroup. (4) uCAF level was positively correlated with uα1M and uIgG levels in patients with early diabetic kidney disease ( r=0.757, 0.596, both P<0.001). Conclusion:Analytical performance of enzyme chemiluminescence immunoassay for the detection of CAF is satisfactory and could be used a biomarker for monitoring damage and progression of early diabetic kidney disease in patients with type 2 diabetes.
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As immunotherapy has become the latest treatment for recurrent or metastatic squamous cell carcinoma of the head and neck (HNSCC), radiotherapy combined with immunotherapy has become the focus of this field. It has been reported that radiotherapy combined with immunotherapy can produce synergistic effect, but the mechanism of synergistic effect has not been determined yet. Basic researches involve immune cells and immunoregulation of microenvironment, and clinical researches include timing of combination therapy, radiotherapy site, treatment mode and dose, and selection of beneficiary population. This paper reviews the progress of combined application of radiotherapy and immunotherapy in the field of basic and clinical treatment of head and neck cancer.
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Objective: To investigate the frequency characteristics and the pathological characteristics of the horizontal crista ampullaris in patients with Meniere's disease,and to analyse its structural basis. Methods: Between March, 2019 and November, 2019, seventy-two patients diagnosed as Meniere's disease (27 males and 45 females, aged from 13 to 74 years, with a course of disease ranging from 4 months to 32 years)in Shandong Provincial ENT Hospital were included.Caloric test, sinusoidal harmonic acceleration test (SHA), video-head impulse test (v-HIT), Gadolinium-enhanced inner-ear 3D-FLAIR MRI and pure tone audiometry were conducted in the patients. The function of the horizontal semicircular canal in these patients were analysed as well as its relationship with the degree of endolymphatic hydrops,clinical stage and duration. Light microscopy and transmission electron microscopy were used to observe the ultrastructure of horizontal semicircular canal crista ampullaris from six patients with refractory Meniere's disease who underwent labyrinthectomy. The number of type Ⅰ and type Ⅱ vestibular hair cells, the common pathophysiological changes of horizontal semicircular canal crista ampullaris were investigated in these patients. Statistical analysis was performed using SPSS 19.0. Results: With the increase of detection frequency, the abnormal rate decreased gradually. The abnormal rate of caloric test was 69.4% (50/72), SHA 51.4% (37/72), V-HIT 36.1% (26/72), comparation of the positive rate among the three tests showed statistically significant differences(P<0.05).Neither caloric test nor SHA had correlation with the degree of hydrops(P>0.05), but v-HIT(r=0.434,P<0.01).There was correlation with clinical stage to SHA and v-HIT(r=0.338,0.462,P<0.01), except caloric test(P>0.05).No significant relation was found with caloric test, SHA, v-HIT and course of disease(P>0.05).Morphological observation found abnormal monolayer epithelialization of the horizontal semicircular canal crista ampullaris significantly decreased number of type Ⅱ hair cells compared with type Ⅰhair cells. Hair cells showed perinuclear vacuolization, cytoplasmic vacuoles, mitochondrial electron density increasement and loss of stereocilia. Conclusions: The horizontal semicircular canal damage in the patients with Meniere's disease has a frequency-dependent characteristic, mainly occurres in low frequency area. With progress of the disease, the high frequency area of ampulla will be impaired gradually, and it is related to the degree of endolymphatic hydrops and hearing level. Hair cell injury would be observed,the frequency characteristics may be more associated with the disorder of type Ⅱ hair cells.
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Female , Humans , Male , Caloric Tests , Endolymphatic Hydrops , Meniere Disease , Semicircular Canals , Semicircular DuctsABSTRACT
The current global pandemic of COVID-19 is caused by a novel coronavirus SARS-CoV-2. The SARS-CoV-2 spike protein receptor-binding domain (RBD) is the critical determinant of viral tropism and infectivity. To investigate whether naturally occurring mutations in the RBD during the early transmission phase have altered the receptor binding affinity and infectivity, firstly we analyzed in silico the binding dynamics between mutated SARS-CoV-2 RBDs and the human ACE2 receptor. Among 32,123 genomes of SARS-CoV-2 isolates (January through March, 2020), 302 non-synonymous RBD mutants were identified and clustered into 96 mutant types. The six dominant mutations were analyzed applying molecular dynamics simulations. The mutant type V367F continuously circulating worldwide displayed higher binding affinity to human ACE2 due to the enhanced structural stabilization of the RBD beta-sheet scaffold. The increased infectivity of V367 mutants was further validated by performing receptor-ligand binding ELISA, surface plasmon resonance, and pseudotyped virus assays. Genome phylogenetic analysis of V367F mutants showed that during the early transmission phase, most V367F mutants clustered more closely with the SARS-CoV-2 prototype strain than the dual-mutation variants (V367F + D614G) which emerged later and formed a distinct sub-cluster. The analysis of critical RBD mutations provides further insights into the evolutionary trajectory of SARS-CoV-2 under negative selection pressure and supports the continuing surveillance of spike mutations to aid in the development of new COVID-19 drugs and vaccines. ImportanceA novel coronavirus SARS-CoV-2 has caused the pandemic of COVID-19. The origin of SARS-CoV-2 was associated with zoonotic infections. The spike protein receptor-binding domain (RBD) is identified as the critical determinant of viral tropism and infectivity. Thus, whether the mutations in the RBD of the circulating SARS-CoV-2 isolates have altered the receptor binding affinity and caused them more infectious, should be paid more attentions to. Given that SARS-CoV-2 is a novel coronavirus, the significance of our research is in identifying and validating the RBD mutant types emerging during the early transmission phase that have increased human ACE2 receptor binding affinity and infectivity. The RBD mutation analysis provides insights into SARS-CoV-2 evolution. The continuous surveillance of RBD mutations with increased human ACE2 affinity in human or other animals is important and necessary, particularly when the direct correlation between the virus variations and vaccine effectiveness is underdetermined during the sustained COVID-19 pandemic.
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Prevention and control about the situation of 2019 coronavirus disease (COVID-19) are grim at present. In addition to supporting the frontline actively, medical workers in general surgery spare no efforts in making good diagnosis and treatment of specialized diseases by optimizing treatment process, providing medical advice online, mastering indications of delayed operation and emergency operation reasonably, etc. Budd-Chiari syndrome is a complex disorder, and severity of the disease varies, serious cases can be life threatening. While fighting the epidemic, medical workers should also ensure the medical needs of patients. However, instead of continuing the traditional treatment, a new management system should be developed. Based on the characteristics of Budd-Chiari syndrome patients in China and our experience, we divide the patients into ordinary and critical cases, and treatment strategies suitable for the epidemic period of COVID-19 are put forward for reference and discussion by physicians.
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Objective:To investigate the effect of virus inactivation on weak positive result of 2019 novel coronavirus(2019-nCoV) nucleic acid test.Methods:A retrospective study was conducted on the nasopharyngeal swabs of three patients with positive PCR nucleic acid test for 2019-nCoV at different concentrations in the Second affiliated Hospital of Zhejiang University Medical College from January to February 2020.The virus in nasopharyngeal swab specimens were inactivated by water bath at 56 ℃ for 30 min, dry bath at 56 ℃ for 60 min and dry bath at 60 ℃ for 30 min respectively. After treatment, these samples RNA were extracted and then detected by three new commercial quantitative real-time polymerase chain reaction reagent kits for 2019-nCoV.Cycle threshold (Ct) value was used to evaluate the effect of virus inactivation on nucleic acid detection of 2019-nCoV.Results:There was no significant difference between the groups before and after inactivation. Ct values of ORF1ab gene before inactivation were 23.28±0.28, 25.25±0.25, 28.93±0.44, 32.06±0.47, 35.20±0.38, 32.89±0.38, 36.24±0.23, 33.30±0.46, and those after inactivation were, group 1:23.60±0.20, 27.29±0.30, 31.83±0.51, 37.41±0.46, group 2: 24.25±0.34, 27.18±0.42, 31.84±0.61, 34.99±1.01, 34.89±0.45,group 3: 23.37±0.17, 26.89±0.52, 32.05±0.50.Ct value of N gene before inactivation were 24.38±0.09, 26.64±0.11, 30.35±0.12, 33.29±0.33, 36.93±0.11, 34.50±0.12, 35.63±0.12, those after inactivation were, group 1: 24.66±0.11, 28.52±0.14, 32.71±0.14, 37.00±0.13;group 2: 25.41±0.10, 28.79±0.15, 33.29±0.28; group 3: 23.37±0.11, 28.68±0.11, 33.54±0.13, 37.18±0.23(ORF1ab gene: t=-1.416; N gene: t=-1.379, P>0.05). There was no significant difference among the three inactivation groups, the specific Ct values are shown above(ORF1ab gene: t=-0.460; N gene: t=-0.132, P>0.05). However, the Ct values of the inactivated groups (1,2,3) and the non-inactivated group at different dilution times were different (10 ×:Ct value of ORF1ab was 25.25±0.25 in the non-inactivated group, and 27.29±0.30, 27.18±0.42 and 26.89±0.52 in the inactivated group1,2 and 3, t(ORF1ab)=-7.327, P<0.01.Ct value of N gene in the non-inactivated group was26.64±0.11, those in inactivated group 1, 2 and 3 were 28.52±0.14, 28.79±0.15 and 28.68±0.11, respectively, t (N)=-19.340, P<0.01. 100 ×:Ct value of ORF1ab was 28.93±0.44 in the non-inactivated group, and 31.83±0.51,31.84±0.61 and 32.05±0.50 in the inactivated group1,2 and 3, t (ORF1ab)=-9.462, P<0.01. Ct value of N gene in the non-inactivated group was 30.35±0.12, those in the inactivated group 1, 2 and 3 were 32.71±0.14, 33.29±0.28 and 33.54±0.13, respectively, t (N)=-18.583, P<0.01. The positive detection rate of the non-inactivated group (7/11, 8/11, 5/11) was significantly different from that of the inactivated group (inactivated group 1:4/11, 4/11, 3/11, inactivated group 2:3/11, 3/11, 3/11, and inactivated group 3:3/11, 3/11, 2/11) ( Z=-2.670, P<0.01). There were no significant difference among the inactivated groups(inactivated group 1:4/11, 4/11, 3/11, inactivated group 2:3/11, 3/11, 3/11, inactivated group 3:3/11, 3/11, 2/11) ( Z=4.413, P>0.05) and among the three reagents(reagent 1:7/11, 4/11, 3/11, 3/11, reagent 2:8/11, 4/11, 3/11, 3/11, reagent 3:5/11, 3/11, 3/11, 2/11)(χ 2=1.199, P>0.05). Conclusion:The virus inactivation can degrade the nucleic acid of the 2019-nCoV, resulting in the decrease of the Ct value and the false negative results of the low-concentration specimens.
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BACKGROUND: Exosomes are lipid-bilayer enclosed nano-sized vesicles that transfer functional cellular proteins, mRNA and miRNAs. Mesenchymal stem cells (MSCs) derived exosomes have been demonstrated to prevent memory deficits in the animal model of Alzheimer's disease (AD). However, the intravenously injected exosomes could be abundantly tracked in other organs except for the targeted regions in the brain. Here, we proposed the use of central nervous system-specific rabies viral glycoprotein (RVG) peptide to target intravenously-infused exosomes derived from MSCs (MSC-Exo) to the brain of transgenic APP/PS1 mice. MSC-Exo were conjugated with RVG through a DOPE-NHS linker. RESULTS: RVG-tagged MSC-Exo exhibited improved targeting to the cortex and hippocampus after being administered intravenously. Compared with the group administered MSC-Exo, in the group administered RVG-conjugated MSC-Exo (MSC-RVG-Exo) plaque deposition and Aß levels were sharply decreased and activation of astrocytes was obviously reduced. The brain targeted exosomes derived from MSCs was better than unmodified exosomes to improve cognitive function in APP/PS1 mice according to Morris water maze test. Additionally, although MSC-Exo injected intravenously reduced the expression of pro-inflammatory mediators TNF-α, IL-ß, and IL-6, but the changes of anti-inflammatory factors IL-10 and IL-13 were not obvious. However, administration of MSC-RVG-Exo significantly reduced the levels of TNF-α, IL-ß, and IL-6 while significantly raised the levels of IL-10, IL-4 and IL-13. CONCLUSIONS: Taken together, our results demonstrated a novel method for increasing delivery of exosomes for treatment of AD. By targeting exosomes to the cortex and hippocampus of AD mouse, there was a significant improvement in learning and memory capabilities with reduced plaque deposition and Aß levels, and normalized levels of inflammatory cytokines.
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Objective:To investigate the mechanism of Sishenwan in the treatment of Ulcerative Colitis and to explore the key targets and signal pathway on the treatment of Ulcerative Coltis based on network pharmacology and bioinformatics. Method:To obtain the active ingredients and predicted target genes of Sishenwan by searching the Encyclopedia of Traditional Chinese Medicine(ETCM) database, from the Gene Expression Omnibus (GEO) database and Database of Gene-disease Associations (DisGeNET), Online Mendelian Inheritance in Man (OMIM), Drug-targetDatabase (DrugBank), The Comparative Toxicogenomics Database (CTD) and Pharmacogenetics and Pharmacogenomics Knowledge Base (PharmGKB) disease database collection of Ulcerative Colitis target genes, the drug-disease protein target gene was obtained by intersecting the two and to display the results by Cytoscape software, through the algorithm of network topology to screen out the key target genes, Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were carried out on key target genes using Gene Ontology Enrichment Analysis Softword Toolkit (GOEAST) and The Database for Annotation, Visualization and Integrated Discovery (DAVID) online tools, analyze the mechanism of Sishenwan in preventing and treating Ulcerative Colitis combined with relevant literature. Result:There are 182 active ingredients and 611 predicted targets in Sishen Wans, 914 known disease targets related to the occurrence and development of Ulcerative Colitis were retrieved through the disease database, it was concluded that the effect of Sishenwan on Ulcerative Colitis mainly involves steroid hormone-mediated signal pathway, exogenous metabolic process, positive regulation of transcription of RNA polymerase II promoter, lipid metabolic process, detoxification of cell oxidant, signal transduction and other biological functions, and participates in arachidonic acid, drug metabolism-cytochrome P450, cytochrome P450 for xenobiotics, chemical carcinogenesis and other key signal pathways. Conclusion:Sishenwan has the characteristics of multi-target, multi-channel and multi-level in the treatment of Ulcerative Colitis. Its multiple signal pathways are directly or indirectly related, participating in lipid protein metabolism, drug metabolism and anti-cancer mechanism, etc. It exerts its efficacy through comprehensive intervention on the digestive system, circulatory system, immune system and other multiple systems of the body, thus being consistent with the comprehensive effect mechanism of Ulcerative Colitis induced by multiple factors.
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OBJECTIVE: To explore the feasibility of different operative approaches for the treatment of upper thyroid gland. METHODS: The clinical data of 87 patients underwent lobectomy in Department of Oncological Surgery, the First Affiliated Hospital of Bengbu Medical College from January 2016 to December 2018 were analyzed retrospectively.Preoperative ultrasound was used to evaluate the location of the tumor in the upper thyroid gland or thyroid gland hypertrophy.According to the operative approach,87 cases were divided into two groups including 42 cases of the cricothyroid approach and 45 cases of viacervical strap muscles approach. The intraoperative exposure of superior laryngeal nerve and postoperative complications of superior laryngeal nerve function and parathyroid gland were compared. RESULTS: Compared with the superior laryngeal nerve finding rate(83.3%)in the cricothyroid approach,the superior laryngeal nerve finding rate was higher(95.6%)(P0.05). CONCLUSION: The viacervical strap muscles approach compares the cricothyroid approach to the laryngeal nerve with a high rate of finding and a short searching time. Applying viacervical strap muscles approach in the case of an upper thyroid tumor and glandular hypertrophy helps to expose the upper pole and protect the external nerve branch of the larynx.
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To evaluate the clinical efficacy and safety of Shugan Jieyu Capsules,Jieyu Pills and Xiaoyao Pills in the treatment of liver-stagnation and spleen-deficiency depression by the network Meta-analysis( NMA),so as to provide evidence-based clinical practice. Chinese databases,including CNKI,VIP,Wan Fang Data,CBM as well as English databases including the Cochrane Library,PubMed,EMbase and Web of Science were retrieved from inception to October 30,2018,to collect randomized controlled trials( RCTs) about clinical study of the three kinds of Chinese patent medicines. The quality and bias risk of the included studies were assessed by 5. 1 standard in Cochrane Handbook,ADDIS software was applied in the statistical analysis,and the result were compared by NMA. A total of 37 studies involving 3 105 patients were included. The results of NMA showed that the adjuvant therapy with the three kinds of traditional Chinese patent medicines could improve the clinical efficacy. Jieyu Pills had the most significant effect( OR = 4. 59,95%CI[1. 94,12. 71],P<0. 05). In HAMD,Shugan Jieyu Capsules( MD = 3. 22,95%CI[2. 07,4. 39],P< 0. 05) and Xiaoyao Pills( MD= 2. 23,95%CI[0. 41,4. 03],P<0. 05) can effectively reduce the depression scale indicators. In the incidence of adverse reactions,the three kinds of Chinese patent medicines can reduce the incidence of adverse reactions. The three kinds of Chinese patent medicines can be combined with auxiliary Western medicine to treat liver-stagnation and spleen-deficiency depression,with complementary advantages in action mechanisms. In the clinical efficacy and safety,the Chinese patent medicines had good clinical manifestations. Although this study showed that Jieyu Pills may be the referred medicine for depression,this conclusion is still immature and needs to be further verified by high-quality RCTs studies,and the application shall be selective based on specific characteristics in clinic.
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Humans , Depression/drug therapy , Drugs, Chinese Herbal/therapeutic use , Liver/physiopathology , Medicine, Chinese Traditional , Network Meta-Analysis , Nonprescription Drugs/therapeutic use , Randomized Controlled Trials as Topic , Spleen/physiopathologyABSTRACT
Objective To explore the effect of interpersonal and social rhythm therapy combined drugs on sleep quality and quality of life in patients with insomnia.Methods A total of 100 patients with insomnia treated in hospital from January 2016 to October 2017 were selected as subjects.The patients were divided into experimental group (n=50) and control group (n=50) according to the random number table.The control group was given conventional drug only,and the experimental group was combined with interpersonal and social rhythm therapy on the basis of the drugs treatment.The clinical efficacy was compared between the two groups.Pittsburgh Sleep Quality Index (PSQI) and Sleeping Personal Beliefs and Attitudes (DBAS) were used to assess the recent sleep quality of the two groups.The WHO Quality of Life Measurement Profile (WHOQOL-BREF) was used to compare of the quality of life between two groups.Results The clinical effective rate was 94.0％ in the experimental group and 80.0％ in the control group.There was significant difference between the two groups (x2=4.332,P＜0.05).Before treatment,there was no significant difference in PSQI ((13.61±2.09) vs (13.60±2.08),t=0.03,P＞0.05) and DBAS((80.96±10.11) vs (80.87±11.03),t =0.02,P＞ 0.05) scores between experimental group and control group.After treatment,D BAS score ((125.74 ±21.53) vs (104.22±20.97),t=4.93,P＜0.05) of both groups increased significantly,and PSQI score decreased significantly((7.51±2.35) vs (10.02±2.40),t=16.73,P＜0.05).The PSQI score in experimental group was significantly lower than that of the control group(t=7.97,P＜0.05),and the DBAS score was significantly higher than that of the control group (t =13.72,P＜0.05).Before treatment,scores in the psychological,physiological,environmental and social relations fields of the two groups were not statistically different (P ＞0.05).After the treatment,all the scores in the four fields of the two groups were significantly increased (P ＜0.05),and the scores in the experimental group were significantly higher than those in the control group (P ＜0.05).Conclusion Interpersonal and social rhythm therapy combined with drugs can effectively improve sleep quality and the quality of life.
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Objective To investigate the effect of ropivacaine on painless delivery and its effect on mother and infant.Methods From March 2016 to May 2017,64 cases of maternal painless labor demand in the Eighth People's Hospital of Taiyuan were chosen as the observation group ,42 cases of natural childbirth pregnant women in the Eighth People's Hospital of Taiyuan were selected as control group .The degree of labor pain,pregnancy outcome and the effect on mother and infant were compared .Results The excellent rate of normal delivery ,oxytocin usage rate in the observation group were 50%,7.81%,respectively,which were better than those in the control group ( all P＜0.05).The Apgar scores of newborns at 1 min 5 min after birth in the observation group were (8.92 ±1.20)points, (9.43 ±0.56)points,respectively,which were higher than those in the control group (t ＝5.362,4.036,all P＜0.05).The postpartum lactation of the observation group was 54.69%,and had no statistically significant difference compared with the control group .After delivery,the level of NO in the observation group was higher than that in the control group [(94.2 ±9.6) μmol/L vs.(82.6 ±5.6) μmol/L],and the cortisol level was lower than that in the control group [(726.3 ±68.1)ng/mL vs.(892.7 ±136.4)ng/mL],the differences were statistically significant (all P＜0.05).Conclusion Ropivacaine combined with spinal and epidural anesthesia is an ideal way for painless delivery, with good analgesic effect ,which can improve the natural delivery rate and has little effect on mother and child .
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<p><b>OBJECTIVE</b>To study the effect of the inhibitory concentration minocycline on the proliferation, differentiation, and expression of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP) and osteopontin (OPN) mRNA of osteoblasts.</p><p><b>METHODS</b>Primary osteoblasts were cultured in osteogenic induction medium containing 0, 0.1, 0.5, 1, 10 μg·mL⁻¹ minocycline. Cell counting kit-8 was used to observe cell proliferation. ALP activity assay, alizarin red S staining, and real-time quantitative polymerase chain reaction (PCR) were used to determine cell differentiation and mineralization.</p><p><b>RESULTS</b>The groups with 0.1, 0.5, 1 μg·mL⁻¹ minocycline promoted cell proliferation. The mRNA expression levels of ALP and Runx2 were up-regulated. Osteoblast-mediated mineralization was increased. The group with 1 μg·mL⁻¹ showed maximal promotion effect (P<0.05). When the concentration increased to 10 μg·mL⁻¹, the promoting effect began to decline, and the ALP activity and OPN expression were significantly inhibited (P<0.01).</p><p><b>CONCLUSIONS</b>Appropriate concentration of minocycline can promote osteoblasts proliferation, up-regulate the expression levels of Runx2, ALP and OPN, and increase the differentiation and mineralization of osteoblasts.</p>
Subject(s)
Aortic Aneurysm/diagnosis , Carcinoma/diagnosis , Hematoma/diagnosis , Mediastinal Neoplasms/diagnosis , Positron Emission Tomography Computed Tomography/methods , Aortic Aneurysm/diagnostic imaging , Biopsy, Needle , Carcinoma/surgery , Diagnosis, Differential , Hematoma/surgery , Humans , Immunohistochemistry , Male , Mediastinal Neoplasms/surgery , Middle Aged , Thoracic Surgery, Video-Assisted/methods , Treatment OutcomeABSTRACT
Objective To explore the association of methylenetetrahydrofolate reductase (MTHFR)gene C677T polymorphism with weight gain induced by risperidone.Methods 356 patients with schizophrenia according to the DSM-IV criteria in this study.The height and body weight of the patients were measured before starting risperidone treatment and 8-week later.The MTHFRC677T polymorphism was genotyped using direct DNA sequencing method.Results A significant association was found between MTHFR gene C677T and body weight mass index (BMI) change after 8-week risperidone treatment.CC-carriers experienced higher BMI gain than CT/TT-carriers (CC (4.47 ± 1.09),CT (4.54 ± 1.27),TT (2.31 ± 0.75),F =5.634,P＜0.01).The frequency of allele C in bodyweight gain (＞7％) was higher than that in non-bodyweight gain groups (48.4％ vs 32.4％,x2=11.342,P＜0.01).Conclusion MTHFRC677T polymorphism is associated with risperidone induced weight gain in Chinese Han population.
ABSTRACT
Objective To explore the association of methylenetetrahydrofolate reductase (MTHFR)gene C677T polymorphism with weight gain induced by risperidone.Methods 356 patients with schizophrenia according to the DSM-IV criteria in this study.The height and body weight of the patients were measured before starting risperidone treatment and 8-week later.The MTHFRC677T polymorphism was genotyped using direct DNA sequencing method.Results A significant association was found between MTHFR gene C677T and body weight mass index (BMI) change after 8-week risperidone treatment.CC-carriers experienced higher BMI gain than CT/TT-carriers (CC (4.47 ± 1.09),CT (4.54 ± 1.27),TT (2.31 ± 0.75),F =5.634,P＜0.01).The frequency of allele C in bodyweight gain (＞7％) was higher than that in non-bodyweight gain groups (48.4％ vs 32.4％,x2=11.342,P＜0.01).Conclusion MTHFRC677T polymorphism is associated with risperidone induced weight gain in Chinese Han population.