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OBJECTIVE To explore the neuroprotective effect of sodium aescinate on rats with Parkinson’s disease by regulating the silent information regulator 1 (SIRT1)/nuclear factor-κB (NF-κB) signaling pathway. METHODS The Parkinson’s disease rat model was constructed by using 6-hydroxydopamine injection method. Forty-eight rats successfully modeled were randomly divided into model group, sodium aescinate low-dose group (1.8 mg/kg), sodium aescinate high-dose group (3.6 mg/kg), sodium aescinate+EX527 (sodium aescinate 3.6 mg/kg+SIRT1 inhibitor EX527 5 mg/kg) group, with 12 rats in each group. Another 12 healthy rats were selected as the sham operation group. Each group was injected with the corresponding drug solution intraperitoneally, once a day, for 21 consecutive days. Twenty-four hours after the end of the last administration, the motor and cognitive functions of rats were detected, and the morphology of neurons in the substantia nigra and CA1 region of hippocampal tissue were observed. The content of dopamine (DA) in the nigrostriatal and the expression levels of tyrosine hydroxylase (TH) and α-synuclein (α-Syn) in the substantia nigra were detected. The serum levels of pro-inflammatory factor [interleukin-6 (IL-6), IL-18], anti-inflammatory factor (IL-10), and the expression levels of SIRT1, phosphorylated NF-κB p65 (p-NF-κB p65) and NF- κB p65 protein in nigrostriatal were detected. RESULTS Compared with sham operation group, the neurons in the substantia nigra and CA1 region of hippocampal tissue were seriously damaged in model group; the number of rotations, escape latency, the expression levels of α-Syn in substantia nigra, the levels of serum pro-inflammatory factors, the relative expression ratio of p-NF- κB p65 and NF-κB p65 protein in nigrostriatal were increased or prolonged significantly (P<0.05); the target quadrant residence time, the content of DA in nigrostriatal, the expression level of TH in substantia nigra, the serum level of anti-inflammatory factor, and the expression level of SIRT1 protein in substantia nigra striatum were significantly decreased or shortened (P<0.05). Compared with model group, the damage degrees of neuron in sodium aescinate groups were alleviated, and the quantitative indicators were significantly improved, which were more significant in the high-dose group (P<0.05); EX527 could reverse the improvement effect of high-dose sodium aescinate (P<0.05). CONCLUSIONS Sodium aescinate can inhibit the activation of NF-κB signal by up-regulating the protein expression of SIRT1, thereby reducing the neuroinflammation of rats with Parkinson’s disease, improving the motor and cognitive dysfunctions, and finally playing a neuroprotective role.
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Objective To explore the expression, correlation with clinicopathologic parameters, and clinical significance of MIS18 binding protein 1 (MIS18BP1) in bladder cancer. Methods TCGA and GEO databases were used to analyze the mRNA expression of MIS18BP1 in tumors and controls, and the results were verified via qRT-PCR. UALCAN online database was utilized in the analysis of the expression of MIS18BP1 and its correlation with clinicopathological parameters and the degree of immune cell infiltration. Immunohistochemistry was employed to analyze the expression of MIS18BP1 in bladder cancer and its relationship with clinicopathological features. The ROC curve was applied to evaluate the diagnostic value of MIS18BP1 mRNA in bladder cancer. Results Bioinformatics analysis and qRT-PCR results revealed the increased expression of MIS18BP1 mRNA in bladder cancer compared with that in the control group (P<0.05). Immunohistochemistry unveiled the significantly high positive rate of MIS18BP1 protein in bladder cancer (P<0.05) and its correlation with the clinical stage of tumors, depth of invasion, and lymph node metastasis (P<0.05). The immune infiltration analysis showed the association of MIS18BP1 with immune cell infiltration in bladder cancer. Conclusion The increased expression level of MIS18BP1 gene and protein in bladder cancer may regulate the development of bladder cancer by influencing immune cell infiltration.
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Objective To explore the application effect of multimodal MRI in the diagnosis of lumbar intervertebral disc degeneration.Methods A total of 78 patients with lumbar intervertebral disc degeneration treated conservatively were retrospectively selected.The patients underwent sagittal T2WI,axial T2WI sequence and sagittal synthetic MRI scanning and post-processing to generate T1,T2 and proton density(PD)mapping quantitative sequences by GE Signa Pioneer 3.0T MR machine.The T1,T2 and PD values of the anterior and posterior annulus fibrosus and nucleus pulposus of L1-L2 to L5-S1 lumbar intervertebral disc were measured.The Pfirrmann grade,visual analogue scale(VAS)and Oswestry disability index(ODI)scale of each intervertebral disc were evaluated.The T1,T2,PD,VAS and ODI of patients with different Pfirrmann grades were compared.Pearson linear analysis was used to analyze the relationship between T1,T2,PD and VAS,ODI.Spearman rank correlation method was used to analyze the relationship between T1,T2,PD and Pfirrmann.Logistic regression analysis was used to analyze the evaluation value of T1,T2 and PD in Pfirrmann.Results With the increase of Pfirrmann grade,the T1,T2 and PD values of patients decreased,while the VAS score and ODI increased(P<0.05).The T1,T2 and PD values were negatively correlated with VAS score,ODI and Pfirrmann grade(P<0.05).Logistic regression analysis showed that T1,T2 and PD values had good evaluation values for Pfirrmann grade(P<0.05).Conclusion Multimodal MRI can effectively evaluate the Pfirrmann grade,pain and lumbar function of lumbar intervertebral disc degeneration,which can be used to help determine the diagnosis.
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Objective To explore the efficacy and safety of enhanced external counterpulsation(EECP)in elderly patients with acute ischemic stroke(AIS)complicated by coronary heart dis-ease(CHD).Methods A total of 65 AIS patients with CHD admitted in our hospital from Janu-ary to June 2023 were recruited and randomly divided into a control group(drug secondary pre-vention,n=32)and a treatment group(drug combined with EECP therapy,n=33).Their NIHSS score,mRS score and Canadian Cardiovascular Society(CCS)angina grade were evaluated before and after treatment and compared between the two groups.The incidences of recurrent ischemic stroke,new hemorrhagic stroke and major adverse cardiovascular events(MACE)were also recor-ded during treatment.Results The NIHSS score and mRS score were significantly decreased in both groups after treatment(P<0.01).After treatment,the NIHSS score(2.67±1.63 vs 3.56± 1.83),mRS score[1.0(0.0,1.0)vs 2.0(1.0,2.0)]and CCS grade[1.0(1.0,2.0)vs 2.0(1.0,2.0)]were obviously lower in the treatment group than the control group(P<0.05,P<0.01).There were no statistical differences in the incidence rates of recurrent ischemic stroke,new-onset hem-orrhagic stroke,and MACE between the control group and the treatment group(9.4%vs 6.1%,6.3%vs 3.0%,12.5%vs 6.1%,P>0.0 5).Conclusion EECP is a safe and effective treatment option for elderly AIS patients with CHD.
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OBJECTIVE: To observe the efficacy of moxibustion in the treatment of chronic fatigue syndrome (CFS) and explore the effects on gut microbiota and metabolic profiles. METHODS: Forty-eight male Sprague-Dawley rats were randomly assigned to control group (Con), CFS model group (Mod, established by multiple chronic stress for 35 d), MoxA group (CFS model with moxibustion Shenque (CV8) and Guanyuan (CV4), 10 min/d, 28 d) and MoxB group (CFS model with moxibustion Zusanli (ST36), 10 min/d, 28 d). Open-field test (OFT) and Morris-water-maze test (MWMT) were determined for assessment the CFS model and the therapeutic effects of moxibustion.16S rRNA gene sequencing analysis based gut microbiota integrated untargeted liquid chromatograph-mass spectrometer (LC-MS) based fecal metabolomics were executed, as well as Spearman correlation analysis, was utilized to uncover the functional relevance between the potential metabolites and gut microbiota. RESULTS: The results of our behavioral tests showed that moxibustion improved the performance of CFS rats in the OFT and the MWMT. Microbiome profiling analysis revealed that the gut microbiomes of CFS rats were less diverse with altered composition, including increases in pro-inflammatory species (such as Proteobacteria) and decreases in anti-inflammatory species (such as Bacteroides, Lactobacillus, Ruminococcus, and Prevotella). Moxibustion partially normalized these changes in the gut microbiota. Furthermore, CFS was associated with metabolic disorders, which were effectively ameliorated by moxibustion. This was demonstrated by the normalization of 33 microbiota-related metabolites, including mannose (P = 0.001), aspartic acid (P = 0.009), alanine (P = 0.007), serine (P = 0.000), threonine (P = 0.027), methionine (P = 0.023), 5-hydroxytryptamine (P = 0.008), alpha-linolenic acid (P = 0.003), eicosapentaenoic acid (P = 0.006), hypoxanthine (P = 0.000), vitamin B6 (P = 0.000), cholic acid (P = 0.013), and taurocholate (P = 0.002). Correlation analysis showed a significant association between the perturbed fecal microbiota and metabolite levels, with a notable negative relationship between LCA and Bacteroides. CONCLUSIONS: In this study, we demonstrated that moxibustion has an antifatigue-like effect. The results from the 16S rRNA gene sequencing and metabolomics analysis suggest that the therapeutic effects of moxibustion on CFS are related to the regulation of gut microorganisms and their metabolites. The increase in Bacteroides and decrease in LCA may be key targets for the moxibustion treatment of CFS.
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Síndrome de Fatiga Crónica , Microbioma Gastrointestinal , Moxibustión , Ratas , Masculino , Animales , Ratas Sprague-Dawley , Moxibustión/métodos , Síndrome de Fatiga Crónica/terapia , ARN Ribosómico 16S/genética , ARN Ribosómico 16S/análisis , MetabolómicaRESUMEN
Electrospun composite nanofiber scaffolds are well known for their bone and tissue regeneration applications. This research is focused on the development of PVP and PVA nanofiber composite scaffolds enriched with hydroxyapatite (HA) nanoparticles and alendronate (ALN) using the electrospinning technique. The developed nanofiber scaffolds were investigated for their physicochemical as well as bone regeneration potential. The results obtained from particle size, zeta potential, SEM and EDX analysis of HA nanoparticles confirmed their successful fabrication. Further, SEM analysis verified nanofiber's diameters within 200-250 nm, while EDX analysis confirmed the successful incorporation of HA and ALN into the scaffolds. XRD and TGA analysis revealed the amorphous and thermally stable nature of the nanofiber composite scaffolds. Contact angle, FTIR analysis, Swelling and biodegradability studies revealed the hydrophilicity, chemical compatibility, suitable water uptake capacity and increased in-vitro degradation making it appropriate for tissue regeneration. The addition of HA into nanofiber scaffolds enhanced the physiochemical properties. Additionally, hemolysis cell viability, cell adhesion and proliferation by SEM as well as confocal microscopy and live/dead assay results demonstrated the non-toxic and biocompatibility behavior of nanofiber scaffolds. Alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) assays demonstrated osteoblast promotion and osteoclast inhibition, respectively. These findings suggest that developed HA and ALN-loaded PVP/PVA-ALN-HA nanofiber composite scaffolds hold significant promise for bone regeneration applications.
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Electrospinning is a versatile method for fabrication of précised nanofibrous materials for various biomedical application including tissue engineering and drug delivery. This research is aimed to fabricate the PVP/PVA nanofiber scaffold by novel electrospinning technique and to investigate the impact of process parameters (flow rate, voltage and distance) and polymer concentration/solvent combinations influence on properties of electrospun nanofibers. The in-vitro and in-vivo degradation studies were performed to evaluate the potential of electrospun PVP/PVA as a tissue engineering scaffold. The solvents used for electrospinning of PVP/PVA nanofibers were ethanol and 90% acetic acid, optimized with central composite design via Design Expert software. NF-2 and NF-35 were selected as optimised nanofiber formulation in acetic acid and ethanol, and their characterization showed diameter of 150-400 nm, tensile strength of 18.3 and 13.1 MPa, respectively. XRD data revealed the amorphous nature, and exhibited hydrophilicity (contact angles: 67.89° and 58.31° for NF-2 and NF-35). Swelling and in-vitro degradability studies displayed extended water retention as well as delayed degradation. FTIR analysis confirmed solvent-independent interactions. Additionally, hemolysis and in-vitro cytotoxicity studies revealed the non-toxic nature of fabricated scaffolds on RBCs and L929 fibroblast cells. Subcutaneous rat implantation assessed tissue response, month-long biodegradation, and biocompatibility through histological analysis of surrounding tissue. Due to its excellent biocompatibility, this porous PVP/PVA nanofiber has great potential for biomedical applications.
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Traditional Chinese Medicine (TCM) external therapy for sleep disorder of chronic fatigue syndrome (CFS) has good anti-fatigue effect and can improve sleep quality of patients. The treatment for sleep disorders of CFS with TCM external treatment mainly adopts acupuncture, moxibustion, massage, TCM bath, transcutaneous acupoint electrical stimulation and auricular point sticking, etc., or alone, or comprehensive application, or combined with oral Chinese materia medica. The appropriate treatment method can be selected according to the patients' condition and compliance, which reflects the unique advantages of TCM syndrome differentiation and treatment and the treatment according to people and time. The existing research still needs to further form a standardized and recognized diagnosis and treatment system, so as to better guide clinical popularization and application.
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Objective To investigate the diagnostic value of high-resolution magnetic resonance im-aging(HRMRI)in elderly patients with non-cardioembolic acute ischemic stroke(NCAIS).Meth-ods A retrospective analysis was conducted on 101 elderly NCAIS patients having HRMRI in our hospital from July 2022 to July 2023.Stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment(TOAST)system and the Chinese Ischemic Stroke Sub-classification(CISS)system.The constituent ratio distribution of each subtype classification was compared before and after HRMRI in both classification systems.Results TOAST system identi-fied 8 cases of small-artery occlusion(SAO),1 case of other determined etiology(SOE),5 cases of undetermined etiology(SUE)and then reclassified as large artery atherosclerosis(LAA),1 case of SUE which was reclassified as SAO,and 7 cases of LAA and 4 cases of SUE being reclas-sified as SOE after HRMRI.In total,the diagnosis of 26 cases(25.74%)was modified.In the CISS system,10 cases of penetrating artery disease(PAD),1 case of other etiologies(OE),and 4 cases of undetermined etiology(UE)were reclassified as LAA.Furthermore,9 cases of LAA and 3 cases of UE were reclassified as OE after HRMRI.In total,the diagnosis of 27 cases(26.73%)was modified.There were statistical differences in the constituent ratio before and after HRMRI in both TOAST(x2=15.425,P<0.01)and CISS(x2=17.300,P<0.01)systems.Conclusion HRMRI is of diagnostic value and significance in accurately diagnosing the etiology of AIS in eld-erly patients without cardioembolic causes.
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OBJECTIVE@#To explore the genetic basis for 4 patients with globozoospermia.@*METHODS@#Semen and blood samples were collected from the patients for the determination of sperm concentration, viability, survival rate, morphology and acrosome antigen CD46. Meanwhile, DNA was extracted for whole exome sequencing (WES), and candidate variants were validated by Sanger sequencing.@*RESULTS@#All of the four patients were found to harbor variants of the DPY19L2 gene. Patients 1 ~ 3 had homozygous deletions of the DPY19L2 gene. Sanger sequencing confirmed that the DPY19L2 gene in patient 3 was disrupted at a recombination breakpoint area BP2, resulting in nonallelic homologous recombination and complete deletion of the DPY19L2 gene. Patients 2 and 3 respectively harbored novel homozygous deletions of exons 2 ~ 22 and exons 14 ~ 15. Patient 4 harbored heterozygous deletion of the DPY19L2 gene, in addition with a rare homozygous deletion of the 3' UTR region.@*CONCLUSION@#DPY19L2 gene variants probably underlay the globozoospermia in the four patients, which has fit an autosomal recessive pattern of inheritance and the characteristics of genomic diseases.
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Masculino , Humanos , Teratozoospermia/genética , Homocigoto , Semen , Eliminación de Secuencia , Regiones no Traducidas 3' , Proteínas de la MembranaRESUMEN
Background and objective: It has been widely reported that Early neurological improvement (ENI) after rt-PA intravenous thrombolysis contributes to a good long-term prognosis in patients experiencing acute ischemic stroke (AIS). However, which clinical factors influence after intravenous administration of recombinant tissue-type plasminogen activator (IV-rt PA) in AIS patients ENI is still unclear. This study aimed to evaluate the impact of influencing factors on the benefit of ENI after intravenous thrombolysis neurological improvement after IV-rt PA. Methods: The data of 73 patients with acute anterior circulation ischemic stroke who received intravenous thrombolysis with rt-PA in Chongqing University Jiangjin Hospital from January 2021 to July 2022 were retrospectively studied. According to the change rate of 24 h NISHH score, the research subjects were divided into the recovery group, the significant curative effect group, the curative effect group and the no curative effect group, the ENI after intravenous thrombolysis with rt-PA was defined as the improvement rate of National Institutes of Health Stroke Scale (NIHSS)score >46% at 24 h after IV-rt PA, and univariate factor analysis was used Clinical factors associated with ENI after intravenous thrombolysis. Results: According to the 24-h NIHSS improvement rate of rt-PA intravenous thrombolysis in patients with acute anterior circulation ischemic stroke, 35 cases (47.95%) of the study population had ENI. There was no statistical difference between the improvement and non-improvement group in general demographic data, stroke TOAST classification, stroke risk factors (history of stroke, heart disease, hyperlipidemia, hypertension), and laboratory test data. There was a statistically significant difference in the random blood glucose levels between the two groups (p < 0.001, t = 3.511). Conclusion: The effect of rt-PA intravenous thrombolysis within the time window of patients with acute anterior circulation ischemic stroke is significant, but the ENI after thrombolysis is easily affected by the level of blood glucose; diabetes is the most important factor affecting the acute anterior circulation ischemic stroke patients Clinical factors of ENI after intravenous thrombolysis with rt-PA.
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Objective:To explore the risk factors of posterior circulation ischemic dizziness/vertigo and nursing effects of emotional releasing therapy combined with positive psychological suggestion in patients.Methods:A total of 368 patients with dizziness/vertigo treated in Qinhuangdao First Hospital were selected by Convenience sampling method from January 2018 to August 2020, including 153 cases confirmed with posterior circulation ischemic dizziness/vertigo in posterior circulation group and 215 cases with non-posterior circulation ischemic dizziness/vertigo in non-posterior circulation group. The risk factors were analyzed by Logistic regression analysis. According to random number table method, 153 patients in posterior circulation group were divided into control group (76 cases received routine nursing) and observation group (77 cases received emotional releasing therapy combined with positive psychological suggestion on basis of routine nursing). All patients were intervened until discharge. The onset frequency and duration of dizziness/vertigo before and after intervention, effects of vertigo on patients, anxiety, depression, treatment compliance, and nursing satisfaction after intervention were compared between the two groups.Results:Multivariate analysis showed that male gender ( OR=2.675, 95% CI 1.179-6.070), age not younger than 60 years old ( OR=2.255, 95% CI 1.105-4.602), hypertension ( OR=3.330, 95% CI 1.651-6.717), diabetes ( OR=2.044, 95% CI 1.270-3.291), smoking ( OR=2.333, 95% CI 1.266-4.300), previous history of stroke or transient ischemic attack (TIA) ( OR=2.601, 95% CI 1.333-5.075), and previous history of cardiovascular diseases ( OR=2.143, 95% CI 1.085-4.230) were independent risk factors of posterior circulation ischemic dizziness/vertigo (all P<0.05). After intervention, onset frequency and duration of dizziness/vertigo in observation group were (1.26 ± 0.34) times/month and (4.16 ± 1.02) min, significantly shorter than (3.18 ± 0.95) times/month, (6.43 ± 1.18) min in control group ( t=16.69, 12.74, both P<0.05). The scores of Dizziness Handicap Inventory, Self-rating Depression Scale and Self-rating Anxiety Scale in observation group were (12.27 ± 3.34), (37.35 ± 3.62), (38.13 ± 3.22) points, significantly lower than (18.35 ± 4.61), (44.19 ± 3.14), (43.25 ± 3.08) points in control group ( t=9.35, 12.48, 10.05, all P<0.05). After intervention, Morisky Medic Ationadherence Scale and Newcastle Satisfaction with Nursing Scales scores in observation group were (6.77 ± 0.52), (87.06 ± 3.12) points, significantly higher than (5.34 ± 0.37), (79.14 ± 4.28) points in control group ( t=19.58, 13.09, both P<0.05). Conclusions:Male gender, age not younger than 60 years old, hypertension, diabetes, smoking, previous history of stroke or TIA, and previous history of cardiovascular diseases are independent risk factors of posterior circulation ischemic dizziness/vertigo. The emotional releasing therapy combined with positive psychological suggestion can effectively improve onset of dizziness/vertigo, anxiety, depression and treatment compliance in patients with posterior circulation ischemia, with high nursing satisfaction.
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The treatment rules of point selection and treatment principles for treating chronic fatigue syndrome (CFS) can be divided into three categories: regulating and replenishing, invigorating original yang and regulating zang-fu organs. The mechanism of moxibustion includes improving gut microbiota imbalance, regulating immune cell imbalance and correcting endocrine dysfunction. The moxibustion methods include ginger-partitioned moxibustion, thunder-fire moxibustion, warm acupuncture, and governor moxibustion. Acupuncture points such as Shenque (RN8), Guanyuan (RN4), Qihai (RN6), Zusanli (ST36), Baihui (DU20), Yongquan (KI1) and back-shu points are often selected to exert anti-chronic fatigue effects.
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The electroencephalogram (EEG) signal is a general reflection of the neurophysiological activity of the brain, which has the advantages of being safe, efficient, real-time and dynamic. With the development and advancement of machine learning research, automatic diagnosis of Alzheimer's diseases based on deep learning is becoming a research hotspot. Started from feedforward neural networks, this paper compared and analysed the structural properties of neural network models such as recurrent neural networks, convolutional neural networks and deep belief networks and their performance in the diagnosis of Alzheimer's disease. It also discussed the possible challenges and research trends of this research in the future, expecting to provide a valuable reference for the clinical application of neural networks in the EEG diagnosis of Alzheimer's disease.
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Humanos , Enfermedad de Alzheimer/diagnóstico , Redes Neurales de la Computación , Aprendizaje Automático , Encéfalo , ElectroencefalografíaRESUMEN
@#Objective To evaluate the feasibility, safety, and short-term effect of minimally invasive ascending aorta surgery through a right anterior thoracotomy via the second intercostal incision. Methods The clinical data of 13 patients who underwent minimally invasive ascending aorta surgery (including minimally invasive Bentall operation in 7 patients, minimally invasive Wheat operation in 2 patients, and minimally invasive ascending aorta replacement in 4 patients) through a right anterior thoracotomy via the second intercostal incision in our center from October, 2019 to September, 2020 were retrospectively analyzed. There were 12 males and 1 female at age of 19-69 (52.4±13.7) years. Results The aortic cross-clamping time was 84.3±18.3 min. Three patients received blood transfusion, with the rate of 23.1%. The drainage volume in the first 24 hours after operation was 214.5±146.3 mL, with no redo for bleeding. The duration of mechanical ventilation was 19.0±11.3 hours and the length of intensive care unit stay was 1.8±1.3 days. The drainage tube was removed 2.5±1.0 days after operation. All the 13 patients recovered and discharged 6.4±2.0 days after operation, with no dead patients found. All patients survived with New York Heart Association (NYHA) functional classⅠandⅡduring a median follow-up of 8 months. Conclusion Minimally invasive ascending aorta surgery through a right anterior thoracotomy via the second intercostal incision may be a safe and effective method with less injury and quick recovery.
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Objective To investigate the correlation between the level of microalbuminuria and severity of coronary artery disease in elderly coronary heart disease(CHD)patients combined with diabetes.Methods A total of 176 elderly CHD patients combined with diabetes were enrolled and prospectively studied.They were randomized into observation group(n=98)with microalbuminuria and the control group(n=78)with normoalbuminuria.The correlation between level of microalbuminuria and Gensini score was analyzed.Results The level of microalbuminuria and Gensini score were higher in observation group than in control group (P < 0.05).There were statistically significant differences in level of microalbunminuria(F =9.87,P =0.013) and in Gensini score (F =9.07,P =0.015)among patients with single-,double-and triple-vessel disease.There was a positive correlation between levels of microalbuminuria and Gensini scores in CHD patients with type 2 diabetes(r =0.68,P<0.01).Conclusions The level of microalbuminuria is positively correlated with the severity of coronary artery disease in elderly CHD patients with type 2 diabetes.The microalbuminuria level can reflect the severity of coronary artery disease in a certain degree.It has certain clinical significance for predicting patient's condition in elderly CHD patients with type 2 diabetes.
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Objective To evaluate the safety and efficacy of percutaneous balloon pulmonary valvuloplasty (PBPV)in the treatment of the children with pulmonary stenosis (PS),and to observe the long - term prognosis and analyze the influencing factors. Methods The total of 230 children were collected,who had been diagnosed with pul-monary valve stenosis and had undergone percutaneous balloon pulmonary valvuloplasty between November 1987 and November 2015 in Shandong Provincial Hospital Affiliated to Shandong University. Their ages ranged from 4 months to 17 years,and the follow - up duration lasted from 1 month to 29 years. The data included clinical data and long - term follow - up data of hospitalized children,and the echocardiography data from the healthy peers in the same period. Then the data were analyzed statistically. Results In this study,228 cases of children were successfully performed PBPV, and the success rate was 99%(228 / 230 cases). The pulmonary transvalvular gradient (△P)of preoperation,24 hours postoperatively,half a year postoperatively,2 years postoperatively,5 years postoperatively,and 10 years postope-ratively was (63. 5 ± 23. 8)mmHg (1 mmHg = 0. 133 kPa),(26. 2 ± 11. 1)mmHg,(24. 8 ± 9. 8)mmHg,(20. 9 ± 8. 9)mmHg,(18. 1 ± 8. 7)mmHg,(15. 3 ± 7. 3)mmHg and (15. 3 ± 7. 3)mmHg,respectively. The immediate post-operative △P was significantly lower than that of preoperation (P < 0. 01),and the △P of the most children decreased in the long - term follow - up. The results of Logistic regression analysis showed that valve dysplasia with right ventricu-lar outflow tract stenosis and the immediate postoperative residual transvalvular gradient degree were the risk factors for long term curative effect of PBPV in children who could not reach the best standard. The restenosis rate was 4. 6%(3 /65 cases)with children followed up for more than 10 years. The incidence of long - term follow - up pulmonary valve regurgitation (83%)was significantly higher than that before operation (58%)and short term (68%)after operation, and the degree of regurgitation also increased (P < 0. 05),while the degree of regurgitation of the tricuspid regurgitation decreased gradually during the follow - up (P < 0. 05);the right ventricular diastolic diameter of the patients at 10 years or more after the operation was measured as (19. 27 ± 3. 03)mm,which was significantly higher than that (15. 24 ± 2. 89)mm of the healthy children of at the same term healthy age (P < 0. 05). Conclusions The PBPV has a high success rate in the treatment of children with PS,and it has good medium - long - term curative effect,less com-plications and lower restenosis rate. Therefore,PBPV can be used as the first choice for PS. However,the incidence and degree of pulmonary regurgitation has an increasing trend after PBPV and the right ventricular diastolic diameter is still larger than that of the healthy children. Therefore,the long - term follow - up is necessary out of the hospital.
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Objective The aim of the study is to evaluate the early and long-term outcomes of mitral valve repair for degenerative mitral regurgitation.Methods From January 2003 to December 2015,clinical profiles of 1 903 patients with degenerative mitral regurgitation who underwent mitral valve repair at our institution were analyzed retrospectively.There were 1 312 males (68.9 %) and 591 females (31.1%) the mean age was (54.2 ± 13.1) years.Early and long-term outcomes were summarized and risk factors for adverse events were assessed.Results There were 35 in-hospital deaths(1.8%) and in-hospital mortality for isolated mitral valve repair was 0.9% (10/1 163).Perioperative complications included central nerve system complications(0.7%),respiratory failure requiring tracheotomy(1.8%),acute renal injury requiring hemodialysis(1.2%) and reoperation for bleeding(0.7 %).NYHA function class Ⅲ-Ⅳ (OR =3.65),atrial fibrillation (OR =2.85) and ejection fraction <0.6(OR =2.34) were identified as independent risk factors for in-hospital mortality.12 years over follow-up,overall survival,freedom from reoperation for mitral valve and freedom from recurrent moderate/severe regurgitation were 85% 、91% and 75%,respectively.Age > 60 years(HR =7.43),preoperative stroke(HR =6.51),ejection fraction < 0.6 (HR =3.87),left ventricular end-systolic dimension > 40 mm (HR =3.98) and pulmonary systolic pressure > 50 mmHg (1 mmHg =0.133 kPa) (HR =2.85) were independent predictive factors for late death.Ejection fraction < 0.6 (HR =4.01),left ventricular end-diastolic dimension > 60 mm(HR =1.88),leaflet lesion involving anterior leaflet (HR =2.40) and residue mild regurgitation(HR =4.17) were independent predictors for late recurrent regurgitation.Leaflet lesion involving anterior leaflet(HR =2.40) and residue mild regurgitation (HR =3.35) were independent predictor for late reoperation for mitral valve.Conclusion Mitral valve repair is safe and effective in degenerative mitral regurgitation.Early surgical intervention for asymptomatic patients with preserved left ventricular function before onset of atrial fibrillation and pulmonary artery hypertension is associated with decreased incidence of adverse events and improved long-term outcomes.Early surgical intervention should be restricted in experienced high-volume centers.
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Objective To explore the effect of habit reversal training (HRT) on the quality of life of patients with senile pruritus (SP) Methods A total of 60 patients with SP were selected from the dermatology department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine.Using random number table method,the patients were divided into two groups,namely 30 patients in each group.Two groups of patients were treated with antihistamines and anticnesmatic.On this basis,the control group given health guide by holding group health lecture,once a week,about 60min each time,for eight consecutive times.The experimental group adopted the HRT on the basis of the control group,1 times per week in the first 4 weeks,and once every 2 weeks in the 5th to 12th week,and 30-60 min each time.Before the intervention and 4 weeks,8 weeks and 12 weeks after intervention,the Negative Emotion Scale and the Pittsburgh Sleep Quality Index(PSQI) were respectively used to evaluate the negative emotion and the sleep quality.Before the intervention and 12 weeks after intervention,the Structured Pruritus Symptom(SPS) and Dermatology Life Quality Index(DLQI) were respectively used to evaluate the pruritus symptom and the life quality of the patients with SP.Results The scores of Negative Emotion Scale and PSQI in the experimental group at the fourth,eighth and 12th weekends after intervention were lower than those in the control group at the same time,and the difference was statistically significant (the negative emotion:t=0.131,-6.072,-6.884;PSQI:t=-3.972,-5.173,-8.246,P < 0.01).And the scores of two scales in the two groups were statistically significant in the inter-group effect,time effect and interaction effect.(The score of the Negative Emotion Scale:Ftime=96.635,Finter-group=10.329,Finteraction=5.371;the total score of PSQI:Ftime=5.371,Finter-group=368.063,Finteraction=19.910,P < 0.05).Meanwhile,the total score of the SPS and the DLQI in the experimental group were lower than the control group after 12 weeks of intervention (Z =-3.267,t =8.283,P < 0.01).Among them,there was no statistically significant difference in daily living items of DLQI (t =1.873,P>0.05).Also,after intervention,the total score of the Negative Emotion Scale,PSQI and each item of PSQI in the experimental group at each time point were lower than previous point (P < 0.05).The total score of the SPS,DLQI and each item of DLQI in the experimental group were lower than pre-intervention (Z =-4.610,t=15.850,P < 0.01).Conclusions HRT could effectively relieve itching symptoms of patients with SP,improve the negative emotion and the sleep quality.It is worthy of further clinical promotion,thus effectively improve the quality of life of the patients with SP.
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Objective:To investigate the role of Smad7 in the Hepatocellular carcinoma (HCC) migration and proliferation and its clinical significance.Methods:Through transfecting pcDNA3.1 (+)-Smad7 or siRNA Smad7 to overexpress or knockdown the Smad7 expression in HCC cell lines HepG2 and Huh7.The MTT assays were used to test the role of Smad7 in proliferation of HCC cells.Transwell and wound-healing assays were used to detect the effect of Smad7 on migratory ability in both tow cell lines.RT-PCR was used to test the Smad7 expression in 9 clinical HCC patients' specimens.Results:As the results,overexpression of Smad7 significantly inhibited the proliferation of cells compared with the control group,while knockdown Smad7 promoted the proliferation.At the same time,overexpression of Smad7 could inhibit the migratory ability of HCC cells compared with the control group,while knockdown smad7 could accelerate this ability.The expression of Smad7 in cancer tissue was significantly lower compared with normal mucosa tissue adjacent to cancer.Conclusions:Smad7 is a kind of anti-progressive molecule in HCC.