Efficacy of hemodialysis combined with hemofiltration in the treatment of uremia complicated with intractable hypertension.

OBJECTIVE: To explore the efficacy of hemodialysis and hemofiltration in the management of uremia complicated with refractory hypertension (RH). METHODS: In this retrospective study, 80 patients with uremia complicated with RH who were admitted to the First People's Hospital of Huoqiu County from March 2019 to March 2022 were included. Patients who received routine hemodialysis were assigned to the control group (C group, n=40), whereas patients received routine hemodialysis and hemofiltration were assigned to the observational group (R group, n=40). The clinical indexes of the two groups were recorded and compared. Differences in diastolic blood pressure, systolic blood pressure, mean pulsating blood pressure, urinary protein, blood urea nitrogen (BUN) and urinary microalbumin, cardiac function parameters and plasma toxic metabolites were observed after one month of treatment. RESULTS: The effective rate of the treatment in the observation group was 97.50%, whereas that for the control group was 75.00%. The observation group showed significantly better improvement of diastolic blood pressure, systolic blood pressure and mean arterial pressure compared with the control group (all P<0.05). The levels of urinary microalbumin were lower after treatment than those before treatment. The levels of urinary protein and BUN were higher in the observation group than those in the control group; and the levels of urinary microalbumin were significantly lower in the observation group compared with the levels in the control group (all P<0.05). The cardiac parameters of the study cohort were significantly lower after treatment. The levels of plasma toxic metabolites in the observation group were significantly lower after the 12-week treatment. CONCLUSION: Hemodialysis combined with hemofiltration is effective in the management of uremic patients with refractory hypertension. This treatment strategy effectively reduces blood pressure and average pulsation, improves cardiac function, and promotes the clearance of toxic metabolites. The method is associated with fewer adverse reactions and is safe for clinical applications.

Full Endoscopy Combined with Allogeneic Bone Grafting for Benign Spinal Lesions: Technical Notes and Preliminary Clinical Results.

Benign lesions of the spine include benign tumors and tumor-like lesions of the spine, which usually occur in the thoracic and lumbar vertebrae. The incidence rate is low, accounting for about 1% of primary bone tumors. Few cases of endoscopic treatment of benign spinal lesions have been reported in the literature. Here, we introduce a new surgical technique using full endoscopy and allogeneic bone grafting to treat benign spinal lesions. All patients in this study successfully underwent the operation, and their pain was significantly relieved postoperatively. The patient VAS scores decreased from 3.07 ± 0.70 preoperatively to 0.33 ± 0.49 at the last follow-up visit (p < 0.05). The mean total blood loss (including drainage blood) was 16.67 ± 6.98 mL. The mean operative time was 63.33 ± 7.23 min. No patients developed numbness in the corresponding segmental distribution after surgery, none of the patients had serious postoperative complications, and none had focal recurrence during follow-up requiring reoperation. Patients reported symptom relief throughout the whole follow-up period. We believe that endoscopic surgery preserves the ligaments and soft tissues around the vertebral body, and that this technique is feasible with minimal trauma, rapid recovery, and good outcomes at short-term follow-up. This minimally invasive treatment modality offers a new option for the treatment of patients with benign spinal lesions.

Author Correction: STEEP mediates STING ER exit and activation of signaling.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

STEEP mediates STING ER exit and activation of signaling.

STING is essential for control of infections and for tumor immunosurveillance, but it can also drive pathological inflammation. STING resides on the endoplasmic reticulum (ER) and traffics following stimulation to the ERGIC/Golgi, where signaling occurs. Although STING ER exit is the rate-limiting step in STING signaling, the mechanism that drives this process is not understood. Here we identify STEEP as a positive regulator of STING signaling. STEEP was associated with STING and promoted trafficking from the ER. This was mediated through stimulation of phosphatidylinositol-3-phosphate (PtdIns(3)P) production and ER membrane curvature formation, thus inducing COPII-mediated ER-to-Golgi trafficking of STING. Depletion of STEEP impaired STING-driven gene expression in response to virus infection in brain tissue and in cells from patients with STING-associated diseases. Interestingly, STING gain-of-function mutants from patients interacted strongly with STEEP, leading to increased ER PtdIns(3)P levels and membrane curvature. Thus, STEEP enables STING signaling by promoting ER exit.

Endoscopic Surgery versus External Ventricular Drainage Surgery for Severe Intraventricular Hemorrhage.

The efficacy and applied value of endoscopic hematoma evacuation vs. external ventricular drainage (EVD) in the treatment of severe ventricular hemorrhage (IVH) were explored and compared. From Jan. 2015 to Dec. 2016, the clinical data of 42 cases of IVH were retrospectively analyzed, including 18 patients undergoing endoscopic hematoma evacuation (group A), and 24 patients receiving EVD (group B). The hematoma clearance rate was calculated by 3D Slicer software, and complications and outcomes were compared between the two groups. There were no significant differences in age, sex and Graeb score between groups A and B (P>0.05). The hematoma clearance rate was 70.81%±27.64% in group A and 48.72%±36.58% in group B with a statistically significant difference (P<0.05). The operative time in groups A and B was 72.45±25.26 min and 28.54±15.27 min, respectively (P<0.05). The Glasgow Coma Scale (GCS) score increased from 9.28±2.72 at baseline to 11.83±2.91 at 1 week postoperatively in group A, and from 8.25±2.62 at baseline to 10.79±4.12 at 1 week postoperatively in group B (P<0.05). The length of hospital stay was 12.67±5.97 days in group A and 17.33±8.91 days in group B with a statistically significant difference (P<0.05). The GOS scores at 6 months after surgery were 3.83±1.12 in group A, and 2.75±1.23 in group B (P<0.05). These results suggested that endoscopic hematoma evacuation has an advantage of a higher hematoma clearance rate, fewer complications and better outcomes in the treatment of severe IVH, indicating it is a safe, effective and promising approach for severe IVH.

Biomechanical Influences of Transcorporeal Tunnels on C4 Vertebra Under Physical Compressive Load Under Flexion Movement: A Finite Element Analysis.

BACKGROUND: Anterior percutaneous endoscopic transcorporeal cervical discectomy is an alternative operation for cervical disc herniation. However, few reports have evaluated the biomechanical influence of tunnels on vertebrae. We compared biomechanical distinctions between intact and tunneled models of vertebrae to analyze the safety of anterior percutaneous endoscopic transcorporeal cervical discectomy based on a C2-T1 finite element (FE) model. METHODS: Groups of C2-T1 FE models were simulated with C4 tunneled by 2 methods (group A: with partial superior endplate excision; group B: without partial superior endplate excision) and various tunnel diameters (6, 8, and 10 mm). All FE models were loaded under a 1-Nm flexion moment. RESULTS: The area and maximum of stress concentrations were correlated with tunnel diameter. The distribution of stress on C4 superior endplates showed no significant difference between B6 and the intact model (P > 0.05), but significant differences with other tunneled models (P < 0.001). Maximum stress on the lateral wall of tunnels was positively correlated with tunnel diameter and induced high risks of cancellous bone fracture for diameters reaching 10 mm in group B and 8 mm in group A. CONCLUSIONS: Transcorporeal tunnel in C4 vertebrae without endplate excision should be limited with diameter of 6 mm, and a tunnel diameter >10 mm, excision of the endplate >8 mm, and excision of the center side of the endplate should also be avoided.

Clinical analysis of minimally invasive surgery in the treatment of hypertensive lobar cerebral hemorrhage / 天津医药

Objective To explore the clinical value and effect of neuronavigation-assisted neuroendoscopy for hypertensive lobar cerebral hemorrhage. Methods Clinical data of 35 cases treated with the neuroendoscopy (neuroendoscopy group) and 32 cases treated with the neuronavigation-assisted microscope (microscope group) were retrospectively analyzed. Data of the operative time, intraoperative blood loss and the clearance rate of hematoma, the postoperative complications (stress gastric ulcer, pulmonary infection, urinary tract infection and intracranial infection), the hospital stay, postoperative ability of daily life (ADL) in 6 months and fatality rates were observed and compared. Results The operative time and intraoperative blood loss were less in the neuroendoscopy group than those in the microscopy group, and the clearance rate of hematoma was higher in neuroendoscopy group than that in the microscopy group (P＜0.01). There was no significant difference in postoperative complications between the two groups (P＞0.05). The hospital stay was less in the neuroendoscopy group than that of the microscope group (P＜0.01). On the basis of ADL grading method, the prognosis of the endoscopy group was better than that of the craniotomy group (P＜0.05). There was no significant difference in the fatality rate between the neuroendoscopy group and the microscopy group (P＞0.05). Conclusion The neuronavigation-assisted neuroendoscopy is a safe and effective surgical method for hypertensive lobar cerebral hemorrhage, and which can improve the prognosis of patients with hypertensive intracerebral hemorrhage.

[Significance of MACC1 protein expression in esophageal carcinoma].

OBJECTIVE: To explore the expression of metastasis-associated colon cancer 1 (MACC1) proteins in esophageal carcinoma and neighboring tissues. METHODS: The expressions of MACC1 were detected in 60 specimens of esophageal carcinoma and neighboring tissues with immunohistochemistry and Western blotting. All the specimens were selected from 2010-2012 of Guangfu Hospital of Jinhua, 38 males and 22 females, aged (50 ± 12) years. And the correlations of the expressions of MACC1 proteins with the clinicopathologic features of esophageal carcinoma were also analyzed. RESULTS: Expression of MACC1 protein was predominantly located in cytoplasm and membrane. The positivity rates of MACC1 protein were 68.3% (41/60) in esophageal carcinoma tissue and there were significant differences from those in neighboring tissue (25.0(15/60), P < 0.01). Western blotting analysis showed that the expression level of MACC1 protein in esophageal carcinoma was greater than that in corresponding adjacent tissues (0.64 ± 0.05 vs 0.21 ± 0.10, P < 0.05). Moreover, the positivity rates and relative expressions of MACC1 showed significant correlations with TNM stage and pathology grade (all P < 0.05). CONCLUSION: The abnormal expression of MACC1 may be associated with malignant progression of esophageal carcinoma.

[Comparison of the exposure rates of risk factors and inducing factors of acute myocardial infarction between younger and aged adults].

OBJECTIVE: To study the clinical characteristics of acute myocardial infarction (AMI) among younger adults and to explore the possible mechanisms of early myocardial infarction, combined with the newly discovered risk factors of coronary heart disease. METHODS: Data on comparative analysis to the exposure rates of the risk factors and inducing factors of non-CAD patients with two groups of AMI patients including younger adults group (< or =40 years old) and aged adults group (> or =50 years old). Coronary angiography was applied. RESULTS: There were differences noticed between the frequencies of risk factors of the two AMI groups. In younger adults group the exposure rates of smoking, hyperlipidemia, positive family history, C-reactive protein (CRP) and fibrinogen were markedly higher, while in elderly group the exposure rates of hypertension, smoking, hyperlipidemia, diabetes, CRP, fibrinogen and homocysteine (HCY) were markedly higher (P < 0.05). Although the clustering status of risk factors of the younger adult group was not higher than that of the elderly group. There were obvious inducing factors before the patients were attacked by AMI and the inducing factors inclined to cluster, which had obvious dose-reaction relationships with the occurrence of AMI in young people. CONCLUSION: Early AMI of younger adults might relate to the clustering status of inducing factors. The coexistence of several kinds of inducing factors was resulted in the occurrence of AMI of the atherosclerosis (As) and non-As patients by means of myocardial ischemia accumulation effect.

Comparison of the exposure rates of risk factors and inducing factors of acute myocardial infarction between younger and aged adults / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics of acute myocardial infarction (AMI) among younger adults and to explore the possible mechanisms of early myocardial infarction, combined with the newly discovered risk factors of coronary heart disease.</p><p><b>METHODS</b>Data on comparative analysis to the exposure rates of the risk factors and inducing factors of non-CAD patients with two groups of AMI patients including younger adults group (< or =40 years old) and aged adults group (> or =50 years old). Coronary angiography was applied.</p><p><b>RESULTS</b>There were differences noticed between the frequencies of risk factors of the two AMI groups. In younger adults group the exposure rates of smoking, hyperlipidemia, positive family history, C-reactive protein (CRP) and fibrinogen were markedly higher, while in elderly group the exposure rates of hypertension, smoking, hyperlipidemia, diabetes, CRP, fibrinogen and homocysteine (HCY) were markedly higher (P < 0.05). Although the clustering status of risk factors of the younger adult group was not higher than that of the elderly group. There were obvious inducing factors before the patients were attacked by AMI and the inducing factors inclined to cluster, which had obvious dose-reaction relationships with the occurrence of AMI in young people.</p><p><b>CONCLUSION</b>Early AMI of younger adults might relate to the clustering status of inducing factors. The coexistence of several kinds of inducing factors was resulted in the occurrence of AMI of the atherosclerosis (As) and non-As patients by means of myocardial ischemia accumulation effect.</p>

NMR study on the low-affinity interaction of human serum albumin with diclofenac sodium.

The low-affinity interaction between human serum albumin (HSA) and Diclofenac sodium (DCF) was studied using NMR techniques. Both 13C-NMR chemical shift and linewidth show that the dichlorophenyl ring in DCF molecule plays a primary role in its interaction with HSA. Langmuir adsorption isotherm was applied to evaluate the association constant K and the number of binding sites n of the drug/HSA complex through (1)H-NMR spin-lattice relaxation measurement. The results indicate that Langmuir isotherm can perfectly explain the capacity of low-affinity binding of proteins for the ligands.