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This paper summarized the clinical experience of Professor GE Linyi in treating ulcerative colitis (UC) by stages with the method of clearing. Professor GE believes that the core pathogenesis of UC is dampness and heat in the intestines, and by taking the method of clearing as the basis, he proposed four methods for treatment of UC including clearing and transforming, clearing and dispersing,clearing and moisterning, clearing and nourishing. The pathogenesis of UC in its active stage is dampness and heat in the intestines, congestion and stagnation of qi and blood, and accumulation of stasis toxins, for which the treatment method is to clear and transform, accompanied by clearing and dispersing method. In terms of the clearing and transforming method, Bai Tou Weng Decoction (白头翁汤) combined with Haungqin (Radix Scutellariae), Machixian (Herba Portulacae) and Pugongying (Herba Taraxaci) is taken as the basic prescription to clear and transform dampness and heat, cool blood, resolve toxins and stop dysentery. For the clearing and dispersing method, medicinals to rectify qi such as Chaihu (Radix Bupleuri), Cuxiangfu (Vingar Rhizoma Cyperi), Muxiang (Radix Aucklandiae), Zhiqiao (Fructus Aurantii), and Binlang (Semen Arecae), as well as those to regulate blood such as Danggui (Radix Angelicae Sinensis), Cebaiye (Cacumen Platycladi) and Diyutan (Radix Sanguisorbae Carbonisatus) are recommended. The pathogenesis of the remission stage is healthy qi depletion and lingering pathogen of dampness and heat stasis toxin in the intestines, for which the method of clearing and nourishing, clearing and moistening can be used; the latter is mainly for people with yin fluids injury, and self-made Qingrun Yichang Decoction (清润益肠汤) is recommended, while the former is for those with spleen and stomach weakness, and self-made Qingyang Jianpi Decoction (清养健脾汤) can be used.
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Originally used as an antimalarial drug,hydroxychloroquine is now widely used in the treatment of rheumatic immune diseases due to its cost-effectiveness,safety,and efficacy.In addition to its immunomodulatory effects,hydroxychloroquine also exhibits anti thrombotic,anti-hypolipidemic,and anti-hypoglycemic properties.Hydroxychloroquine blood levels are correlated with clinical outcomes and adverse reactions,and can reflect patient compliance.However,due to the complex pharmacokinetic profile of hydroxychloroquine,significant inter-individual differences in blood concentration exist even with the administration of the same dosage.This study investigates the factors affecting the blood concentration of hydroxychloroquine in terms of physiological factors,pathological factors,metabolic enzyme gene polymorphisms,and drug-related factors.The aim is to provide a reference for rational clinical use and the development of individualized dosing.
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Purpose To assess the right atrial and right ventricular strain and right ventricular-pulmonary artery(RV-PA)coupling in rheumatoid arthritis(RA)via two-dimensional speckle tracking.Materials and Methods Sixty patients with RA in the General Hospital of Ningxia Medical University from June 2020 to June 2022 were prospectively selected,and all RA patients were divided into three groups according to pulmonary artery systolic pressure(PASP),including group A(n=20 cases)with PASP<33 mmHg,group B(n=20 cases)with PASP 33-39 mmHg as mild ePH,and group C(n=20 cases)PASP≥40 mmHg,twenty healthy individuals were selected as the control group.All subjects underwent transthoracic echocardiography,and right atrial and right ventricular systolic function was assessed by two-dimensional speckle tracking technique,and RV-PA coupling was assessed noninvasively by right ventricular free wall strain/pulmonary artery systolic pressure(RV FWS/PASP),pulmonary function was analyzed by pulmonary function instruments.Spearman's analysis was used to analyze the correlation between right heart function and RV-PA coupling to pulmonary diffusion function.Results There were statistical differences in right ventricular base diameter,right atrium diameter,tricuspid annular plane systolic excursion,inferior vena cava diameter,PASP,right ventricular global strain,RV FWS,right atrium strain-reservoi,right atrium strain-conduit(S-CD),RV FWS/PASP among the four groups(F/H=2.369-74.880,all P<0.05).Right atrium strain-reservoi[(36.0±7.9)%vs.(30.9±7.8)%],right atrium S-CD[(19.9±6.9)%vs.(15.3±4.7)%]and RV FWS/PASP(0.96±0.19 vs.0.56±0.13)in group B were significantly lower than those of group A(t=2.040,2.262,7.704,all P<0.05).There was a good correlation between diffusing capacity of the lung for carbon monoxide single-breathmethod and right ventricular global strain,RV FWS,right atrium S-CD and RV FWS/PASP in RA patients(r=0.392,0.472,0.431,0.572,all P<0.05).Conclusion The more increases of pulmonary artery pressures,the more decreases of right heart function in RA patients,and the more uncoupling in RV-PA.Right heart dysfunction and right ventricle-pulmonary artery uncoupling have developed in RA patients with PASP 33-39 mmHg,with association of pulmonary diffusion dysfunction.
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Epstein-Barr virus (EBV) is generally susceptible in human beings and multi-organ systems can be involved in EBV infection, such as blood, respiratory, urinary, digestive and nervous systems. EBV infection also plays an important role in the pathogenesis of related tumors, autoimmune diseases and other diseases, posing a great threat to human health. As a DNA virus, EBV can be sensed by DNA recognition receptors to trigger a series of downstream immune responses. A DNA-sensing pathway consists of DNA sensors, adaptor molecules and downstream effector signals. Double-stranded DNA sensors mainly include absent in melanoma 2-like receptors (ALRs) and cyclic GMP-AMP synthase (cGAS). Adaptors were mainly stimulator of interferon genes (STING) and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC). Downstream immune responses mainly involve typeⅠIFN, inflammasomes and proinflammatory cytokines. As a double-stranded DNA virus of the Herpesviridae family, EBV triggers complex innate and adaptive immune responses in the host, especially the sensing pathways mediated by a variety of DNA recognition receptors, which play a key role in host immune defense and pathogen immune evasion. This review made the DNA sensor as the clue to comprehensively summarize the progress in the activation, regulatory mechanism and clinical relevance of DNA-sensing pathways in EBV infection in recent years, aiming to achieve a better understanding of the host innate immune responses during EBV infection and provide an immunological basis for the prevention and treatment of EBV infection-related diseases.
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Objective:To explore the differences of fecal calprotectin (FC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) between colon and small intestinal Crohn′s disease, and their predictive values for disease activity and mucosal healing in patients with small intestinal Crohn′s disease.Methods:From January 2017 to January 2023, 64 patients with Crohn′s disease who underwent capsule endoscopy in the First Affiliated Hospital of Zhejiang Chinese Medical University were enrolled, among them 28 patients had only small intestinal lesions (small intestine group) and 36 patients had lesions involving both small intestine and colon or only colon involvement (ileocolon group). The FC, CRP, and ESR levels of the two groups were detected and compared 15 days before capsule endoscopy examination. Wilcoxon rank-sum test was used for statistical analysis. Receiver operating characteristic curve analysis was used to evaluate the predictive value of FC, CRP, and ESR for disease activity and mucosal healing in patients with small intestinal Crohn′s disease.Results:The FC, CRP, and ESR levels of the small intestine group during the active phase of the disease were 1 689.00 μg/g (727.75 μg/g, 1 800.00 μg/g), 5.67 mg/L (1.00 mg/L, 17.01 mg/L), and 4.50 mm/1 h (2.00 mm/1 h, 11.00 mm/1 h), respectively; while FC, CRP, and ESR levels during the mucosal healing phase were 112.00 μg/g (46.50 μg/g, 130.50 μg/g), 1.00 mg/L (1.00 mg/L, 1.62 mg/L), and 2.00 mm/1 h (2.00 mm/1 h, 5.50 mm/1 h), respectively. The FC, CRP, and ESR levels of the ileocolon group during the active phase of the disease were 1 800.00 μg/g (895.50 μg/g, 1 800.00 μg/g), 4.94 mg/L (3.10 mg/L, 14.80 mg/L), and 10.00 mm/1 h (2.00 mm/1 h, 27.75 mm/1 h), respectively, while FC, CRP, and ESR levels during the mucosal healing phase were 66.00 μg/g (32.50 μg/g, 97.50 μg/g), 1.00 mg/L (1.00 mg/L, 1.55 mg/L), and 2.00 mm/1 h (2.00 mm/1 h, 4.50 mm/1 h), respectively. There were no statistically significant differences in FC, CRP, and ESR between the small intestine group and the ileocolon group during the active phase of the disease and mucosal healing phase (all P> 0.05). In the small intestine group, the levels of FC and CRP of patients during the active phase of the disease were 1 173.00 μg/g (312.00 μg/g, 1 800.00 μg/g) and 2.10 mg/1 L (1.00 mg/L, 16.00 mg/L), which were both higher than those of patients during the mucosal healing phase (112.00 μg/g (46.50 μg/g, 130.50 μg/g) and 1.00 mg/L (1.00 mg/L, 1.62 mg/L)), and the differences were statistically significant ( Z=-4.35 and-2.67, P<0.001 and =0.008). In the small intestine group, the level of ESR of patients during the active phase of the disease was 4.00 mm/1 h (2.00 mm/1 h, 16.00 mm/1 h), and there was no significant difference compared with that of patients during the mucosal healing phase (2.00 mm/1 h (2.00 mm/1 h, 5.50 mm/1 h)) ( P>0.05). When the cut-off level of FC was 188.50 μg/g, the sensitivity, specificity, and area under the curve for predicting disease activity in patients with small intestinal Crohn′s disease was 93.3%, 100.0%, and 0.964, respectively. When the cut-off value of CRP was 3.12 mg/L, the sensitivity, specificity, and area under the curve for predicting disease activity in patients with small intestinal Crohn′s disease was 46.7%, 92.3%, and 0.744, respectively. When the cut-off level of ESR was 10.00 mm/1 h, the sensitivity, specificity, and area under the curve for predicting disease activity in patients with small intestinal Crohn′s disease was 33.3%, 100.0%, and 0.654, respectively. There were no statistically significant differences in the area under the curve between the combinations of FC and CRP, FC and ESR, FC, CRP and ESR, and FC alone for predicting disease activity in patients with small intestinal Crohn′s disease (0.964, 0.959, and 0.959 vs. 0.964, all P> 0.05). There was a statistically significant difference in the area under the curve between the combination of CRP and ESR and FC alone in predicting disease activity in patients with small intestinal Crohn′s disease (0.708 vs. 0.964, Z=-2.57, P=0.010). Conclusions:There are no statistically significant differences in FC, CRP, and ESR between colon and small intestinal Crohn′s disease. FC has a high predictive value for disease activity and mucosal healing in patients with small intestinal Crohn′s disease and has certain clinical application value.
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@#Objective To compare the in-hospital outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) for bicuspid aortic valve (BAV) patients and tricuspid aortic valve (TAV) patients. Methods Patients (including BAV and TAV patients) who underwent TA-TAVR with the J-ValveTM in West China Hospital from July 2014 to July 2020 were included consecutively. The clinical outcomes of the patients were analyzed. Results A total of 354 patients were included in the study, 75 in the BAV group and 279 in the TAV group. There were 229 males and 125 females with a mean age of 72.2±6.0 years. No death occurred during the procedure, and the overall technical success rate was 97.7%. The all-cause in-hospital mortality rate was 1.4%. Twenty (26.7%) patients with BAV and 46 (16.5%) patients with TAV had mild or higher perivalvular leaks immediately after the procedure. No patients with BAV required permanent pacemaker implantation postoperatively, while 13 (4.7%) TAV patients required permanent pacemaker implantation, with an overall pacemaker implantation rate of 3.7%. One (1.3%) BAV patient and 7 (2.5%) TAV patients developed acute kidney injury postoperatively. One (1.3%) BAV patient and 1 (0.4%) TAV patient developed peri-operative myocardial infarction. The average postoperative hospital stay was 7.6±3.6 d for BAV patients and 8.6±6.1 d for TAV patients. There was no statistical difference in primary or secondary in-hospital outcomes between BAV and TAV patients (P>0.05). Conclusion Compared to TAV patients, BAV patients have similar in-hospital outcomes, with a low incidence of adverse clinical outcomes, which provides preliminary evidence for its implementation in Chinese patients with a high proportion of BAV.
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Objective: To investigate the prognoses of advanced (T3-T4) sinonasal malignancies (SNM). Methods: The clinical data of 229 patients with advanced (T3-4) SNM who underwent surgical treatments in the First Affiliated Hospital of Sun Yat-sen University from 2000 to 2018 were retrospectively analyzed, including 162 males and 67 females, aged (46.8±18.5) years old. Among them, 167 cases received endoscopic surgery alone, 30 cases received assisted incision endoscopic surgery, and 32 cases received open surgery. The Kaplan-Meier method was used to estimate the 3-year and 5-year overall survival (OS) and event-free survival (EFS). Univariate and multivariate Cox regression analyses were performed to explore significant prognostic factors. Results: The 3-year and 5-year OS were respectively 69.7% and 64.0%. The median OS time was 43 months. The 3-year and 5-year EFS were respectively 57.8% and 47.4%. The median EFS time was 34 months. The 5-year OS of the patients with epithelial-derived tumors was better than that of the patients with mesenchymal-derived tumors and malignant melanoma (5-year OS was respectively 72.3%, 47.8% and 30.0%, χ2=36.01, P<0.001). Patients with microscopically margin-negative resection (R0 resection) had the best prognosis, followed by macroscopically margin-negative resection (R1 resection), and debulking surgery was the worst (5-year OS was respectively 78.4%, 55.1% and 37.4%, χ2=24.63, P<0.001). There was no significant difference in 5-year OS between the endoscopic surgery group and the open surgery group (65.8% vs. 53.4%, χ2=2.66, P=0.102). Older patients had worse OS (HR=1.02, P=0.011) and EFS (HR=1.01, P=0.027). Patients receiving adjuvant therapy had a lower risk of death (HR=0.62, P=0.038). Patients with a history of nasal radiotherapy had a higher risk of recurrence (HR=2.48, P=0.002) and a higher risk of death (HR=2.03, P=0.020). Conclusion: For patients with advanced SNM, the efficacy of endoscopic surgery can be comparable to that of open surgery when presence of safe surgical margins, and a treatment plan based on transnasal endoscopic surgery as the main comprehensive treatment is recommended.
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Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Pronóstico , Terapia Combinada , Melanoma/cirugía , EndoscopíaRESUMEN
OBJECTIVE@#To investigate the anti-coronavirus potential and the corresponding mechanisms of the two ingredients of Reduning Injection: quercetin and luteolin.@*METHODS@#A pseudovirus system was designed to test the efficacy of quercetin and luteolin to inhibit SARS-CoV-2 infection and the corresponding cellular toxicity. Luteolin was tested for its activities against the pseudoviruses of SARS-CoV-2 and its variants. Virtual screening was performed to predict the binding sites by Autodock Vina 1.1.230 and PyMol. To validate docking results, surface plasmon resonance (SPR) was used to measure the binding affinity of the compounds with various proteins of the coronaviruses. Quercetin and luteolin were further tested for their inhibitory effects on other coronaviruses by indirect immunofluorescence assay on rhabdomyosarcoma cells infected with HCoV-OC43.@*RESULTS@#The inhibition of SARS-CoV-2 pseudovirus by luteolin and quercetin were strongly dose-dependent, with concentration for 50% of maximal effect (EC50) of 8.817 and 52.98 µmol/L, respectively. Their cytotoxicity to BHK21-hACE2 were 177.6 and 405.1 µmol/L, respectively. In addition, luetolin significantly blocked the entry of 4 pseudoviruses of SARS-CoV-2 variants, with EC50 lower than 7 µmol/L. Virtual screening and SPR confirmed that luteolin binds to the S-proteins and quercetin binds to the active center of the 3CLpro, PLpro, and helicase proteins. Quercetin and luteolin showed over 99% inhibition against HCoV-OC43.@*CONCLUSIONS@#The mechanisms were revealed of quercetin and luteolin inhibiting the infection of SARS-CoV-2 and its variants. Reduning Injection is a promising drug for COVID-19.
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Humanos , SARS-CoV-2 , COVID-19 , Luteolina , QuercetinaRESUMEN
Objective:To explore the role of navigation-assisted valgus stress method in avoiding excessive correction of lower limb mechanical axis after high tibial osteotomy (HTO).Methods:A retrospective study was carried out on osteoarthritis (OA) patients who were treated with HTO for medial compartment pain of knee from January 2020 to March 2022 in the Department of Joint Surgery, Shanghai Changhai Hospital, the First Affiliated Hospital of Naval Medical University. According to the different ways of confirming alignment during operation, they were divided into computer navigation assisted valgus stress HTO group (referred to as navigation group) and traditional rod fluoroscopy HTO group (referred to as traditional group). There were 28 patients in the navigation group, 10 males and 18 females, with age of 54.4±9.1 years (range, 41-73 years) and body mass index of 26.1±3.3 kg/m 2 (range, 19.8-35.2 kg/m 2); There were 30 patients in the traditional group, 13 males and 17 females, aged 56.9±8.5 years (range, 40-70 years), with a body mass index of 25.7±4.0 kg/m 2 (range, 19.2-32.9 kg/m 2). Measuring the mechanical femoral tibial angle (mFTA), joint line convergence angle (JLCA), medial proximal tibial angle (MPTA), Lysholm score and Hospital for Special Surgery (HSS) score before operation and at the last follow-up of the two groups, and conduct statistical analysis. Results:Both groups were followed up. The follow-up time of navigation group and traditional group was 21.3±8.7 months and 22.5±7.6 months, respectively, with no significant difference ( t=0.53, P=0.596). There were significant differences between the two groups in the amount of mechanical axis correction (ΔmFTA) and the amount of bone correction (ΔMPTA) ( t=2.09, P=0.041; t=2.58, P=0.012), while there was no significant difference in ΔJLCA ( t=0.32, P=0.753). In the navigation group, there were 9 cases (32%) of undercorrection, 17 cases (61%) with acceptable alignment, and 2 cases (7%) with over correction, while in the traditional group, there were 5 cases (17%) with under correction, 13 cases (43%) with acceptable alignment, and 12 cases (40%) with over correction. There was significant difference in the distribution rate of alignment between the two groups ( P=0.012), and the rate of overcorrection in the navigation group was significantly lower than that in the control group (7% vs. 40%, P=0.005). The intra group correlation coefficient between the navigation correction mechanical axis and ΔmFTA was 0.787. There was no significant difference in Lysholm score and HSS score between the two groups before and after surgery (all P>0.05), and they were significantly improved after operation (all P<0.05). Conclusion:Navigation-assisted valgus stress method HTO is reliable, which can accurately achieve the target alignment, reduce the incidence of over correction, and obtain good clinical results.
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Objective:To understand the current level of work engagement of new nurses and analyze the relationship between the variables of emotion regulation difficulties, job crafting, and work engagement, to provide a theoretical basis for nursing managers to develop interventions to enhance the level of work engagement of new nurses.Methods:The convenience sampling method was applied to select a total of 637 new nurses from 11 tertiary levels A hospitals in Beijing City, Zhejiang Province, Guangxi Zhuang Autonomous Region, Anhui Province, and Hubei Province from April to June 2022 as the respondents, and the general information questionnaire, Emotion Regulation Difficulties Scale, Job Crafting Scale and Work Engagement Scale were used to conduct a cross-sectional survey. The mediation effect was analyzed by AMOS 26.0 structural equation model.Results:Finally, 626 new nurses were included, and scored (31.08 ± 10.94) points on the Work Engagement Scale, with a mean entry score of (3.45 ± 1.22) points. Work engagement was significantly negatively associated with difficulties in emotion regulation ( r=-0.291, P<0.01) and positively associated with job crafting ( r=0.724, P<0.01). Analysis of mediating effects revealed that job crafting partially mediated the relationship between difficulties in emotion regulation and work engagement ( β=-0.424, P<0.001). Conclusions:New nurses' work engagement was at an intermediate level, and job crafting partially mediated the relationship between emotion regulation difficulties and work engagement. Nursing managers should strengthen training on emotion regulation strategies for new nurses and construct intervention strategies based on job crafting, to improve new nurses′ work engagement.
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Objective:To explore the characteristics of echocardiographic parameters among the many parameters of two-dimensional transthoracic echocardiography(2D-TTE) and three-dimensional speckle tracking imaging (3D-STI) that can be used for early identification of familial hypertrophic cardiomyopathy(FHCM) mutation gene carriers, and construct a Nomogram prediction model, in order to provide a diagnostic method for early identification of G+ P- patients for clinical practice.Methods:A total of 15 FHCM families admitted to the General Hospital of Ningxia Medical University from November 2017 to August 2022 were enrolled.Whole exome sequencing and Sanger sequencing technology were used for gene detection, among which 54 were G+ P- and 75 were G-P-. Stratified random sampling was used to divide the subjects into training set ( n=90) and test set ( n=39) according to the ratio of 7∶3. Philips iE33 ultrasonic diagnostic instrument and TomTec offline software were used to obtain relevant ultrasonic parameters. Lasso regression and Logistic regression were used to screen echocardiographic parameters and obtain independent risk factors for early prediction of G+ P-, based on which a Nomogram prediction model was established. Results:①Lasso-Logistic regression showed that global longitudinal strain(GLS) ( OR=1.739, 95% CI=1.305-2.316) and left ventricular outflow trac velocity time integral(LVOT-VTI) ( OR=1.358, 95% CI=1.072-1.722) could be used as independent risk factors for early prediction of G+ P-. ②The Nomogram prediction model was established based on the above indicators. After 1000 internal verifications of Bootstrap self-sampling, the C-indices of the training set and the test set were 0.885 (95% CI=0.816-0.954), 0.878 (95% CI=0.764-0.992), which had good internal consistency. ③The results of the calibration curve showed that the risk of G+ P- predicted by the Nomogram model was basically consistent with the actual risk (training set P=0.990, test set P=0.961); the clinical decision curve shows that under different threshold probabilities, using this prediction model to provide patients with clinical decision-making could bring benefits to patients. Conclusions:Echocardiographic parameters GLS and LVOT-VTI can be used as independent risk factors to predict FHCM mutation gene carriers. The Nomogram prediction model has good discrimination, goodness of fit and clinical benefit in identifying whether the family members of FHCM patients carry the mutation gene, and it can provide a new idea and evaluation method for the early identification of FHCM mutation gene carriers by echocardiography.
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Wurfbainia villosa fruit is rich in volatile terpenoids, among which pinene is one of the main components and has anti-inflammatory, antibacterial, anti-tumor, and other pharmacological activities. This research group found that W. villosa fruits were rich in α-pinene by GC-MS, and terpene synthase(WvTPS63, formerly known as AvTPS1) with β-pinene as the main product was cloned and identified, but α-pinene synthase had not been identified. In this study, based on the genome data of W. villosa, we screened and found WvTPS66 with highly similar sequences to WvTPS63, identified enzyme functions of WvTPS66 in vitro, and performed a comparative analysis of sequence, catalytic function, expression pattern, and promoter with WvTPS63. Multiple sequence alignment showed that the amino acid sequences of WvTPS63 and WvTPS66 were highly similar and the conservative motif of terpene synthase was almost identical. In vitro enzymatic experiments on catalytic functions showed that both could produce pinene, and the main product of WvTPS63 was β-pinene, while that of WvTPS66 was α-pinene. Expression pattern analysis showed that WvTS63 was highly expressed in flowers, WvTPS66 was expressed in the whole plant, and the highest expression level was found in the pericarp, which indicated that it might be mainly responsible for the synthesis of α-pinene in fruits. In addition, promoter analysis revealed the presence of multiple regulatory elements related to stress response in the promoter regions of both genes. The findings of this study can provide a reference for the functional study of terpene synthase genes and new genetic elements for pinene biosynthesis.
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Terpenos , Secuencia de Aminoácidos , AntibacterianosRESUMEN
Purpose: This study aimed to investigate the influence of orthokeratology (OK) on myopia control and ocular surface and meibomian gland function in myopic adolescents. Methods: A prospective study was conducted over a 12-month period. The subjects were classified into two groups, namely, the OK lens group and the frame glasses control group. Axial length, corneal curvature, ocular surface, and meibomian gland parameters were measured at baseline, 1, 3, 6, and 12 months after wearing OK lenses. Results: The axial length growth rate in the OK group was significantly slower than in the control group (P < 0.01). The naked eye vision and the ocular surface disease index (OSDI) scores recorded 1, 3, 6, and 12 months after wearing OK lenses were significantly higher than the scores recorded before wearing OK lenses. There was no significant difference in other ocular parameters at each follow-up time point compared with pre-wearing (P > 0.05). After using the OK lens for 6 months, the OSDI score and corneal fluorescein staining (CFS) score increased significantly (P < 0.001), but there were no significant differences in other parameters among the groups. No infectious keratitis occurred during the study. Conclusion: These results provide evidence that the use of OK lenses can control the axial growth and progress rate of myopia compared with frame glasses. During the 12-month follow-up, although wearing OK lenses may have aggravated dry eye symptoms, each patient's ocular surface and meibomian gland function did not change significantly, indicating that the use of OK lenses is a relatively safe modality for the control of myopia in adolescents.
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Objective: A clinical prediction model for postoperative combined Acute kidney injury (AKI) in patients with Type A acute aortic dissection (TAAAD) and Type B acute aortic dissection (TBAAD) was constructed by using Machine Learning (ML). Methods: Baseline data was collected from Acute aortic division (AAD) patients admitted to First Affiliated Hospital of Xinjiang Medical University between January 1, 2019 and December 31, 2021. (1) We identified baseline Serum creatinine (SCR) estimation methods and used them as a basis for diagnosis of AKI. (2) Divide their total datasets randomly into Training set (70%) and Test set (30%), Bootstrap modeling and validation of features using multiple ML methods in the training set, and select models corresponding to the largest Area Under Curve (AUC) for follow-up studies. (3) Screening of the best ML model variables through the model visualization tools Shapley Addictive Explanations (SHAP) and Recursive feature reduction (REF). (4) Finally, the pre-screened prediction models were evaluated using test set data from three aspects: discrimination, Calibration, and clinical benefit. Results: The final incidence of AKI was 69.4% (120/173) in 173 patients with TAAAD and 28.6% (81/283) in 283 patients with TBAAD. For TAAAD-AKI, the Random Forest (RF) model showed the best prediction performance in the training set (AUC = 0.760, 95% CI:0.630-0.881); while for TBAAD-AKI, the Light Gradient Boosting Machine (LightGBM) model worked best (AUC = 0.734, 95% CI:0.623-0.847). Screening of the characteristic variables revealed that the common predictors among the two final prediction models for postoperative AKI due to AAD were baseline SCR, Blood urea nitrogen (BUN) and Uric acid (UA) at admission, Mechanical ventilation time (MVT). The specific predictors in the TAAAD-AKI model are: White blood cell (WBC), Platelet (PLT) and D dimer at admission, Plasma The specific predictors in the TBAAD-AKI model were N-terminal pro B-type natriuretic peptide (BNP), Serum kalium, Activated partial thromboplastin time (APTT) and Systolic blood pressure (SBP) at admission, Combined renal arteriography in surgery. Finally, we used in terms of Discrimination, the ROC value of the RF model for TAAAD was 0.81 and the ROC value of the LightGBM model for TBAAD was 0.74, both with good accuracy. In terms of calibration, the calibration curve of TAAAD-AKI's RF fits the ideal curve the best and has the lowest and smallest Brier score (0.16). Similarly, the calibration curve of TBAAD-AKI's LightGBM model fits the ideal curve the best and has the smallest Brier score (0.15). In terms of Clinical benefit, the best ML models for both types of AAD have good Net benefit as shown by Decision Curve Analysis (DCA). Conclusion: We successfully constructed and validated clinical prediction models for the occurrence of AKI after surgery in TAAAD and TBAAD patients using different ML algorithms. The main predictors of the two types of AAD-AKI are somewhat different, and the strategies for early prevention and control of AKI are also different and need more external data for validation.
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ObjectiveTo investigate the effect of the expression of HBcAg in hepatocytes on the serum level of HBcAb and seroconversion of HBeAg after antiviral therapy with nucleos(t)ide analogues (NUCs). MethodsSerum samples and liver tissue paraffin sections were collected from 101 chronic hepatitis B (CHB) patients who received antiviral therapy with NUCs in Nanfang Hospital and Panyu Central Hospital from January 2015 to June 2018. ELISA was used to measure the serum level of HBcAb, and immunohistochemistry was used to measure the expression of HBcAg in the liver. The GEO database (GSE96851) was analyzed to obtain differentially expressed genes in the liver of patients with HBcAg-positive hepatitis. The two-independent-samples t test was used for comparison of continuous data between two groups; the multiple-independent-samples nonparametric Kruskal-Wallis H test was used for comparison of continuous data between multiple groups, and Dunnett method was used for further comparisons; the chi-square test was used for comparison of categorical data between groups. ResultsThe expression pattern of HBcAg in hepatocytes was classified as absent expression, nuclear expression, cytoplasmic expression, and nuclear/cytoplasmic expression, and according to expression level, HBcAg expression was classified as grades Ⅰ, Ⅱ, Ⅲ, and Ⅳ expression. HBeAg seroconversion rates after 96 weeks of antiviral therapy were 5.88%, 16.67%, 22.73%, and 24.24%, respectively, in the patients with absent expression, nuclear expression, cytoplasmic expression, and nuclear/cytoplasmic expression (χ2=4753, P=0.037), and HBeAg seroconversion rates after 96 weeks of antiviral therapy were 5.88%, 13.04%, 27.59%, and 26.67%, respectively, in the patients with grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ expression (χ2=6.580, P=0.016). There were significant differences in the serum levels of HBcAb-IgM and total HBcAb between the patients with absent expression, nuclear expression, cytoplasmic expression, and nuclear/cytoplasmic expression of HBcAg (HBcAb-IgM: H=9.760, P=0.021; total HBcAb: H=21.46, P<0.001), and there were also significant differences in the serum levels of HBcAb-IgM and total HBcAb between the patients with grade Ⅰ, Ⅱ, Ⅲ, and IV expression of HBcAg (HBcAb-IgM: H=18.80, P<0.001; total HBcAb: H=26.03, P<0.001). The analysis of differentially expressed genes in the liver showed that the expression of antibody-related genes was upregulated in the liver of patients with HBcAg-positive acute liver failure. ConclusionThe expression pattern and level of HBcAg in the cytoplasm of hepatocytes are associated with serum HBcAb, and the measurement of HBcAg may help to predict the efficacy of antiviral therapy with NUCs.
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Objective@#: To study the physiochemical characteristics of podophyllotoxin (PPT) conjugated stearic acid grafted chitosan oligosaccharide micelle (PPT-CSO-SA), and evaluate the ability of the potential antineoplastic effects against glioma cells. @*Methods@#: PPT-CSO-SA was prepared by a dialysis method. The quality of PPT-CSO-SA including micellar size, zeta potential, drug encapsulation efficiency and drug release profiles was evaluated. Glioma cells were cultured and treated with PPT and PPT-CSO-SA. The ability of glioma cells to uptake PPT-CSO-SA was observed. The proliferation of glioma cells was determined by 3-[4, 5-dimethyl-2-thiazolyl]-2, 5-diphenyl-2H-tetrazolium bromide (MTT) assay. The apoptosis and morphology of U251 cells were observed by 4’,6-Diamidino-2-phenylindole dihydrochloride (DAPI) dye staining. Cell cycle analysis was performed by flow cytometry. The migration ability of U251 cells was determined by wound healing test. @*Results@#: PPT-CSO-SA had nano-level particle size and sustained release property. The encapsulation efficiency of drug reached a high level. The cellular uptake percentage of PPT in glioma cells was lower than that of PPT-CSO-SA (p<0.05). The inhibitory effect of PPT-CSO-SA on glioma cells proliferation was significantly stronger than that of PPT (p<0.05). The morphologic change of apoptosis cell such as shrinkage, karyorrhexis and karyopyknosis were observed. The percentage of U251 cells in G2/M phase increased significantly in the PPT-CSO-SA group compared with PPT group (p<0.05). Compared with the PPT group, the cell migration ability of the PPT-CSO-SA group was significantly inhibited after 12 and 24 hours (p<0.05). @*Conclusion@#: PPT-CSO-SA can effectively enhance the glioma cellular uptake of drugs, inhibit glioma cells proliferation and migration, induce G2/M phase arrest of them, and promote their apoptosis. It may be a promising anti-glioma nano-drug.
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Objective Transdifferentiation exists between stromal cells or between stromal cells and cancer cells. Evodiamine and berberine are predominant pharmacological components of pill, a prescription of Traditional Chinese Medicine, playing crucial functions in remolding of tumor microenvironment. This study aimed to explore the effect of combination of evodiamine with berberine (cBerEvo) on the phenotypic transition of colon epithelial cells induced by tumor-associated fibroblasts, as well as the involved mechanisms.Methods Human normal colon epithelial cell line HCoEpiC cells were treated with the prepared conditioned medium of CCD-18Co, a human colon myofibroblast line, to induce epithelial-mesenchymal transition. Phase contrast microscope was used to observe the morphological changes. Epithelial-mesenchymal transition markers including E-cadherin, vimentin and alpha-smooth muscle actin (α-SMA) were observed with immunofluorescence microscopy. Migration was assessed by wound healing assay. Western blotting was used to detect the expressions of E-cadherin, vimentin, α-SMA, Snail, ZEB1 and Smads. Results In contrast to the control, the tumor-associated fibroblasts-like CCD-18Co cells induced down-regulation of E-cadherin and up-regulation of vimentin, α-SMA, Snail and ZEB1 (<0.05), and promoted migration of HCoEpiCs (<0.05), with over expression of Smads including Smad2, p-Smad2, Smad3, p-Smad3 and Smad4 (<0.05), which were abolished by a transforming growth factor-β (TGF-β) receptor inhibitor LY364947 and by cBerEvo in a concentration dependent manner. In addition, cBerEvo-inhibited ratios of p-Smad2/Smad2 and p-Smad3/Smad3 were also dose dependent.Conclusion The above results suggest that cBerEvo can regulate the differentiation of colon epithelial cells induced by CCD-18Co through suppressing activity of TGF-β/Smads signaling pathway.
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Objective:To analyze the changes of soil microbial community structure before and after planting Gastrodia elata in different producing areas,and to investigate the response of soil microorganisms to the planting of G. elata. Method:ITS and 16S rDNA high-throughput sequencing technologies were used to detect fungal and bacterial community compositions in the soil,including the soil without planting G. elata(CK1,CK2),the soil around G. elata(GE1,GE2)before harvesting, and the soil around the rhizomorph of Armillaria(AGE1,AGE2) in Dafang, Guizhou and Jinzhai, Anhui respectively. Result:Principal component analysis (PCA) showed that the soil microorganisms changed significantly after G. elata planting as compared with the control soil. The sequencing results showed that the planting of G. elata increased the OTUs number of fungi and bacteria. As compared with the control soil,the diversity and abundance of fungal and bacterial communities showed an increase trend after the cultivation of G. elata in soil of Dafang, Guizhou, such changes of fungal communities were not significant, but the abundance of soil bacteria communities increased in Jinzhai, Anhui as compared with the control soil. The abundance of genera Ilyonectria and Nitrospira increased,while genera Russula decreased significantly both in the soil of Guizhou and Anhui. Furthermore,the abundance of Fusarium and Mortierella increased significantly in the soil of Dafang, Guizhou. Conclusion:The soil microorganisms were out of balance after planting of G. elata, and the abundance of pathogenic microorganisms such as Ilyonectria and Fusarium increased,which may be related to the plant diseases and insect pests of G. elata.
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Objective:To explore the effects of high temperature stress on the growth characteristics of different Armillaria strains,and to provide guidance for screening excellent Armillaria strains with high-temperature resistance. Method:14 strains of Armillaria from different G. elata producing areas were used as experimental materials to observe the growth characteristics and conduct phenotypic classification for the strains. rDNA-IGS sequence analysis was used for molecular identification to further determine the genetic relationship of the tested strains.The strain growth rate, biomass,mycelial length and other indicators under the condition of 23 ℃ (CK) and 30 ℃ high temperature stress were recorded. Result:All the 14 strains of Armillaria had the highest similarity and the closest relationship with Armillaria gallica,but there were significant differences in growth characteristics among different G. elata producing areas. The 14 strains of Armillaria were classified into Ⅳ groups,and the growth status was groupⅠ>group Ⅱ>group Ⅲ>group Ⅳ. After treatment with high temperature stress,the tolerance of each strain to high temperature also showed obvious differences,as shown in the average growth rate of the mycelial was GZ16>SX1>GZ1. The rank of relative mycelial length was GZ16>SX1>GZ3 and the relative biomass was GZ16>SX4>GZ1>HB1>AH2. Conclusion:Under high temperature stress,GZ16 was best in growth rate,relative length of mycelial,relative biomass and growth state,followed by SX1 and GZ1 strains. The results indicate that strains GZ16,SX1 and GZ1 have the strong resistance to high temperature and excellent growth characteristics at normal temperature,so these three strains are suitable to be produced in main G. elata producing areas in China.
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Criticality pathways and genes related to osteoporosis were identified. We downloaded the expression data of osteoclasts treated with or without bisphosphonates and all human pathways from the public database. Gibbs sampling and Markov chain were performed to identify the disturbed pathways and the hub genes in the disturbed pathways. Pathways and genes with adjusted probability (αadj ) ≥0.75 were considered as the disturbed pathways and hub genes. We identified four disturbed pathways (Maturity onset diabetes of the young, Olfactory transduction, Cyanoamino acid metabolism, Taurine and hypotaurine metabolism) and two hub genes (OR2A4 and NKX2-2) with αadj ≥0.75. The expression levels of these disturbed pathways and hub genes were downregulated in bisphosphonates group. In conclusion, four disturbed pathways and two hub genes related to osteoporosis were identified. These results give us a better understanding of the potential mechanism of bisphosphonate treatment and the pathogenesis of osteoporosis.