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Objective:Trigeminal neuralgia(TN)is a severe chronic neuropathic pain that mainly affects the distribution area of the trigeminal nerve with limited treating efficacy.There are numerous treatments for TN,but currently the main clinical approach is to suppress pain by carbamazepine(CBZ).Brain-derived neurotrophic factor(BDNF)is closely related to chronic pain.This study aims to determine the effects of CBZ treatment on BDNF expression in both the trigeminal ganglion(TG)and serum of TN via a chronic constriction injury of the infraorbital nerve(ION-CCI)rat model. Methods:The ION-CCI models were established in male Sprague-Dawley rats and were randomly divided into a sham group,a TN group,a TN+low-dose CBZ treatment group(TN+20 mg/kg CBZ group),a TN+medium-dose CBZ treatment group(TN+40 mg/kg CBZ group),and a TN+high-dose CBZ treatment group(TN+80 mg/kg CBZ group).The mechanical pain threshold in each group of rats was measured regularly before and after surgery.The expressions of BDNF and tyrosine kinase receptor B(TrkB)mRNA in TGs of rats in different groups were determined by real-time PCR,and the expression of BDNF protein on neurons in TGs was observed by immunofluorescence.Western Blotting was used to detect the protein expression of BDNF,TrkB,extracellular regulated protein kinases(ERK),and phospho-extracellular regulated protein kinases(p-ERK)in TGs of rats in different groups.The expression of BDNF in the serum of rats in different groups was detected by enzyme-linked immunosorbent assay(ELISA). Results:The results of mechanical pain sensitivity showed that there was no significant difference in the mechanical pain threshold in the right facial sensory area of the experimental rats in each group before surgery(all P>0.05).From the 3rd day after operation,the mechanical pain threshold of rats in the TN group was significantly lower than that in the sham group(all P<0.01),and the mechanical pain threshold of rats in the TN+80 mg/kg CBZ group,the TN+40 mg/kg CBZ group,and the TN+20 CBZ mg/kg group was higher than that in the TN group(all P<0.05).The BDNF and TrkB mRNA and protein expressions in TGs of rats in the TN group were higher than those in the sham group(all P<0.05),and those in the TN+80 mg/kg CBZ group,the TN+40 mg/kg CBZ group,and the TN+20 mg/kg CBZ group were lower than the TN group(all P<0.05).The p-ERK levels in TG of rats in the TN+80 mg/kg CBZ group,the TN+40 mg/kg CBZ group,and the TN+20 mg/kg CBZ group were significantly decreased compared with the TN group(all P<0.05).The BDNF and neuron-specific nuclear protein(NeuN)were mainly co-expressed in neuron of TGs in the TN group and they were significantly higher than those in the sham group(all P<0.05).The co-labeled expressions of BDNF and NeuN in TGs of the TN+ 80 mg/kg CBZ group,the TN+40 mg/kg CBZ group,and the TN+20 mg/kg CBZ group were lower than those in the TN group(all P<0.05).The results of ELISA showed that the level of BDNF in the serum of the TN group was significantly higher than that in the sham group(P<0.05).The levels of BDNF in the TN+80 mg/kg CBZ group,the TN+40 mg/kg CBZ group,and the TN+20 mg/kg CBZ group were lower than those in the TN group(all P<0.05).Spearman correlation analysis showed that the BDNF level in serum was negatively correlated with mechanical pain threshold(r=-0.650,P<0.01). Conclusion:CBZ treatment can inhibit the expression of BDNF and TrkB in the TGs of TN rats,reduce the level of BDNF in serum of TN rats and the phosphorylation of ERK signaling pathway,so as to inhibit TN.The serum level of BDNF can be considered as an indicator for the diagnosis and prognosis of TN.
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Serum antibodies IgM and IgG are elevated during COVID-19 to defend against viral attack. Atypical results such as negative and abnormally high antibody expression were frequently observed whereas the underlying molecular mechanisms are elusive. In our cohort of 144 COVID-19 patients, 3.5% were both IgM and IgG negative whereas 29.2% remained only IgM negative. The remaining patients exhibited positive IgM and IgG expression, with 9.3% of them exhibiting over 20-fold higher titers of IgM than the others at their plateau. IgG titers in all of them were significantly boosted after vaccination in the second year. To investigate the underlying molecular mechanisms, we classed the patients into four groups with diverse serological patterns and analyzed their two-year clinical indicators. Additionally, we collected 111 serum samples for TMTpro-based longitudinal proteomic profiling and characterized 1494 proteins in total. We found that the continuously negative IgM and IgG expression during COVID-19 were associated with mild inflammatory reactions and high T cell responses. Low levels of serum IgD, inferior complement 1 activation of complement cascades, and insufficient cellular immune responses might collectively lead to compensatory serological responses, causing overexpression of IgM. Serum CD163 was positively correlated with antibody titers during seroconversion. This study suggests that patients with negative serology still developed cellular immunity for viral defense, and that high titers of IgM might not be favorable to COVID-19 recovery.
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Objective:To investigate the methyl-CpG-binding protein 2 (MeCP2) expression in specimens of pancreas cancer tumor and para-cancerous tissues and its prognostic value.Methods:The tissue microarray and immunohistochemistry were used to examine the MeCP2 expression in 59 cases of pancreatic cancer tumor tissues and 53 adjacent normal tissues. The correlation between the MeCP2 expression and clinicopathological characteristics of pancreas cancer patients was analyzed. Furthermore, the survival curve was drawn by Kaplan-Meier method and the Cox regression hazards model was used to study the prognostic value of MeCP2 expression in pancreas cancer.Results:The MeCP2 positive expression rate in 59 pancreas cancer tumor tissues was 47.5%, which was 67.9% in 53 adjacent tissues. The MeCP2 positive expression rate in adjacent tissues was obviously higher than that in pancreatic cancer tissues, and the difference was statistically significant ( P<0.05). The MeCP2 positive expression was significantly associated with pathological grade and lymph node metastasis(both P<0.05). The overall survival in patients positive for the MeCP2 expression was longer than that in those with negative MeCP2 expression( P<0.05). Cox multivariate analysis demonstrated that the level of MeCP2 expression was an independent predictor for prognosis in patients with pancreas cancer. Conclusions:MeCP2 is obviously positively expressed in para-cancerous tissues, but was lowly expressed in pancreatic cancer, indicating that MeCP2 detection can help to evaluate the prognosis of pancreatic cancer patients.
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: Emerging adult patients with Type 1 diabetes mellitus (T1DM) appear to have a reduced opportunities on learning and exercise, a decreased skill in learning and work, a lower degree of social support due to fear and avoidance of social interaction. This study aimed to assess the level of social avoidance and distress in emerging adults with T1DM, and to explore the correlation between social avoidance and distress and self-management or glycemic control. : A total of 342 T1DM patients aged 18-30 years old were recruited from 8 tertiary hospitals in Hunan Province from September 2014 to February 2019. The questionnaire included general information questionnaire, the Social Avoidance and Distress Scale (SAD), and Self-management Scale of Type 1 Diabetes for Chinese Adults (SMOD-CA). The total scores of SAD in emerging adult patients with T1DM were compared with those of norm. Correlation between glycated hemoglobin (HbA1c) and social avoidance and distress of emerging adult patients with T1DM was analyzed. : The total score of SAD (11.13±6.18) in emerging adults with T1DM was significantly higher than that in healthy adults (=77.06, <0.01). Pearson correlation analysis showed that the scores of SAD, social avoidance subscale, and social distress subscale were negatively correlated with the scores of SMOD-CA (all <0.01), and they were positively correlated with HbA1c (all <0.01). Multivariate linear regression analysis showed that social avoidance and distress, self-management, gender, and educational level were independent influential factors for HbA1c in emerging adults with T1DM. : The degree of social avoidance and distress of emerging adult patients with T1DM is higher than that of healthy people. The higher the degree of social avoidance and distress, the lower the level of self-management and the worse the control of blood sugar. Attention should be paid to social avoidance and distress in emerging adults with T1DM, and targeted interventions should be formulated.
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Adolescente , Adulto , Humanos , Adulto Jovem , Glicemia , Estudos Transversais , Diabetes Mellitus Tipo 1 , Hemoglobinas Glicadas , Autogestão , Inquéritos e QuestionáriosRESUMO
Type 1 diabetes results from a continuous destruction of pancreatic β-cell function and requires life-long administration of exogenous insulin.Maintaining stable glycemic control while minimizing hypoglycemic events with flexible daily routine always remains a challenge.Despite a multidisciplinary support,the person with diabetes and their care givers share the responsibility for glucose monitoring and insulin administration.An effective diabetes self-management education is core to a rounded type 1 diabetes management system.However,to date,there is still lack of a standardized and sustainable type 1 diabetes management system,compatible with local medical environment,which could be adapted nationwide in China.In the hope to change this situation,in the year of 2015,The Second Xiangya Hospital established the first integrated management system for type 1 diabetes in China,starting with an outpatient clinic jointly by diabetologists,diabetes educators,dieticians,physical therapists,ophthalmologists and psychologists.This pioneer type 1 diabetes management system has set up a brand-new and feasible care model,and opened up new horizons for type 1 diabetes management in China.
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Objective To explore the association of nocturnal serum cortisol levels with diabetic microvascular complications in overweight or obese patients with type 2 diabetes mellitus. Methods Serum cortisol levels of 316 overweight or obese type 2 diabetic patients were tested at midnight by the method of chemiluminescence. Diabetic microvascular complications were compared among various groups according to nocturnal serum cortisol levels. All the patients with nocturnal serum cortisol level > 50 nmol/L were asked to undergo overnight low-dose dexamethasone suppression test to rule out the possibility of subclincal Cushing's syndrome. The incidences of diabetic nephropathy ( DN ) , diabetic retinopathy ( DR ) , and diabetic peripheral neuropathy ( DPN ) were examined in all the patients. Results (1)The incidence of DN was gradually increased from 13.3%to 27.7%and 44.2%in patients with low, medium, and high cortisol level groups, showing a statistical difference among 3 groups ( P<0.05) . The incidences of DR in medium and high cortisol level groups were higher than that in low cortisol level group (40.6%and 47.7%vs 22.7%, both P<0.01). The incidence of DPN in high cortisol level group was higher as compared with low cortisol level group (60.5% vs 38.7%, P<0.01). (2) Nocturnal serum cortisol level in patients with diabetic microvascular complications was higher than that in patients without complications [ (136.87 ± 105.78 vs 97.55 ± 93.48) nmol/L, P<0.01]. Nocturnal serum cortisol level in patients with multiple diabetic microvascular complications was higher than that in patients with single diabetic microvascular complication [ (151.66±114.54vs117.69±90.26)nmol/L,P<0.05].(3)Singlefactorlogisticregressionanalysisshowedthat higher nocturnal serum cortisol level was a risk factor for diabetic microvascular complications in addition to female, age, longer diabetic duration, higher fasting plasma glucose ( FPG ) . Multivariate logistic regression analysis showed that higher nocturnal serum cortisol level was still a risk factor for diabetic microvascular complications after adjusted by diabetic duration, FPG, HbA1C, and the use of insulin (P=0.013). Conclusion Nocturnal serum cortisol level seems to be a risk factor for diabetic microvascular complications in overweight or obese patients with type 2 diabetes mellitus.
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Objective To explore the CT features of ground-glass nodules. Methods A total of 104 cases of GGN le-sions were divided into three groups, 25 cases in preinvasive lesion group, 42 cases in minimally invasive adeno-careinoma group(MIA), 37 cases in invasive adenocarcinoma group (IAC), the lesion size, 3-dimensional ratio, 2-dimen-sional ratio, shape were analyzed and compared with pathological. Results ①All preinvasive lesions presented as pure GGN on CT image, MIA presented as pure GGN or mixed GGN on CT image, IAC most presented as mixed GGN on CT image; ②Speculation, lobulation, air-containing space and pleural indentation displayed gradually increasing from preinvasive lesions to MIA and IAC; ③There were statistically significant differences in lesion size, CT density, shape between the MIA and IAC groups (P<0.05); ④There were statistically significant differences in CT density values and long diameters of solid component of the lesions between the preinvasive lesion group and MIA group (P<0.05). Con-clusion Comprehensive analysis of the CT image features of GGNs, especially the solid component in the lesions, may help to the preoperative and differential diagnosis of preinvasive lesions, MIA and IAC, which is worth promoting the clinical application.
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Objective To optimize preparation of freeze-dried 16-dehydropregnenolone (16-DHP) liposome and evalu-ate the quality. Methods The freeze-dried liposome was prepared by rotary-evaporated film-ultrasonication with lyophilization. Single factor experiments and orthogonal design were used to optimize the prescription and preparation,and the quality was evalua-ted. Results The optimum preparation technics were as follows: the concentration of PC-98T was 6. 5% (W/ V), the quantity ratio of PC-98T to cholesteryl sodium sulfate salt was 4∶1,hydration temperature was 60 ℃ , ultrasonic time was 2 min,and the cryoprotectant was 7. 5% glucose. The average particle size, Zeta potential and encapsulation efficiency were (121. 3±48. 7) nm,-41. 9 mV and (98. 7±0. 1)% , respectively. Conclusion The formulation of freeze-dried 16-DHP liposome is reasonable, the technology is practicable and stable.
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BACKGROUND:In recent years, commonly used removable partial denture materials include Vitalium200 material, cobalt-chromium aloys and titanium materials. OBJECTIVE:To explore the value of different removable partial dentures in the repair of dentition defects. METHODS: Ninety cases of dentition defects, including 45 males and 45 females, aged 20-57 years old, were subject to removable partial denture repair. Among them, 30 cases were treated with Vitalium2000 removable partial dentures, 30 cases with titanium removable partial dentures, and 30 cases with cobalt-chromium removable partial denture. Denture inplace rate, incidence rates of denture stomatitis, periodontal disease and secondary caries, patient satisfaction self-evaluation were compared between three groups within 2 years after implantation. RESULTS AND CONCLUSION:Vitalium2000 material group was superior to pure titanium and cobalt-chromium aloy groups in the denture inplace rate, incidence rates of denture stomatitis, periodontal disease and secondary caries (P < 0.05). Patients in the Vitalium2000 material group were more satisfied with lightweight and comfort, aesthetics, chewing ability, odor degree of removable partial dentures than those in the other two groups (P < 0.05). These findings suggest that Vitalium2000 removable partial dentures can better improve the denture in place rate, reduce the incidence of denture stomatitis, periodontal disease and secondary caries, ensuring the comfort level and aesthetics of dentures.
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Objective To explore the association between CRP and circadian variation of blood pressure in both hypertensive and normotensive old population.Methods The 82 patients with essential hypertension (EH) and 79 normotensive adults were enrolled in this study. Serum high sensitive CRP (hsCRP) level was tested by fluorescence immunoassay technology. The 24-hour ambulatory monitor of the level and variability of blood pressure was carried out. Multivariable linear regression models were run to adjust the age, gender, body mass index, blood sugar, blood fat,smoking history and baseline blood pressure for analyzing the association between hsCRP and circadian variation of blood pressure.Results ( 1 ) The variability of systolic blood pressure during daytime,nighttime and 24-h our periods were higher in EH group than in control group (P<0.01 or P<0. 05), the variabilities of diastolic blood pressure were also significantly higher than in control group (P<0. 05), the dipping ratios of nocturnal systolic, diastolic and mean artery pressure were all less than in contrast group (all P<0.05). (2) The hsCRP was obviously higher in EH group than in control group [(5.44± 1.78)mg/L vs. (3.03±0. 72) mg/L, P<0. 01]. (3) The hsCRP had positive associations with diastolic blood pressure variability during daytime (r= 0. 492, P<0. 001 ), nighttime (r=0.240, P=0.048), and 24-hour (r=0.271, P=0.030). The variability in diastolic blood pressure predic ted the level of hs CRP(r=0.660, R2=0.436, P<0.001). (4) In control group, no significant association was found between CRP and variation of blood pressure.Conclusions The BP variability and serum CRP in EH patients are obviously higher than in normotensive patients,however, the nocturnal BP dipping ratio is less than in normotensive patients. Furthermore, the level of serum hsCRP in EH patients is positively associated with the variation of blood pressure, especially for variation of diastolic blood pressure.