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1.
IEEE Trans Neural Netw Learn Syst ; 34(9): 6368-6378, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35007201

RESUMO

In high-stakes applications of data-driven decision-making such as healthcare, it is of paramount importance to learn a policy that maximizes the reward while avoiding potentially dangerous actions when there is uncertainty. There are two main challenges usually associated with this problem. First, learning through online exploration is not possible due to the critical nature of such applications. Therefore, we need to resort to observational datasets with no counterfactuals. Second, such datasets are usually imperfect, additionally cursed with missing values in the attributes of features. In this article, we consider the problem of constructing personalized policies using logged data when there are missing values in the attributes of features in both training and test data. The goal is to recommend an action (treatment) when ~ X , a degraded version of X with missing values, is observed. We consider three strategies for dealing with missingness. In particular, we introduce the conservative strategy where the policy is designed to safely handle the uncertainty due to missingness. In order to implement this strategy, we need to estimate posterior distribution p(X| ~ X) and use a variational autoencoder to achieve this. In particular, our method is based on partial variational autoencoders (PVAEs) that are designed to capture the underlying structure of features with missing values.

2.
Accid Anal Prev ; 176: 106792, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35952395

RESUMO

Bicyclists and pedestrians are two large vulnerable groups of road users. Many cities have allowed cyclists to share space with pedestrians on footpaths and off-road paths to reduce conflict with motor vehicles. The risk of bicyclist-pedestrian accidents is also increasing accordingly. Therefore, there is a need to understand the factors that affect the risk of injury in such accidents, especially to pedestrians who are considered more vulnerable. This paper presents a detailed investigation of bicyclist-pedestrian collisions and possible injury outcomes. The study has considered five levels of collision speed ranging from 10 km/h to 30 km/h, three pedestrian profiles (adult, child, and elderly) differentiated by their weight and height, three bicycles with different masses, and five impact directions. The bicyclist-pedestrian collision simulations have been analyzed based on four metrics: throw distance, peak head velocity on impact with the ground, head injury criterion (HIC) value, and the probability of severe head injury. For each simulation, the throw distance and peak head velocity on impact with the ground are extracted. Following that, the HIC and the probability of severe head injury to pedestrians are computed. The results show a significant effect of collision speed (p < 0.05) on all four metrics. The analysis has been further extended to study the effect of height and weight profile, bicycle mass, and impact directions on bicyclist-pedestrian collisions. According to the results, the impact directions largely influence the outcome of bicycle-pedestrian collisions. In general, direct impacts on pedestrian body center have been found to yield higher HIC values and probability of severe head injury to pedestrians than off-center impacts. Also, video analysis of simulated collisions has suggested that the accident mechanism depends on weight and height profiles (correlated with different age groups) and impact directions. Finally, recommendations have been proposed based on the study, including a speed limit of not more than 12 km/h for bicyclists on narrow shared paths and footpaths where risks of collisions with pedestrians are high. The results and analysis presented could be helpful for developing legislation to minimize conflicts between bicyclists and pedestrians on shared paths and to reduce potential injury to pedestrians.


Assuntos
Acidentes de Trânsito , Ciclismo , Traumatismos Craniocerebrais , Pedestres , Caminhada , Adulto , Idoso , Criança , Humanos , Acidentes de Trânsito/prevenção & controle , Ciclismo/lesões , Estatura , Peso Corporal , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/prevenção & controle , Caminhada/lesões , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/prevenção & controle
3.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-928179

RESUMO

In recent years, the MYB-related gene family has been found pivotal in plant growth and development. MYB-related gene family in Angelica dahurica var. formosana was systematically investigated based on "Chuanzhi No. 2" through transcriptome database search and bioinformatics and the temporal and spatial expression patterns were analyzed through real-time fluorescence-based quantitative polymerase chain reaction(PCR). The results showed that 122 MYB-related proteins family were identified, mainly including the unstable hydrophilic proteins with good thermal stability. Most of the proteins were located in nuclei. The majority of the proteins had the structures of random coil and α-helix. Five MYB-related proteins family of A. dahurica var. formosana had membrane-binding domains. The conserved domain analysis of MYB-related proteins family of A. dahurica var. formosana showed that the MYB domains of genes in five subgroups, similar to 2 R-, 3 R-, and 4 R-MYB proteins, contained three evenly distributed Trp(W) residues in the MYB repeat sequence. The phylogenetic analysis of MYB-related proteins family in A. dahurica var. formosana and Arabidopsis thaliana showed that the MYB-related members were unevenly distributed in five subgroups, and A. thaliana and A. dahurica var. formosana had almost the same number of genes in the CCA1-like subgroup. There were differences in the number, type, and distribution of motifs contained in 122 encoded proteins. Transcription factors with similar branches had similar domains and motifs. The expression pattern analysis showed that the transcription factors AdMYB53, AdMYB83, and AdMYB89 responded to hormones to varying degrees, and they were highly expressed in leaves and responded quickly in roots. This study lays a foundation for further investigating the function of MYB-related transcription factors of A. dahurica var. formosana and solving the corresponding biological problems such as bolting early.


Assuntos
Animais , Angelica/química , Biologia Computacional , Gastrópodes , Filogenia , Folhas de Planta , Proteínas de Plantas/genética , Fatores de Transcrição/genética
4.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-923491

RESUMO

@#Worldwide morbidity and mortality of acute myocardial infarction (AMI) and related heart failure are still high.While effective early reperfusion of the criminal coronary artery after a confirmed AMI is the typical and effective treatment at present, collateral myocardial ischemia reperfusion injury (MIRI) and pertinent cardio-protection are still challenging to address and have inadequately understood mechanisms.One important reason might be that AMI is multifactorial, causing cardiomyocyte death via multiple mechanisms, as well as affecting other cell types, including platelets, fibroblasts, endothelial and smooth muscle cells, and immune cells.Many cardioprotective strategies act through common end-effectors and may be suboptimal in patients with comorbidities.Therefore, unveiling the related multitarget strategies participating in triggering and resisting the pathobiology of MIRI is a promising and valuable frontier.The review specifically focuses on the recent MIRI advances that are supported by multitarget strategies and new targets under development in order to bring the rational combination of multitarget therapies up to date, as well as to identify findings that may facilitate the new drug of novel targets.

5.
Front Neurol ; 12: 658661, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33935955

RESUMO

Objective: To explore the role of balloon-assisted coils technique for ophthalmic segment aneurysms (OSAS). Methods: Clinical data of 30 patients with OSAS were reviewed between December 2017 and December 2018. OSAS were defined as arising from the internal carotid artery (ICA), reaching from the distal dural ring to the origin of the posterior communicating artery. OSAS were classified into four types based on the angiographic findings. The balloon-assisted coils technique was used for the embolization of aneurysms. The duration of balloon inflation cycles, as well as difficulty and complications during the embolization procedure, were recorded. The immediate angiographic results were evaluated according to the Raymond scale. Clinical results were evaluated based on the MRS score. Follow-ups were performed at 18 months post-embolization by DSA or MRA at our institution. Results: Thirty-two aneurysms in 30 patients were detected by digital subtraction angiography (DSA), which included 30 unruptured and two ruptured cases. The patients with ruptured aneurysms were grade II status according to the Hunt-Hess scale. Three cases were type A, nine cases were type B, 17 cases were type C, and three cases were type D. According to aneurysm size, there were 19 cases of small, 11 cases of medium, two cases of large aneurysm. Thirty-two aneurysms were successfully embolized in 30 patients by balloon-assisted coils technique. The ophthalmic artery could be protected by an engorged balloon in the procedure, especially for type A aneurysms. Considering that type D aneurysm arises from the side-wall of the artery and near to tortuous ICA siphon, the balloon catheter was inflated to stabilize the microcatheter allowing for overinflation when necessary. The average duration of balloon dilatation was 4 min, and the average time was 2.5 times. Raymond class was one in 28 aneurysms and two in four aneurysms according to the immediate post-embolization angiographic results. All the patients achieved good clinical effects, except for one patient who presented with brain ischemia resulting in dizziness and contralateral limb weakness for 10 h due to prolonged temporary clamping of the responsible ICA. The follow-up angiography results were satisfactory at 18 months post-embolization. Conclusion: OSAS endovascular treatment with balloon-assisted coils has different advantages in a different classification. The technique is safe, effective, and relatively inexpensive, especially for small and medium OSAS.

6.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21257465

RESUMO

The rapid international spread of the SARS-CoV-2 virus 19 led to unprecedented attempts to develop and administer an effective vaccine. However, there is considerable vaccine hesitancy in some countries. We investigated willingness to vaccinate in three nations with historically different levels of vaccine willingness and attitudes: Israel, Japan and Hungary. Employing an ecological-systems approach we analysed associations between demographic factors and health status, individual cognitions, normative pressures, trust in government, belief in COVID-19 myths and willingness to be vaccinated, using data from three nationally representative samples (Israel, N=1011 (Jan 2021); Japan, N= 997 (Feb 2021); Hungary, N=1131 (Apr 2021)). In Israel 74% indicated a willingness to vaccinate, but only 51% in Japan and 31% in Hungary. Multigroup regression analyses indicated greater vaccine willingness amongst those who perceived benefits to vaccination, anticipated regret if not vaccinated and trusted the government. Multi-group latent class analysis of ten COVID-19 (mis)beliefs identified three classes of myths, with concerns about the alteration of DNA (Israel), allergies (Hungary) and catching COVID-19 from the vaccine (Japan) specific to vaccine willingness for each culture. Intervention campaigns should focus on increasing trust and addressing culturally specific myths while emphasising the individual and social group benefits of vaccination.

7.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-911574

RESUMO

Objective:To evaluate the safety and efficacy of a Zenith fenestrated aortic stent-graft (ZFEN) system in the treatment of short-necked aneurysms.Methods:The clinical data of 5 patients receiving F-EVAR in Zhongshan Hospital, Fudan University from Mar 2018 to Sep 2019 according to the standards of short-necked abdominal aortic aneurysm and COOK ZFEN custom stent were retrospectively analyzed.Results:Patients' average age was (69±11) years old. The time of stent customization was 4-6 weeks. The average maximum diameter of AAA was (60.8±14.0) mm. The average proximal neck diameter was (26.0±2.6) mm and the average length anchoring zone was (6.4±2.2) mm. The rate of technical success was 100%. There was no intraoperative loss of visceral vessels and stent displacement. The meane follow-up time was 6.8 months. The perioperative mortality was 0, and there were no other major complications. There were 3 patients with simple type Ⅱ endoleak and 1 patient with type Ⅲ endoleak. The endoleaks disappeared in 4 patients during follow-up of 3-12 months. 1 patient suffered with type Ⅱ and type Ⅲ endoleak, and the visceral vessels and branching stents were patent in all patients.Conclusion:The short term result of COOK ZFEN stent-graft system was safe and feasible for the treatment of short-necked AAA.

8.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-774526

RESUMO

In this study,the leaves of autumn-sown Angelica dahurica var. formosana from Sichuan province in different growth years was used to explore the fitting model of photosynthetic response curve and the different photosynthetic physiological characteristics between annual and biennial A. dahurica var. formosana from Sichuan province. The results showed that the fitting model of the optimum light response curve of the leaves of A. dahurica var. formosana from Sichuan province with different growth years was all rectangular hyperbolic correction model. The light saturation points were 1 600,1 700 μmol·m-2·s-1,the light compensation points were17. 98,52. 23 μmol·m-2·s-1 in the leaves of annual and biennial plant,respectively. The diurnal variation curves of net photosynthetic rate,transpiration rate and stomatal conductance in the leaves all acted as a single peak value wave. The daily mean values of net photosynthetic rate and transpiration rate in the leaves of biennial plant were significantly higher than that of annual plant. There was no significant difference in daily mean stomatal conductance. The net photosynthetic rate was significantly positively correlated with stomatal conductance in both of the different growth years. The net photosynthetic rate of annual and biennial A. dahurica var. formosana from Sichuan province had extremely significant and significantly negative correlation with the intercellular CO2 respectively. The transpiration rate of annual plant was positively correlated with the effective photosynthetic radiation intensity and air temperature,but had significantly negative correlation with the intercellular CO2 concentration. The transpiration rate of biennial plant had extremely positive correlation with the effective photosynthetic radiation intensity,and negatively correlated with the intercellular CO2 concentration. In conclusion,the photosynthetic efficiency of the leaves in biennial plant of A. dahurica var. formosana from Sichuan province was higher than that in annual plant,but the ability to utilize weak light was lower than that of annual plant. It should be planted in the sunny field.


Assuntos
Angelica , Fisiologia , Dióxido de Carbono , China , Fotossíntese , Folhas de Planta , Fisiologia , Transpiração Vegetal , Estações do Ano , Temperatura
9.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-710517

RESUMO

Objective To evaluate a self-designed in-situ fenestration system to preserve left subclavian artery during thoracic endovascular aortic repair (TEVAR).Methods From June 2016 to May 2017,aortic dilatation disease patients with insufficient proximal landing zone were treated by the selfdesigned in situ fenestration system to preserve the left subclavian artery during TEVAR.The patients were regularly followed-up with CTA.Results Totally 12 patients with an average age of 65 ± 11 years were enrolled.Among them,6 patients had thoracic aortic aneurysm and the other 6 suffered from aortic dissection.The mean operating time was 145 ± 36 minutes.The perioperative procedure success rate was 100%.One patient had intraoperative type Ⅰ endoleak,1 patient had type Ⅱ endoleak.One patient had suffered from stroke and 1 patient had mild paraplegia post-operatively.All patients were followed-up for a mean time of 6.5 ± 3.0 months.The type Ⅰ endoleak in 1 patient disappeared,type Ⅱ endoleak remained in one.There was no death during perioperative and in follow up period.Conclusions This self-designed in-situ fenestration system effectively and quickly restores the blood flow of the left subclavian artery during TEVAR.

10.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-300529

RESUMO

<p><b>OBJECTIVE</b>To investigate the effect of helix and antihelix skin degloving technique in correction surgery of prominent ears.</p><p><b>METHODS</b>Twenty-three cases of prominent ears were corrected by helix and antihelix skin degloving technique. The clinical results were observed.</p><p><b>RESULTS</b>All the prominent ears were corrected with natural appearance and good symmetry results. The distance from the helix to the skull was decreased obviously (P<0.05). Cranial ear angle, the angle of helix and ear boat were significantly reduced (P<0.05). No complications such as infection, hematoma, skin flap necrosis and deformity recurrence occurred.</p><p><b>CONCLUSIONS</b>The auricle skin degloving technique has advantages of exact suture position, good shape, no obvious cartilage hurt and simple operation procedure.</p>


Assuntos
Humanos , Técnicas Cosméticas , Pavilhão Auricular , Cirurgia Geral , Hematoma , Necrose , Complicações Pós-Operatórias , Procedimentos de Cirurgia Plástica , Métodos , Recidiva , Pele , Patologia
11.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-621929

RESUMO

Objective To compare two different revascularization methods in type 2 diabetes mellitus (T2DM) patients with multivessel coronary artery disease treated by percutaneous coronary intervention (PCI) and coronary artery bypass graft ( CABG) .Methods T2DM patients with multivessel disease undergoing success-ful PCI or CABG were enrolled in the study .They were diagnosed by coronary angiography ( CAG) in Tianjin Chest Hospital from May 2009 to May 2010 whose.The patients were followed up for 3 years.The information of patients including physical performance , clinical features , and laboratory examination results were collected .The major ad-verse cardio cerebral events(MACCE)including death, myocardial infarction(MI), revascularization, angina pecto-ris, heart failure, and stroke were collected.Results During the 3 years of follow-up, MACCE(31.58% vs 17.68%, P<0.01), death(4.82%vs 1.10%, P<0.05), MI(4.39%vs 1.10%, P<0.05), angina pectoris (17.27%vs 10.50%, P<0.05)occurred more frequently in PCI group than in CABG group .Conclusion Evi-dences now tend to support CABG for revascularization in T 2DM patients with multivessel disease .

12.
Chinese Journal of Surgery ; (12): 597-601, 2014.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-336710

RESUMO

<p><b>OBJECTIVE</b>To evaluate the value and clinical effect of peripheral aneurysms with polytetrafluoroethene (PTFE) stent graft after peripheral endovascular procedures.</p><p><b>METHODS</b>From May 2012 to November 2013, 13 patients of peripheral aneurysms were treated with PTFE stent graft. There were 9 male and 4 female patients, aged from 24 to 74 years with a mean of 52 years. There were 7 aneurysms and 6 pseudoaneurysms. This stent graft was a self-expanding nitinol stent, internally covered by an ultra-thin polytetrafluoroethene (PTFE) graft. All peripheral aneurysms were repaired with the PTFE stent graft, using an entirely percutaneous approach. All patients were given clopidogrel and (or) aspirin postoperatively. Complications and reintervention rates were also examined.</p><p><b>RESULTS</b>PTFE stent graft placement was successfully performed in all the 13 cases, and the instant isolation effect was quite satisfactory. During the follow-up period of 3 to 18 months, no stent graft related complications occurred in all patients except one patient with iliac arterial pseudoaneurysm, who developed pseudoaneurysms presented as a complication at puncture site. There were no other symptomatic complications with graft patience.</p><p><b>CONCLUSION</b>Endovascular repair can be considered as an effective treatment strategy for peripheral aneurysms by PTFE stent graft.</p>


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aneurisma , Cirurgia Geral , Stents Farmacológicos , Procedimentos Endovasculares , Fluorocarbonos , Seguimentos , Polímeros , Resultado do Tratamento
13.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-346438

RESUMO

<p><b>OBJECTIVE</b>To investigate the effect of plant growth regulators on the growth and quality of Angelica dahurica var. formosana.</p><p><b>METHOD</b>Five plant growth regulators: chlormequat chloride (CCC), Mepiquat chloride (PIX), Gibberellic acid (GA3), Paclobutrazol (PP333) and Maleic Hydrazide (MH) were sprayed in rosette stage, the effects of these plant growth regulators (PGRs) on the growth, yield and quality of A. dahurica var. formosanaw were observed. The biological traits were first measured and then imperatorin and isoimperatorin contents in roots were determined by HPLC.</p><p><b>RESULT</b>Low concentration GA3 increased the yield while not influenced the premature bolting rate and the coumarin content.</p><p><b>CONCLUSION</b>Spraying of GA3 (30 mg x L(-1)) could guarantee the growth and development of A. dahurica var. formosana to have a higher yield and maintain the active ingredients content in the root as well.</p>


Assuntos
Angelica , Clormequat , Farmacologia , Giberelinas , Farmacologia , Hidrazida Maleica , Farmacologia , Piperidinas , Farmacologia , Reguladores de Crescimento de Plantas , Farmacologia , Triazóis , Farmacologia
14.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-319460

RESUMO

<p><b>OBJECTIVE</b>To investigate high-concentration uric acid-induced endothelial dysfunction mediated by miR-155.</p><p><b>METHODS</b>Human umbilical vein endothelial cells (HUVECs) were incubated with 600 µmol/L uric acid for 24 and 48 h, and eNOS expression and NO content in the cell culture were measured. The target genes of miR-155 were predicted using on-line analysis software and validated by dual-luciferase system. Real-time PCR was used to detect the expression of miR-155 in endothelial cells incubated with high-concentration uric acid. The effect of miR-155 on endothelial dysfunction was assessed by transfection of its inhibitor into HUVECs.</p><p><b>RESULTS</b>The expression of eNOS and NO secretion decreased obviously in HUVECs incubated with 600 µmol/L uric acid. MicroRNA on-line analysis software and dual luciferase reporter experiments suggested that the level of eNOS translation was directly regulated by miR-155. The expression of miR-155 in endothelial cells was upregulated after stimulation with high-concentration uric acid, and was inhibited by transfection of miR-155 inhibitor. Expression of eNOS and secretion of NO were elevated in endothelial cells transfected with miR-155 inhibitor after incubation with high-concentration uric acid.</p><p><b>CONCLUSION</b>High-concentration uric acid can down-regulate eNOS expression via miR-155 to induce endothelial dysfunction.</p>


Assuntos
Humanos , Células Cultivadas , Regulação para Baixo , Células Endoteliais da Veia Umbilical Humana , Biologia Celular , Metabolismo , Hiperuricemia , Metabolismo , Patologia , MicroRNAs , Metabolismo , Óxido Nítrico , Metabolismo , Óxido Nítrico Sintase Tipo III , Metabolismo , Ácido Úrico , Sangue
15.
Chinese Medical Journal ; (24): 4499-4503, 2013.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-327541

RESUMO

<p><b>BACKGROUND</b>Although Multi-planar reconstruction (MPR) has been considered a diagnostic imaging technique that observes more perspectives for diseases, few people have applied it surgically. In fact, MPR is also very useful to clinical operation, especially for patients with type B aortic dissection. It helps the surgeon to locate accurately with more information about aortic dissection, so that the safety and effectiveness of operation can be improved. This study examined the application of the MPR in intraoperative DSA imaging for precise positioning by accurately obtaining a cross-section, a spin angle of the coronal plane, and a tilt angle of the sagittal plane in treatment of type B aortic dissection.</p><p><b>METHODS</b>The conventional and the MPR approaches were compared on positioning the aortic arch for surgery. A group of 40 patients (group A) and another group of 42 patients (group B) was sampled. About the comparison of baseline characteristics, a fourfold table χ(2) test was conducted on gender, and two independent samples t-test was applied to age between group A and group B. Spin as well as tilt angles for group A were obtained from the patients using both approaches, and their effectiveness was compared with pair t-tests; The MPR data guided stent-grafting in this group. Stent graft placement of group B was based on the conventional approach. Percentages of proximal distributed markers as well as incidences of complications were collected from both groups after stent graft placement. They were also compared with a fourfold table χ(2) test.</p><p><b>RESULTS</b>Gender difference was not found between group A and group B (χ(2)0.80, P > 0.05), and age difference was not statistically significant (F = 2.55, homogeneity of variance, t = -1.46, P > 0.05). A significant difference was found between the conventional and the MPR approaches for spin angle (t = 9.17) as well as tilt angle (t = 2.07), P < 0.05. Percentage of proximal distributed markers (5.0%) of group A was significantly lower than that of group B (42.9%), χ(2) = 15.92, P < 0.05; and incidence of complications (5.0%) of group A was also significant lower than that of group B (21.4%), χ(2) = 4.76, P < 0.05.</p><p><b>CONCLUSIONS</b>Application of the MPR facilitated intraoperative angle adaption and led to satisfactory DSA. It is feasible in endovascular treatment of type B aortic dissection, and can effectively and safely guide surgical operations.</p>


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dissecção Aórtica , Cirurgia Geral , Aneurisma da Aorta Torácica , Cirurgia Geral , Prótese Vascular , Implante de Prótese Vascular
16.
Chinese Medical Journal ; (24): 4030-4036, 2013.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-236110

RESUMO

<p><b>BACKGROUND</b>The probability and risk of operations increase in patients with type 2 diabetes mellitus. For diabetic patients, blood glucose control is a key factor to improving the prognosis of surgery. During perioperative period, insulin therapy is usually advised to be used for surgical patients with type 2 diabetes. However, the insulin regimen which one is better remains controversial. In this study, we estimated the efficacy, safety and advantage of different insulin therapy strategy during perioperative period.</p><p><b>METHODS</b>A total of 1086 cases of surgical patients with type 2 diabetes mellitus enrolled in the present study. According to the glucose level at admission, all patients were divided into relatively high glucose group (group A, fasting blood glucose (FBG) ≤13.9 mmol/L) and higher glucose group (group B, FBG >13.9 mmol/L). Patients in group A randomly accepted premixed insulin twice a day, or basal insulin plus oral medications, and were divided into group A1 and A2 respectively. Patients in group B randomly received premixed insulin twice daily, basal insulin plus oral hypoglycemic agents, or basal insulin plus preprandial insulin, and were divided into group B1, B2 and B3 respectively. The data of the preoperative preparation time, the daily doses of insulin used in different periods, postoperative incision healed installments, hypoglycemic events, the total hospitalization time, postoperative complications were all collected and statistically analyzed.</p><p><b>RESULTS</b>Compared the main outcome measures in groups treated by premixed insulin therapy, both in preoperative preparation and postoperative period, the daily insulin dosage and the frequency of hypoglycemic events were decreased in groups treated by basal insulin therapy (P < 0.05). The preoperative preparation time and the total hospitalization time in groups with basal insulin therapy were shorter than that in groups with premixed insulin therapy (P < 0.05). The incision healing rate of stage I, II and III among different therapy protocols were significantly different (P < 0.05).</p><p><b>CONCLUSIONS</b>Basal insulin therapy could be used in diabetic patients undergoing elective major and medium surgery during whole perioperative period. Basal insulin therapy strategy, including a single injection of basal insulin and basal insulin plus preprandial insulin injection subcutaneously, is superior to premixed insulin therapy in the perioperative blood glucose management, and it could be viewed as the best choice in glucose control during perioperative period.</p>


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Glicemia , Diabetes Mellitus Tipo 2 , Sangue , Tratamento Farmacológico , Hipoglicemiantes , Usos Terapêuticos , Insulina , Usos Terapêuticos , Período Perioperatório
17.
Chinese Medical Journal ; (24): 4037-4042, 2013.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-236109

RESUMO

<p><b>BACKGROUND</b>The change of glucose transporter 4 (GLUT4) expression could influence glucose uptake in the myocardial cells and then effect myocardial metabolism, which maybe one of the factor for the diabetes cardiovascular disease. This study aimed to explore the influence of glucose and insulin at different concentrations on H9c2 (2-1) cell proliferation and its GLUT4 expression in vitro, and evaluate the correlation between myocardial cells proliferation and GLUT4 expression. This might be helpful for understanding the relationship between glucose metabolism and cardiovascular disease.</p><p><b>METHODS</b>According to glucose concentrations in culture medium, cultured H9c2 rat myocardial cells were divided into five groups: control group (NC, glucose concentration 5.0 mmol/L), low glucose group (LG, glucose concentration 0.1 mmol/L), high glucose group 1 (HG1, glucose concentration 10 mmol/L), high glucose group 2 (HG2, glucose concentration 15 mmol/L), high glucose group 3 (HG3, glucose concentration 20 mmol/L). Then according to different insulin concentrations in culture medium, each group was further divided into two subgroups: normal insulin subgroup (INSc, insulin concentration 3.8 mU/L), high insulin subgroup (INSh, insulin concentration 7.6 mU/L). H9c2 (2-1) cells were cultured for 1, 2, 3 days, the proliferation of cells were assayed by cell counting Kit-8 assay, the expressions of GLUT4 mRNA and protein were detected with RT-PCR and Western Blotting technique, and the relation between myocardial cells proliferation and GLUT4 expression was evaluated.</p><p><b>RESULTS</b>Compared with NC group, cell proliferation (OD value) was lower in LG, HG2, HG3 group but higher in HG1 group on the second and the third day (P < 0.05). There was a negative correlation between OD value and the glucose level in HG1, HG2, HG3 groups (P < 0.05). OD value in INSc subgroups was lower than that in INSh subgroups (P < 0.05). GLUT4 mRNA was lower in LG, HG2, HG3 groups than that in NC group (P < 0.05). Compared with NC group, GLUT4 mRNA level in HG1 group was higher on the first day but lower on the second and third day (P < 0.05). In HG1, HG2 and HG3 groups, GLUT4 mRNA level had a negative correlation with the level of glucose (P < 0.05). GLUT4 mRNA in INSc subgroups was lower than that in INSh subgroups (P < 0.05). The expression of GLUT4 protein was similar to that of GLUT4 mRNA. There was a positive correlation between H9c2 cell proliferation and GLUT4 expression (P < 0.02).</p><p><b>CONCLUSIONS</b>Glucose levels could regulate glucose uptake in myocardial cells through influencing GLUT4 expression, and thus affected the cell proliferation and cell function. Insulin levels could affect the myocardial cell function by regulating GLUT4 expression. Effects of glucose and insulin on the myocardial cells proliferation might be mediated through regulating GLUT4 expression. There may be a mechanism of hyperglycemia pre-accommodation (HGPA) in myocardial cells mediated through regulation of GLUT4 expression.</p>


Assuntos
Animais , Ratos , Western Blotting , Linhagem Celular , Proliferação de Células , Glucose , Farmacologia , Transportador de Glucose Tipo 4 , Genética , Metabolismo , Insulina , Farmacologia , Miocárdio , Biologia Celular , Reação em Cadeia da Polimerase Via Transcriptase Reversa
18.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-338071

RESUMO

<p><b>OBJECTIVE</b>To research the optimal conditions for the callus induction of anther culture and the plant regeneration of Angelica dahurica var. formosana.</p><p><b>METHOD</b>Callus was induced from the anther of A. dahurica from Sichuan province on a MS medium. The effects of callus induction and plant regeneration of different pretreatment hours under low temperature (4 degrees C), different culturing conditions under darkness and illumination, and different culture with different hormone contents and ratios were studied.</p><p><b>RESULT</b>The results showed that A. dahurica anthers without low temperature pretreatment reached the highest induction rate then under the pretreatment under low temperature (4 degrees C) for two days. The optimal culturing condition was under the darkness. The culturing efficiency reached 38.89% on the medium of MS + 2.0 mg x L(-1) 2,4-D + 1.0 mg x L(-1) 6-BA. The optimum medium for differentiate anther callus was MS + 0.5 mg x L(-1) NAA + 1.5 mg x L(-1) KT + 10 mg x L(-1) AgNO3. 1/2MS medium supplemented with 0.5 mg x L(-1) IBA could well promote seedings to take roots.</p><p><b>CONCLUSION</b>An efficient system for callus induction of anther culture and plant regeneration of A. dahurica was preliminarily established.</p>


Assuntos
Angelica , Meios de Cultura , Química , Farmacologia , Flores , Técnicas de Cultura de Tecidos , Métodos
19.
Chinese Medical Journal ; (24): 3440-3444, 2012.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-316491

RESUMO

<p><b>BACKGROUND</b>As two novel adipocytokines, chemerin and apelin play a key role in the pathological process of insulin resistance (IR), glucose metabolism and obesity, researchers have found that the levels of chemerin and apelin changed significantly in type 2 diabetic patients with obesity, however, the underlying mechanism involved remains unclear. The aim of this study was to investigate whether chemerin and apelin play an important role in the pathophysiologic proceeding of diabetes.</p><p><b>METHODS</b>This study enrolled 81 newly diagnosed obese type 2 diabetes mellitus (T2DM) patients (T2DM group, n = 81). All the patients were randomly assigned to DM1 group treated with metformin (n = 41) and DM2 group treated with pioglitazone (n = 40). After hypoglycemic agents treatment, patients under better blood glucose control were chosen to be given antioxidant treatment. Another 79 subjects without T2DM were recruited as normal control group (NC group), including 40 subjects (NC1 group) with normal body mass index (BMI) and 39 obese subjects (NC2 group). Levels of chemerin, apelin, BMI, tumor necrosis factor-α (TNF-α), homeostasis model assessment of IR (HOMA-IR) and 8-isoprotaglandim F2α (8-iso-PGF2α) were examined at baseline and post-treatment. The relationship between chemerin, apelin and BMI, TNF-α, HOMA-IR, 8-iso-PGF2α was analyzed.</p><p><b>RESULTS</b>The baseline levels of chemerin, apelin, TNF-α, HOMA-IR and 8-iso-PGF2α in T2DM group were significantly higher than normal control group (P < 0.001). All indices mentioned above were significantly decreased after treatment (P < 0.05). In T2DM patients treated with pioglitazone, indices mentioned above except for HOMA-IR, were decreased significantly compared with patients treated with metformin (P < 0.05). After antioxidant treatment using lipoic acid, levels of chemerin, apelin, TNF-α and 8-iso-PGF2α were further significantly decreased (P < 0.05). Correlation analysis showed that the levels of chemerin and apelin correlated positively with BMI, TNF-α, HOMA-IR and 8-iso-PGF2α before and after treatment with hypoglycemic agents (P < 0.01). The levels of chemerin and apelin also had positive correlation with TNF-α and 8-iso-PGF2α after antioxidant treatment (P < 0.05).</p><p><b>CONCLUSIONS</b>The levels of chemerin and apelin in obese T2DM patients are closely related to IR. The increased levels may be a result of compensatory response to IR, and also may be the causative factor of IR. The levels of chemerin and apelin correlate closely with oxidative stress and inflammation. The two adipokines may be inflammatory factors playing important roles in the initiation and development of obese T2DM. Chemerin and apelin are related to the pathophysiology of IR, oxidative stress and inflammation.</p>


Assuntos
Humanos , Apelina , Glicemia , Metabolismo , Índice de Massa Corporal , Quimiocinas , Metabolismo , Diabetes Mellitus Tipo 2 , Tratamento Farmacológico , Alergia e Imunologia , Metabolismo , Dinoprosta , Metabolismo , Hipoglicemiantes , Usos Terapêuticos , Inflamação , Metabolismo , Peptídeos e Proteínas de Sinalização Intercelular , Metabolismo , Metformina , Usos Terapêuticos , Tiazolidinedionas , Usos Terapêuticos , Fator de Necrose Tumoral alfa , Metabolismo
20.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-347076

RESUMO

<p><b>OBJECTIVE</b>To investigate therapeutic effects of mini-incision assisted by arthroscope for the treatment of ankylosis of knee.</p><p><b>METHODS</b>From July 2007 to August 2009, 18 patients with ankylosis of knee were treated with mini-incision assisted by arthroscope. Among the patients, 15 patients were male and 3 patients were female, ranging in age from 27 to 56 years, with an average of 33.6 years. Before operation, 5 patients had comminuted fractures in the distal end of femur (including 1 patient with open fracture), 9 patients had comminuted fractures of tibial plateau, 2 patients had comminuted fractures of patella, 1 patient had comminuted fractures of patella combined with comminuted fracture of capitulum fibulae and injuries of complex structure at lateral knee, and 1 patient had floating knee. The duration between the primary operation and the arthrolysis ranged from 6 to 31 months (averaged, 10.6 months). The therapeutic effects were evaluated according to Judet criteria.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 3 to 25 months (averaged, 11.4 months). All the patients had incision healing at the first stage without infection, wound dehiscence and liquifaction necrosis. The preoperative knee flexed motion ranged from 30 degrees to 80 degrees, with a mean of (44.72 +/- 11.60) degrees; and postoperative knee flexed range of motion improved to an average of (109.17 +/- 10.31) degrees (ranged, 95 degrees to 135 degrees). According to Judet evaluation, 16 patients got an excellent result, 2 good.</p><p><b>CONCLUSION</b>Treatment of ankylosis of the knee through a mini-incision assisted by arthroscope has advantages such as reducing the complications of incision on knee, little trauma and early recovery, which is a good operative mode to treat ankylosis of the knee after operation or trauma.</p>


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anquilose , Cirurgia Geral , Artroscópios , Articulação do Joelho , Cirurgia Geral
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