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AIM: To explore the intervention effect of Dahuangtang pellets (DHT) on diabetic nephropathy (DN) based on the AMP-activated protein kinase/mammalian target of rapamycin/unc-51-like kinase 1 (AMPK/mTOR/ULK1) signaling pathway. METHODS: Eight mice were randomly assigned to the model group, the dapagliflozin group, and the DHT (high, medium, and low dosage) group out of a total of 40 C57BL/KSJ-db/db (hereafter referred to as db/db) mice; another 10 C57BL/KSJ-db/dm mice were used as the normal group, saline was provided to the normal and model groups, and the mice in the treatment group received the appropriate medications. The medications were given for 10 consecutive weeks, once per day, to the mice in the treatment group. At weeks 0, 4, 8, and 10 of administration, fasting blood glucose (FBG) was assessed by drawing blood at a predetermined time from the tail vein; Urine samples were taken at 0, 5, and 10 weeks after treatment to evaluate the levels of albumin and creatinine, and the urinary albumin-creatinine ratio (ACR) was computed. After 10 weeks, mice in each group were assayed for 24 h total urine protein, serum creatinine (Scr), urea nitrogen (BUN) levels; Western blotting analysis was conducted to detect the expression of p-AMPK, p-mTOR, and p-ULK1, as well as the expression of autophagy related proteins homolog of yeast Atg6 (Beclin-1), autophagy-related proteins microtubule-associated protein 1 light chain 3 (LC3), P62 in renal tissue; Immunohistochemistry was used to measure the expression of podocyte lacunar membrane proteins (Nephrin, Podocin) in renal tissues; The pathological morphology of renal tissue was observed by light microscopy and transmission electron microscopy. RESULTS: Compared with the model group, FBG, ACR, and 24 h total urine protein were reduced in the dapagliflozin group and DHT groups of mice, and there was no statistically significant difference in Scr and BUN; In renal tissues, there is increased expression of p-AMPK and p-ULK1, decreased expression of p-mTOR, increased expression of LC3II / LC3I and Beclin-1, and decreased expression of P62 (P<0.01, P< 0.05); differentially upregulated in glomeruli are the podocyte lacunar membrane proteins Nephrin and Podocin (P<0.01, P<0.05); renal pathologic damage was reduced to varying degrees; transmission electron microscopy showed an increase in the number of autophagic vesicles and autophagic lysosomes. CONCLUSION: DHT can delay the development of DN by regulating the AMPK / mTOR / ULK1 signaling pathway, enhancing podocyte autophagy, and protecting glomeruli.
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Objective:To explore vibration, position and motion proprioception of the ankle joints after a stroke.Methods:Twenty-eight stroke survivors with impaired ankle proprioception were divided into a right-side stroke group ( n=18) and a left-side stroke group ( n=8). Twenty-two healthy volunteers constituted a control group. Vibration perception thresholds, passive and active joint angle resetting, and motion minimum thresholds were quantified among the stroke survivors on both the healthy and the affected side. With the controls the dominant and non-dominant sides were used. The differences in proprioception between the healthy volunteers and the stroke patients, between the affected side and the healthy side of the stroke patients, and between left- and right-side stroke patients were analyzed and compared. Results:Among the stroke survivors the vibration perception threshold on the affected side averaged (28.91±22.53)μm. The absolute difference in the perception of passive positioning was (5.49±5.39)° for 15° of plantar flexion and (4.48±3.89)° for 5° of dorsal extension. In active positioning plantar flexion was (5.23±4.34)° and for 30° of plantar flexion it was (3.26±1.73)°. The 5° dorsal extension error was (4.97±3.48)°. The motion perception thresholds between 20° of plantar flexion, 10° of plantar flexion and the neutral position were significantly higher, on average, than among the control group. The stroke group also had significantly higher motion perception thresholds than the control group.Conclusion:The vibration, position, and motion sense of the ankle joint on a stroke survivor′s affected side tend to be impaired, with the impairment of vibration and motion sensing tend to be more substantial. After stroke, there is also mild impairment of vibration, position and motion sensing in the healthy ankle joint. The impairment of proprioception caused by right cerebral hemisphere injury may be more serious than that caused by injury on the left.
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OBJECTIVE@#To evaluate the effectiveness of tendon insertion medialized repair in treatment of large-to-massive rotator cuff tears (L/MRCT).@*METHODS@#The clinical and imaging data of 46 L/MRCT patients who underwent arthroscopic insertion medialized repair between October 2015 and June 2019 were retrospectively analyzed. There were 26 males and 20 females with an average age of 57.7 years (range, 40-75 years). There were 20 cases of large rotator cuff tears and 26 cases of massive rotator cuff tears. Preoperative imaging evaluation included fatty infiltration (Goutallier grade), tendon retraction (modified Patte grade), supraspinatus tangent sign, acromiohumeral distance (AHD), and postoperative medializaiton length and tendon integrity. The clinical outcome was evaluated by visual analogue scale (VAS) score, American Society for Shoulder and Elbow Surgery (ASES) score, shoulder range of motion (including anteflexion and elevation, lateral external, and internal rotation) and anteflexion and elevation muscle strength before and after operation. The patients were divided into two groups (the intact tendon group and the re-teared group) according to the integrity of the tendon after operation. According to the medializaiton length, the patients were divided into group A (medialization length ≤10 mm) and group B (medialization length >10 mm). The clinical function and imaging indexes of the patients were compared.@*RESULTS@#All patients were followed up 24-56 months, with an average of 31.8 months. At 1 year after operation, MRI showed that the medializaiton length of supraspinatus tendon was 5-15 mm, with an average of 10.26 mm, 33 cases in group A and 13 cases in group B. Eleven cases (23.91%) had re-teared, including 5 cases (45.45%) of Sugaya type Ⅳ and 6 cases (54.55%) of Sugaya type Ⅴ. At last follow-up, the VAS score, ASES score, shoulder anteflexion and elevation range of motion, lateral external rotation range of motion, and anteflexion and elevation muscle strength significantly improved when compared with those before operation ( P<0.05); there was no significant difference in internal rotation range of motion between pre- and post-operation ( P>0.05). The Goutallier grade and modified Patte grade of supraspinatus muscle in the re-teared group were significantly higher than those in the intact tendon group, and the AHD was significantly lower than that in the intact tendon group ( P<0.05). There was no significant difference in other baseline data between the two groups ( P>0.05). Except that the ASES score of the intact tendon group was significantly higher than that of the re-teared group ( P<0.05), there was no significant difference in the other postoperative clinical functional indicators between the two groups ( P>0.05). There was no significant difference in the incidence of re-tear, VAS score, ASES score, range of motion of shoulder joint, and anteflexion and elevation muscle strength between group A and group B ( P>0.05).@*CONCLUSION@#Tendon insertion medialized repair may be useful in cases with L/MRCT, and shows good postoperative shoulder function. Neither tendon integrity nor medialization length shows apparent correlations with postoperative shoulder function.
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Male , Female , Humans , Middle Aged , Rotator Cuff Injuries/surgery , Retrospective Studies , Treatment Outcome , Rotator Cuff/surgery , Tendons , Rupture/surgery , Shoulder Joint/surgery , Arthroscopy/methods , Range of Motion, ArticularABSTRACT
Occupational health management is one of the major indicators for evaluating the occupational disease prevention and control status of employers. However, there is still a lack of occupational health management evaluation standards or specifications in China. Analysis and evaluation of the problems in occupational health management by employers require technicians to master the relevant laws, regulations, standards, and specifications. In contrast to this high technical demand, in reality various methods have been used for occupational health management evaluation. There are great differences in evaluation contents and the analysis is incomplete, resulting in numerous problems and low practical feasibility. In the Occupational Disease Prevention and Control Act (2016 Amendment), the cancellation of the certificates for institutions and individuals in evaluation of the damage caused by occupational diseases resulted in an increased number of assessment report writers with insufficient capability. Since 2018, the duty of occupational health supervision has been transferred from the work safety administrative department to the health administrative department. The ability of occupational health supervisors needs to be improved urgently. This article mainly analyzes and discusses the contents and methods of occupational health management evaluation, as well as the problems and suggestions. Our results provide a guideline for improvement of occupational health management.
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Accumulating vast amounts of pollutants drives modern civilization toward sustainable development. Construction waste is one of the prominent issues impeding progress toward net-zero. Pollutants must be utilized in constructing civil engineering structures for a green ecosystem. On the other hand, large-scale production of industrial steel fibers (ISFs) causes significant damage to the goal of a sustainable environment. Recycled steel fibers (RSFs) from waste tires have been suggested to replace ISFs. This research critically examines RSF's application in the mechanical properties' improvement of concrete and mortar. A statistical analysis of dimensional parameters of RSFs, their properties, and their use in manufacturing various cement-based composites are given. Furthermore, comparative assessments are carried out among the improvements in compressive, split tensile, and flexural strengths of plain and RSF-incorporated concrete and mortar. In addition, the optimum contents of RSF for each strength property are also discussed. The influence of RSFs parameters on various strength properties of concrete and mortars is discussed. The possible applications of RSF for various civil engineering structures are reviewed. The limitations and errors noticed in previous review papers are also outlined. It is found that the maximum enhancement in compressive strength (CS), split tensile strength (STS), and flexure strength (FS) are 78%, 149%, and 157%, respectively, with the addition of RSF into concrete. RSF increased cement mortars' CS, STS, and FS by 46%, 50.6%, and 69%, respectively. The current study encourages the building sector to use RSFs for sustainable concrete.
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Objective To stud)' the expression of connexin (Cx) 26 and Cx30 in the cochlea in rat model of type 2 diabetes, and their role in the hearing loss of type 2 diabetes. Methods Sixty wistar rats were randomly divided into a control group(re = 20) and a experimental group(re = 4 0) . Rats in the experimental group received intraperitoneally injection of 10 mg/L streptozotocin to establish model of type 2 diabetes. Auditory brainstem response (ABR) was tested before and after molding at month 1, 2, 3, 4, 5. The morphology of cochlea was observed by HE staining, and the level and pattern of Cx26 and Cx30 expression within the cochlea were detected by immunofluorescence and Western blotting. Results In rats in the diabetes group, wave IH and V latency, I -IH and I - V interval of Click-ABRs (60 dBSPL) prolonged at month 1, 2, 3, 4, 5 after molding compared to the control (P < 0 . 0 5) . The number of cells was obvious reduced in the spiral ligament and ganglion of the experimental group (P < 0. 0 5) . Immunofluorescence and Western blotting results showed decreased expression of Cx26 and Cx30 in the experimental group at 2, 3, 4, 5 month(P<0. 05), and the expression of the two proteins decreased gradually with the time extension. Conclusion Expression of Cx26 and Cx30 is reduced at the same time as the occurrence of hearing impairment in rat cochlea with type 2 diabetes.
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Objective:To investigate the feasibility and safety of single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy for penile cancer.Methods:The clinical data of 6 patients with penile cancer admitted to our hospital from January 2019 to January 2020 were retrospectively analyzed. The mean age was (52.0±8.6)years old. The pathology was primary focal squamous cell carcinoma, with 2 cases of high differentiation, and 4 cases of medium differentiation. All the 6 patients underwent single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy. Preoperative physical and imaging examinations indicated bilateral inguinal lymph node enlargement, and no distant metastasis was found in all of the 6 patients. The supine position was taken, with the head low and feet high about 15°, the legs straight and separated as far as possible in the shape of "Chinese eight" . The da Vinci robotic patient cart was placed between legs of the patient, after inserting the trocars. The external boundary of bilateral inguinal lymph node dissection was the line between the anterior superior iliac spine and 20 cm lower, the inner boundary was the pubic tubercle and its 15cm medial lower measurement, and the line between the inner boundary and the external lower edge was the lower boundary.Results:All the 6 operations were successfully completed without transfer to open surgery. Both sides of the inguinal lymph nodes were dissected at the same time. The space establishment and trocar insertion were performed simultaneously. There was no need for mobile robotic arm system during the operation. The average operative time was (105.0±20.5) min, and the amount of intraoperative blood loss was less than 50ml, the average hospital stay was(7±3) days. An average of(15.0±2.5) lymph nodes were dissected on each side. Intraoperative freezing suggested single positive lymph nodein 2 patients and no positive lymph node in 4 patients. There was no skin necrosis, 1 case of delayed wound healing, and 2 cases of lymphatic leakage. All patients were cured by conservative treatment. The 6 patients were followed up for 12-14 months, and there was no recurrence or metastasis.Conclusions:Single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy can achieve the expected surgical outcome, and has fewer perioperative complications. The surgery is safe and effective.
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Objective: To investigate the occupational hazard factors and exposure levels of workers during the construction of power transmission and transformation projects. Methods: Analysis and identification of occupational hazard factors were carried out for typical construction process of 6 power transmission projects and 3 substation projects in September 2018. The on-site occupational health investigation was carried out to detect and analyze the exposure levels of workers to occupational hazard factors. Results: The time weighted average concentration (C(TWA)) of crushing workers exposed to silica dust and welders exposed to welding fume in substation projects were 2.72 and 14.03 mg/m(3), respectively. The 8 h equivalent sound level results of exposure noise of carpenters in power transmission projects and crushing workers, reinforcement workers, carpenters, scaffolders, road builders in substation projects were 87.9, 92.5, 87.1, 92.5, 93.0 and 90.2 dB (A) , respectively. The 4-hour time equal energy frequency weighted vibration acceleration of hand-transmitted vibration of bricklayer in power transmission projects, bricklayer, general worker 3, road builder 1 and road builder 2 of substation projects were 5.36, 5.21, 5.28, 10.71 and 5.22 m/s(2), respectively. The effective irradiance of electric welding arc light of welders' limbs in power transmission projects and substation projects were 401.19, 319.68 μW/cm(2), respectively. All of the above exceeded the requirements of occupational exposure limits. The occupational radiation levels and exposure limits of hazardous chemical factors met the requirements of each post. Conclusion: During the construction of power transmission and transformation projects, the exposure levels of occupational hazard factors in multiple posts exceed the standard. The main responsibility of employers for occupational disease prevention and control should be implemented, and targeted comprehensive measures should be taken to reduce the exposure levels of occupational hazard factors of workers.
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Humans , Dust , Occupational Diseases , Occupational Exposure/analysis , Occupational Health , WeldingABSTRACT
Regulating the catalytic activity of nanozymes is significant for their applications in various fields.Here,we demonstrate a new strategy to achieve reversible regulation of the nanozyme's activity for sensing purpose.This strategy involves the use of zero-dimensional M0S2 quantum dots(MQDs)as the building blocks of nanozymes which display very weak peroxidase(POD)-like activity.Interestingly,such POD-like activity of the MQDs largely enhances in the presence of Fe3+while diminishes with the addition of captopril thereafter.Further investigations identify the mechanism of Fe3+-mediated aggregation-induced enhancement of the POD-like activity and the inhibitory effect of captopril on the enhance-ment,which is highly dependent on their concentrations.Based on this finding,a colorimetric method for the detection of captopril is developed.This sensing approach exhibits the merits of simplicity,rapidness,reliability,and low cost,which has been successfully applied in quality control of captopril in pharmaceutical products.Moreover,the present sensing platform allows smartphone read-out,which has promising applications in point-of-care testing devices for clinical diagnosis and drug analysis.
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The effect of combining filler (carbon black) and fibrous materials (steel fiber and polypropylene fiber) with various sizes of coarse particles on the post-cracking behavior of conductive concrete was investigated in this study. Steel fibers (SF) and carbon black (CB) were added as monophasic, diphasic, and triphasic materials in the concrete to enhance the conductive properties of reinforced concrete. Polypropylene fiber (PP) was also added to steel fiber and carbon to improve the post-cracking behavior of concrete beams. This research mainly focused on the effects of macro fibers on toughness parameters and energy absorption capacity, as well as enhancing the self-sensing of multiple cracks and post-cracking behavior. Fractional changes in resistance and crack opening displacement (COD-FCR) and the relationship of load-deflection-FCR with different coarse aggregates of (5-10 mm and 15-20 mm) sizes were investigated, and the law of resistance signal changes with single and multiple cracking through load-time-FCR curves was explored. Results indicated that the smaller size coarse aggregates (5-10 mm) showed higher compressive strength: up to 8.3% and 14.83% with diphasic (SF + CB), respectively. The flexural strength of PC-10 increased 22.60 and 51.2%, respectively, with and without fibers, compared to PC-20. The diphasic and triphasic conductive material with the smaller size of aggregates (5-10 mm) increased the FCR values up to 38.95% and 42.21%, respectively, as compared to those of greater size coarse aggregates (15-20 mm). The hybrid uses of fibrous and filler materials improved post-cracking behavior as well as the self-sensing ability of reinforced concrete.
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This paper presents a new model for multi-object tracking (MOT) with a transformer. MOT is a spatiotemporal correlation task among interest objects and one of the crucial technologies of multi-unmanned aerial vehicles (Multi-UAV). The transformer is a self-attentional codec architecture that has been successfully used in natural language processing and is emerging in computer vision. This study proposes the Vision Transformer Tracker (ViTT), which uses a transformer encoder as the backbone and takes images directly as input. Compared with convolution networks, it can model global context at every encoder layer from the beginning, which addresses the challenges of occlusion and complex scenarios. The model simultaneously outputs object locations and corresponding appearance embeddings in a shared network through multi-task learning. Our work demonstrates the superiority and effectiveness of transformer-based networks in complex computer vision tasks and paves the way for applying the pure transformer in MOT. We evaluated the proposed model on the MOT16 dataset, achieving 65.7% MOTA, and obtained a competitive result compared with other typical multi-object trackers.
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Objective:To observe the effects of modified Huangqi Biejiatang combined with auricular acupressure on diabetic peripheral neuropathy （DPN） due to Qi and Yin deficiency and serum myeloid differentiation factor 88/inhibitor of nuclear factor-<italic>κ</italic>B （MyD88/I<italic>κ</italic>B） signaling pathway. Method:One hundred and forty cases were randomly divided into an observation group （<italic>n</italic>=70） and a control group （<italic>n</italic>=70）. In addition to routine treatments like dietary intervention and the regulation of fasting blood glucose （FBG） and blood pressure， the modified Huangqi Biejiatang combined with auricular acupressure was further provided in the observation group， while mecobalamine was administered in the control group. After four-week intervention， the toronto clinical scoring system （TCSS） score， traditional Chinese medicine （TCM） syndrome score， the conduction velocities of motor and sensory nerves （median nerve， common peroneal nerve， tibial nerve， and ulnar nerve）， glucose metabolism indexes ［fasting plasma glucose （FPG）， 2 h postprandial blood glucose （2 h PG）， and hemoglobin A1c （HbA1c）］， intestinal genera （<italic>Clostridium</italic>， <italic>Prauserella</italic>， <italic>Bacteroides</italic>， and <italic>Faecalibacterium</italic>）， as well as the serum MyD88， I<italic>κ</italic>B<italic>α</italic>， and phosphorylated I<italic>κ</italic>B<italic>α </italic>（p-I<italic>κ</italic>B<italic>α</italic>） levels in the MyD88/I<italic>κ</italic>B signaling pathway before and after treatment were observed in the two groups， for comparing their clinical efficacy and safety. Result:The total effective rate of the observation group was 85.3% （58/68）， which was higher than 48.5% （32/66） of the control group （<italic>χ</italic><sup>2</sup>=6.143， <italic>P</italic><0.05）. The comparison with the control group revealed that the scores of TCSS and TCM syndrome， the levels of FPG， 2 h PG， HbA1c， MyD88， and p-I<italic>κ</italic>B<italic>α</italic>， as well as the abundances of <italic>Clostridium</italic> and <italic>Prauserella</italic> in the observation group were decreased （<italic>P</italic><0.05）， while the conduction velocities of motor and sensory nerves （median nerve， common peroneal nerve， tibial nerve， and ulnar nerve） were significantly accelerated （<italic>P</italic><0.05）. Besides， the abundances of <italic>Bacteroides</italic> and <italic>Faecalibacterium</italic> and I<italic>κ</italic>B<italic>α</italic> level were significantly elevated （<italic>P</italic><0.05）. The incidence of adverse reactions in the observation group was 1.5% （1/68）， lower than 12.1% （8/66） in the control group （<italic>χ</italic><sup>2</sup>=4.328， <italic>P</italic><0.05）. Conclusion:The modified Huangqi Biejiatang combined with auricular acupressure alleviates DPN due to Qi and Yin deficiency， which may be attributed to the regulation of serum MyD88/I<italic>κ</italic>B signaling pathway.
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Objective:To establish a new fast and accurate method for identifying the authenticity and specifications of Fritillariae Cirrhosae Bulbus based on electronic nose technology， and to discuss the feasibility of this technology in the identification of decoction pieces. Method:Fritillariae Cirrhosae Bulbus was used as the research object， 80 batches of samples to be tested were collected， and the olfactory sensory data of the electronic nose were taken as independent variables （<italic>X</italic>）， the results of the method contained in the 2020 edition of <italic>Chinese Pharmacopoeia</italic> were taken as the focus， and the traditional empirical identification results were used as benchmarking information （<italic>Y</italic>）. Four chemometric methods， including discriminant analysis （DA）， least square support vector machine （LS-SVM）， principal component analysis-DA （PCA-DA） and partial least squares-DA （PLS-DA）， were used to establish the identification model ［<italic>Y</italic>=<italic>F</italic>（<italic>X</italic>）］ of authenticity and commodity specifications of Fritillariae Cirrhosae Bulbus， respectively. Wherein， the identification accuracy and time-consuming was taken as indicators to discuss the results. Result:After cross-verification by leave-one-out method， the correct rates of the above four models were 93.75%， 91.25%， 95.00% and 95.00%， respectively， and the PCA-DA and PLS-DA identification models were the best in terms of authenticity identification. In specification identification， the correct rates of these four models were 86.67%， 88.00%， 89.33% and 68.00%， respectively， and the PCA-DA identification model was the best. The electronic nose had a high accuracy in the identification of authenticity and specification model， and the time consuming was relatively short. Conclusion:Electronic nose technology can identify Fritillariae Cirrhosae Bulbus accurately and quickly， and has significant advantages in terms of timeliness and correct judgment rate.
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Objective:To observe the therapeutic effect of modified Fuyuanwan combined with auricular acupressure bean on stage Ⅱ， Ⅲ diabetic nephropathy and its effect on serum janus kinase （JAK）/ signal transducer and activator of tranions （STAT） signaling pathway. Method:A total of 180 cases were randomly divided into control group and observation group， 90 cases in each group. Losartan potassium， modified Fuyuanwan combined with auricular acupressure bean were given respectively for 12 weeks. Renal function indexes ［blood urea nitrogen （BUN）， serum creatinine （SCr）， urinary albumin excretion rate （UAER）， 24 h urinary protein quantitative （24 h Upor）］， relative abundance of intestinal flora （verruca microflora， scleriobacteriae， deferribacter， proteobacteria）， oxidative stress indicators ［advanced oxidation protein products （AOPPs）， reactive oxygen species （ROS）， glutathione peroxidase （GSH-Px）， total superoxide dismutase （TSOD）］， renal blood flow index ［end-diastolic blood flow velocity （EDV）， peak systolic value （PSV）， pulse index （PI）， blood flow resistance index （RI）］， JAK/STAT signaling pathway ［JAK， phosphorylated JAK （p-JAK）， STAT， phosphorylated STAT （p-STAT） were observed before and after treatment. The safety indexes of two groups were evaluated after treatment. The efficacy was observed after treatment and followed up for 1 years and 2 years. Result:After treatment and follow-up for 1， 2 years， the total effective rates of patients in observation group were 97.8% （87/89）， 81.6% （71/87）， 59.8% （49/82）， respectively， observation group which were significantly higher than those in control group of 79.3%（69/87），57.8%（48/83），37.2%（29/78） （<italic>χ</italic><sup>2</sup>=4.016， <italic>χ</italic><sup>2</sup>=4.503， <italic>χ</italic><sup>2</sup>=4.769， <italic>P</italic><0.05）. Compared with control group after treatment， UAER， BUN， SCr， 24 h Upor， firmicutes， actinobacillus， proteobacteria， AOPPs， ROS， PI， RI， p-JAK， p-STAT3 in observation group were significantly decreased （<italic>P</italic><0.05，<italic>P</italic><0.01）， microflora verruca， GSH-PX， TSOD， JAK， STAT3 were significantly increased （<italic>P</italic><0.05，<italic>P</italic><0.01）， EDV and PSV were significantly accelerated （<italic>P</italic><0.05，<italic>P</italic><0.01）. The incidence of adverse reactions was 1.1% （1/89） in observation group， lower than 13.8% （12/87） in control group （<italic>χ</italic><sup>2</sup>=5.127， <italic>P</italic><0.05）. Conclusion:Modified Fuyuanwan combined with auricular acupressure bean can significantly improve the curative effect of stage Ⅱ， Ⅲ diabetic nephropathy， and its mechanism of action may be related to the serum JAK/STAT signaling pathway.
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Objective:To observe the clinical efficacy of modified Huqianwan combined with auricular acupressure with seeds on girls with central precocious puberty （CPP） due to Yin deficiency and fire hyperactivity. Method:A total of 150 cases were randomly divided into three groups （A group，B group， and C group），with 50 cases in each group. The cases received modified Huqianwan，Zhibo Dihuangwan，and modified Huqianwan combined with auricular acupressure with seeds， respectively， for 12 weeks. The traditional Chinese medicine （TCM） symptoms，bone age difference/chronological age difference （ΔBA/ΔCA）， predicted adult height （PAH），ovarian volume，uterine volume，breast nodule index，serum sex hormones ［follicle-stimulating hormone （FSH），luteinizing hormone （LH），and estradiol （E<sub>2</sub>）］，and serum kisspeptin-1 （KISS-1）/G protein-coupled receptor 54 （GPR54）/hypothalamic gonadotropin-releasing hormone （GnRH） signaling pathway of the three groups were observed before and after treatment. The clinical efficacy and safety of the three groups were evaluated. Result:The total effective rate was 97.9% in the C group， which was higher than 81.3% in the A group （<italic>χ</italic><sup>2</sup>=4.516，<italic>P</italic><0.05） and 71.4% in the B group （<italic>χ</italic><sup>2</sup>=5.162，<italic>P</italic><0.05）. Compared with the results in the A group after treatment，TCM syndrome，ΔBA/ΔCA，E<sub>2</sub>，LH，KISS-1，GPR54，and GnRH decreased（<italic>P</italic><0.05），and ovarian volume，uterine volume，and breast nodule index were reduced （<italic>P</italic><0.05），but PAH increased in the C group （<italic>P</italic><0.05）. Compared with the B group after treatment，the C group showed decreased TCM syndrome，ΔBA/ΔCA， FSH，E<sub>2</sub>，LH，KISS-1，GPR54，and GnRH （<italic>P</italic><0.05），reduced ovarian volume，uterine volume，and breast nodule index （<italic>P</italic><0.05），and increased PAH（<italic>P</italic><0.05）. During the study，there was one case of anorexia in the A group，and no obvious adverse reactions were found in the B group and the C group. Conclusion:Modified Huqianwan combined with auricular acupressure with seeds can significantly increase the PAH of girls with CPP due to Yin deficiency and fire hyperactivity and improve the serum sex hormones and the KISS-1/GPR54/GnRH signaling pathway.
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Objective:To investigate the effect of individualized memory rehabilitation based on the forgetting characteristics in patients with brain injury (BI). Methods:From September, 2018 to October, 2019, 60 BI patients were randomly divided into routine memory training group (control group, n = 30) and individualized memory training group (observation group, n = 30). The observation group group was tested with forgetting characteristics pre-training. Both groups received memory training for four weeks, respectively. All patients were evaluated with Rivermead Behavioural Memory Test-2nd Edition (RBMT-II) and Montreal Cognitive Assessment (MoCA) pre- and post-training. Results:The total post-training scores of RBMT-II and MoCA were higher than the pre-training scores in both groups (|t| > 3.885, P < 0.01). There was no significant difference in the total scores between two groups pre- and post-training (P > 0.05). The differences between post- and pre-training total scores of RBMT-II and MoCA were significantly higher in the observation group group than in the control group (|Z| > 3.757, P < 0.001). Conclusion:Memory rehabilitation training could improve memory abilities and general cognitive function of BI patients, and it is more effective to carry out individualized memory rehabilitation training based on the forgetting characteristics.
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Anti-vascular endothelial growth factor (anti-VEGF) drugs have long been the only first-line treatment for advanced or unresectable hepatocellular carcinoma (HCC). Recently, the combination of bevacizumab (an anti-VEGF drug) and atezolizumab (an immune checkpoint blockade, ICB) has been proven to have superior efficacy over sorafenib. However, the complex association between VEGF signaling pathway and tumor immune microenvironment is still largely unknown. Here, we analyzed the RNA sequencing and clinical data of 365 HCC patients obtained from The Cancer Genome Atlas to investigate the potential correlation between VEGF signaling pathway and tumor immune microenvironment, including immune cell infiltration, 66 immune markers, genomic instability, and immune-related pathways. Our study revealed that VEGF signaling pathway score was positively correlated with immune cell infiltration and the expression profile of 66 immune markers. Enrichment analysis indicated that genes differentially expressed between two VEGF score subtypes were enriched in many immune-related Gene Ontology terms. Most importantly, both VEGF signaling pathway and activated CD8+ T cells were positively correlated with prognosis. Our findings suggest the co-activation of VEGF signaling pathway and tumor immune microenvironment in HCC patients, indicating the underlining mechanism of combination therapy including anti-VEGF drugs and ICBs.
Subject(s)
Carcinoma, Hepatocellular/immunology , Gene Expression Regulation, Neoplastic/immunology , Liver Neoplasms/immunology , Tumor Microenvironment/immunology , Vascular Endothelial Growth Factor Receptor-2/metabolism , Carcinoma, Hepatocellular/genetics , Carcinoma, Hepatocellular/metabolism , Gene Expression Profiling , Gene Expression Regulation, Neoplastic/genetics , Humans , Liver Neoplasms/genetics , Liver Neoplasms/metabolism , Transcriptome , Tumor Microenvironment/genetics , Vascular Endothelial Growth Factor A/metabolismABSTRACT
OBJECTIVE@#To observe the effect of electroacupuncture (EA) of " acupoint combination" on appetite, body fat, insulin sensitivity and central sensitivity of cholecystokinin (CCK) in obese rats with insulin resistance (IR), and to explore the mechanism of EA on improving obesity with insulin resistance.@*METHODS@#Among the fifty 8-week-old healthy SPF male Wistar rats, 10 rats were randomly selected and fed with normal diet; after 8 weeks, 8 rats were randomly selected as a normal group. The remaining 40 rats were fed with high-fat diet to establish the model of obsesity IR; after 8 weeks, 24 rats with successful model of obsesity IR were randomly divided into a model group, an EA group and a sham EA group, 8 rats in each group. Eight weeks after model establishment, the rats in the EA group were intervened with EA at "Fenglong" (ST 40), "Zhongwan" (CV 12), "Guanyuan" (CV 4) and "Zusanli" (ST 36), with continuous wave, in frequency of 2 Hz, and current intensity of 1 mA, for 10 min each time. The rats in the sham EA group were intervened with EA at the points 5 mm next to the acupoints used in the EA group and no electricity was given; the sham EA was given for 10 min each time. Both the treatments were given once every other day for 8 weeks. The Lee's index and food intake were observed before the intervention as well as 2 weeks, 4 weeks, 6 weeks and 8 weeks into intervention; after the intervention, serum insulin (INS) and glucose infusion rate (GIR) were detected; serum cholecystokinin (CCK) level was detected by ELISA; c-fos expression in the area postrema (AP) and nucleus tractus solitarius (NTS) of medulla oblongata was detected by immunohistochemistry.@*RESULTS@#Before the intervention as well as 2 weeks, 4 weeks, 6 weeks and 8 weeks into intervention, the Lee's index and food intake in the model group were higher than those in normal group (<0.01). The Lee's index (6 weeks and 8 weeks into intervention) and food intake (4 weeks, 6 weeks and 8 weeks into intervention) in the EA group were lower than those in the model group and the sham EA group (<0.05, <0.01). After intervention, compared with the normal group, serum level of INS was increased (<0.01), while GIR, serum CCK level, c-fos expression in AP and NTS in the model group were decreased (<0.01, <0.05). Compared with the model group and the sham EA group, serum level of INS in the EA group was decreased (<0.01), and GIR, serum CCK level, c-fos expression in AP and NTS were increased (<0.01, <0.05).@*CONCLUSION@#EA of " acupoint combination" could effectively reduce appetite, body fat and enhance insulin sensitivity in obese rats with IR. The mechanism may be related to the regulation of central sensitivity of CCK.
ABSTRACT
BACKGROUND: There is no uniform standard for acromioclavicular dislocation. Clavicular hook plate fixation is a commonly used fixation method clinically, but minimally invasive ligament reconstruction technology and arthroscopic surgery have become a research hotspot. OBJECTIVE: To observe the application value of suture bridge with thread anchor under arthroscopy in the treatment of acromioclavicular dislocation. METHODS: Patients with Tossy type III acromioclavicular dislocation who were admitted to Department of Orthopedic Surgery of General Hospital of Jizhong Energy Xingtai Mining Group between January 2016 and April 2018 were selected as the subjects. The patients were randomly divided into two groups. The patients in the arthroscopy group were treated with arthroscopic suture bridge technique with suture anchor for reduction and fixation, while those in the clavicle hook plate group were treated with clavicular hook plate for internal fixation. The length of surgical incision, duration of surgery, hospitalization time and time to return to work of both groups were recorded. The shoulder function was evaluated according to the Lazzcano criterion of curative effect at 3, 6 and 12 months after surgery. The visual analogue scale score of shoulder pain, abduction and raising, forward bend and raising were compared between the two groups. All patients were followed up for 1 year to record the occurrence of complications. This study was approved by the Medical Ethics Committee of General Hospital of Jizhong Energy Xingtai Mining Group. All subjects signed the informed consent. RESULTS AND CONCLUSION: (1) There was no significant difference in the duration of surgery between the two groups (P > 0.05). The surgical incision, hospitalization time and time to return to work of the arthroscopy group were significantly better than those of the clavicle hook plate group (P 0.05). (3) Visual analogue scale scores of the two groups showed a decreasing trend at 3, 6 and 12 months after surgery (P < 0.01). The visual analogue scale score of arthroscopy group was significantly lower than that of the clavicle hook plate group at the same time point (P < 0.01). (4) Angles of abduction and raising, forward bend and raising of both groups showed an increasing trend at 3, 6 and 12 months after surgery (P < 0.01). The angles of abduction and raising, forward bend and raising of the arthroscopy group were larger than those of the clavicle hook plate group at the same time point (P < 0.01). (5) The 1-year follow-up results showed that the incidence of complications in the arthroscopy group (6%) was significantly lower than that in the clavicle hook plate group (63%) (P < 0.01). (6) Compared with clavicular hook plate fixation, the technique of suture anchors under arthroscopy has the advantages of small trauma, quick recovery, fewer complications and no need to remove endografts again. Meanwhile, the surgery can also clearly diagnose the concomitant lesions in the joints and treat them when necessary, so as to improve the treatment effect.
ABSTRACT
Objective:To investigate the perioperative and oncological outcomes in patients undergoing laparoscopic radical cystectomy with intracorporealorthotopic neobladder reconstruction.Methods:Clinical data of bladder cancer patients undergoing laparoscopic radical cystectomy(LRC) or robot-assisted radical cystectomy(RARC) with intracorporealorthotopic neobladder reconstruction in Zhejiang Provincial People's Hospital from March 2010 to December 2019 were retrospectively analyzed. There were 166 males and 52 females. The median age was 62 (52, 70) years old. The ASA score was 1-2 in 183 cases (83.9%) and 3 in 35 cases (16.1%). There were 61 cases of hypertension, 28 cases of diabetes, 26 cases of heart disease, 33 cases of history of abdominal surgery, and 3 cases received neoadjuvant chemotherapy. LRC was performed in 82 cases and RARC in 136 cases. The operation was performed by dissecting pelvic lymph nodes from right to left and then cystoprostatectomy. The periureteral blood supply and periperitoneal peritoneum were preserved, and the prostate was resected by intrafascial resection. The 30 cm terminal ileum was used to make a U-shaped new bladder, and then the urethral stump and both sides of the ureter were anastomosed on new bladder without tension. During the operation, two single J tubes were used as ureteral stent.The perioperative and pathological results results were evaluated.Results:The operations of 218 patients were completed successfully and there was no conversion to open operation. The median operation time was 281 (229, 400) ml. Intraoperative blood transfusion was performed in 24 cases (11.0%). Hospital stay was 15 (13, 22) days.Intraoperative complications happened in 11 cases (5.0%). Exhaust time was 2 (1, 3) days. Solid food intake time was 4 (3, 5) days. Total complications within 30 days after operation were 61 cases (28.0%), and total complications within 30-90 days after operation were 81 cases (37.2%). The number of median lymph node dissection in all patients was 19 (14, 24). Positive lymph nodes in 21 cases (9.6%). Positive margin in 6 cases (2.7%). Postoperative tumor pathological stages were T a/T 1/T is stage 48 cases, T 2 stage 134 cases, T 3 stage 36 cases. The median follow-up time of all patients was 33 (20.6, 48.2) months. There were 77 cases of tumor recurrence and 55 cases of death, of which 39 cases were tumor-specific death. The 5-year disease free survival, overall survival , and cancer-specific survival of all patients were 55.4%, 62.4% and 66.4%, respectively. Conclusions:Laparoscopic radical cystectomy and intracorporealorthotopic new bladder reconstruction can be well used in the treatment of muscle invasive or high-risk non-muscle invasive bladder cancer.Laparoscopic intracorporeal bladder reconstruction is feasible with few postoperative complications.
