【摘要】 目的 观察黄精多糖（polygonatum sibiricmu polysaccharides，PSP）对老龄大鼠血液中老化相关酶的影响。 方法 取老龄（15～16月龄）SD大鼠。每组15只，均采用灌胃给药。阴性对照组灌服等体积的0.5%羧甲基纤维素（CMCNa）；阳性对照组给予甲磺酸双氢麦角碱0.5 mg/kg；PSP大剂量组222 mg/（kg·d）；PSP中剂量组111 mg/（kg·d）；PSP小剂量组55 mg/（kg·d）；另取9只青年SD大鼠，作为青年对照组，灌服等体积的0.5% CMCNa。每日1次，连续4周，末次给药后取血，检测老化相关酶:超氧化物歧化酶（SOD）、过氧化脂质（LPO）、脂褐质（LF）、B型单胺氧化酶（MAO-B）。各项指标进行统计分析，比较各组差异。 结果 PSP高、中剂量组的SOD水平明显提高，而LPO、LF和MAO-B水平明显下降。 结论 PSP有较明确的延缓衰老作用。【Abstract】 Objective To observe the effects of Polygonatum sibiricmu polysaccharides (PSP) on enzymes related to the aging in the blood of aged rats. Methods Seventy-five aged rats (15-16 months) were divided into 5 groups randomly containing 15 rats in each group. The rats of each group were treated with different medicines daily for 4 weeks by gavage: negative control group received 0.5% CMCNa; positive control group received dihydroer gotoxine of 0.5 mg/kg; high dose group of PSP received PSP of 222 mg/(kg·d); middle dose group of PSP received PSP of 111 mg/(kg·d); low dose group of PSP received PSP of 55 mg/(kg·d). Another 9 young rats (4 male and 5 female rats) were chosn as an additional control group to study the reaction of youth, which received 0.5% CMCNa by gavage. The enzymes about aging were detected after the last treatment, such as superoxide dismutase (SOD), lactoperoxidase (LPO), lipofuscin (LF), monoamine oxidase type B (MAO-B). Statistical analysis was used to judge the differences of all groups. Results The blood level of SOD in high and middle dose groups of PSP were significantly increased while the blood level of LPO, LF, MAO-B were decreased with markable differences. Conclusion PSP has an obvious effect of anti-aging.
ObjectiveTo review research progress of surgical treatment of patellar fractures.MethodsThe domestic and foreign literature about patellar fracture treatment in recent years was extensively consulted, and the advantages, disadvantages, and indications of various surgical treatments were summarized.ResultsThe patella plays an important role in knee flexion and extension activities, and the fracture significantly affects the patient’s quality of life. At present, the surgical methods include open reduction and internal fixation and patella resection. The internal fixation methods include ring/binding patella fixation, tension band wiring and improved technology, tension band wiring combined with other methods, screw fixation (including absorbable screws), steel plate fixation, and patella fixator fixation. Each surgical method has different indications, advantages, and disadvantages. Choosing an appropriate treatment plan plays a crucial role in clinical prognosis.ConclusionThere are many surgical treatments for patellar fractures. In order to improve the effectiveness and reduce postoperative complications, it is necessary to choose the most appropriate treatment strategy for the type of fracture.
Objective To assess the effectiveness of sternocleidomastoid muscle (SCM) flap in preventing gustatory sweating syndrome following parotidectomy. Methods Databases including The Cochrane Library, MEDLINE, EMbase, CBM, CNKI, VIP and WanFang Data were searched from inception to March 2012 to retrieve randomized controlled trials (RCTs) about SCM flap in preventing gustatory sweating syndrome following parotidectomy. The data of studies meeting the inclusion criteria were extracted by two reviewers independently, the methodological quality was assessed and cross-checked, and meta-analysis was performed using the RevMan 5.1 software. Results A total of 10 RCTs involving 825 patients were included. The results of meta-analyses showed that compared with the blank control group, SCM flap could obviously decrease the subjective incidence of gustatory sweating syndrome by 78% (OR=0.22, 95%CI 0.08 to 0.59, P=0.003) and the objective incidence by 83% (OR=0.17, 95%CI 0.05 to 0.60, P=0.006). The sensitivity analysis indicated the above results were robust. The evidence based on GRADE system was of “low quality”. There was no obvious publication bias according to the tunnel chart. Conclusions Current evidence shows that SCM flap can obviously decrease both subjective and objective incidence of gustatory sweating syndrome following parotidectomy. Considering the limitation of the included studies, this conclusion still needs to be tested by more large-scale and high-quality RCTs taking SCM function as one of the outcome.
ObjectiveTo observe the status of thrombocytopenia in adult patients after cardiac surgery, and to explore its mechanism and clinical significance.MethodsRetrospective analysis of 240 patients after cardiac surgery in the 2nd ward of surgical intensive care unit (ICU) of Fuwai Hospital from May to June 2020 was conducted, including 137 males and 103 females with a mean age of 56.0±12.0 years. According to postoperative platelet status, the patients were divided into a thrombocytopenia group and a non-thrombocytopenia group. The clinical baseline data, preoperative platelet count, postoperative minimum platelet count, volume of drainage, transfusion of blood products, mechanical ventilator time, ICU stay, hospital stay and complications were compared between the two groups.ResultsThe mean preoperative platelet count was 199×109/L±55×109/L and the mean postoperative platelet nadir was 109×109/L±37×109/L, with a mean reduction rate of 44.1%±15.8%. The platelet count of 235 (97.9%) patients after operation was lower than that before operation. Among them, 98 (40.8%) patients had platelet count<100×109/L, 46 (19.2%)<75×109/L and 8 (3.3%)<50×109/L. Results of multivariable logistic analysis showed that cardiopulmonary bypass time>120 min (OR=2.576, 95%CI 1.313-5.053, P<0.05) was an independent risk factor for postoperative thrombocytopenia. Mechanical ventilator time (25.5±16.8 h vs. 17.3±8.5 h, P<0.05), ICU stay (85.2±54.7 h vs. 60.0±33.9 h, P<0.05) and hospital stay (15.8±6.2 d vs. 14.2±3.9 d, P<0.05) were longer in the thrombocytopenia group (<100×109/L) compared with the non-thrombocytopenia group (>100×109/L). More drainage volume [685 (510, 930) mL vs. 560 (440, 790) mL, P<0.05] and complications occurred in the thrombocytopenia group. In multivariable analysis, thrombocytopenia was significantly inversely associated with prolonged ICU stay (OR=2.993, 95%CI 1.622-5.524, P<0.05).ConclusionThrombocytopenia occurs commonly after adult cardiac surgery, and the incidence in different types of surgery varies. Postoperative thrombocytopenia is related to the prolonged recovery. Extracorporeal circulation may be a contributing factor to thrombocytopenia, and further studies investigating mechanism and strategies to reduce postoperative thrombocytopenia are needed.
Objective To study the regulations of visual evoked potential(VEP) changes in 30 patients with multiple sclerosis (MS). Methods VEP were performed in 30 MS patients,and the results were compared with normal subjects. Results The abnormality rate of VEP were 76.7%. 82.6% of patients with abnormal VEP showed clinical visual symptoms; 17.4% among those patients have no clinical visual symptoms. Conclusion The rate of VEP abnormal in MS patients is more high. It may help more in the diagnosis of MS.
ObjectiveThrough the analysis of gene enrichment in gastric cancer samples, the changes of RNA alternative splicing and related molecular mechanisms were explored.MethodsThe pathological samples of three cases of gastric cancer patients and adjacent tissues were obtained clinically, and the data were obtained by cell culture, protein quantitative labeling, gene chip detection, high-throughput sequencing, etc. GO enrichment was performed on samples by DAVID and other network software, KEGG pathway analysis yielded relevant information for screening for variable splicing of differential genes.ResultsA total of 605 genes with individual ENSG IDs consistent with the gene identification of the ENSEMBL database were screened, and the gene levels of cancer tissues and adjacent tissues were compared. There were 411 non-differentiated genes, 119 differentially up-regulated genes, and 75 differentially down-regulated genes. A total of 69 differentially spliced genes were screened out. Functional annotation and pathway analysis revealed that the detection genes were mainly concentrated in molecular metabolic processes, cell migration, extracellular matrix tissue, blood coagulation, cell matrix adhesion, signal transduction, negative apoptosis regulation, angiogenesis, platelet activation, complement system, adipokines signaling pathway, peroxisome, cancer pathway, transforming growth factor (TGF) signaling pathway, axon guidance, cell cycle, etc.ConclusionThere are a large number of differentially spliced genes in gastric cancer tissue samples, and the difference in expression due to changes in splice sites may play an important role in the development of gastric cancer.
ObjectiveTo evaluate the efficacy and safety of modified maze Ⅳ (Cox-maze Ⅳ) in hypertrophic obstructive cardiomyopathy (HOCM) patients.MethodsFrom June 2016 to June 2019, 30 HOCM and persistent atrial fibrillation (pAF) patients received Cox-maze Ⅳ operation with modified extended Morrow operation, including 21 males and 9 females. The average age was 51.36±10.27 years and the average weight was 72.48±11.29 kg. All patients underwent left atrial appendectomy. Recurrence of AF, improvement of symptoms, cardiac function (NYHA) were assessed during follow-up.ResultsThere was no death during the perioperative period. Postoperative left ventricular outflow tract gradient was significantly decreased compared with that before operation (P<0.01), and all systolic anterior motion (SAM) signs disappeared after operation. Thirty patients were all effectively followed up for 3-40 (16.24±8.26) months. During the follow-up period, there was no death, and the cardiac function (NYHA) of all patients recovered to gradeⅠ-Ⅱ. At the end of follow-up, twenty-four patients (80.00%) maintained sinus rhythm, and twenty-seven patients (90.00%) maintained sinus rhythm after amiodarone conversion. Univariate analysis showed that the smoking history (P=0.04), left atrial diameter≥55 mm before operation (P=0.03), left atrial diameter≥50 mm after operation (P=0.02), postoperative tricuspid regurgitation (P=0.02) were closely related to postoperative AF recurrence. The increase of left atrial diameter after operation was an independent risk factor for AF recurrence (P=0.02).ConclusionMorrow/Cox-maze Ⅳ procedure is safe and effective in treatment of patients with HOCM complicated with pAF, which helps to maintain postoperative sinus rhythm, and to improve the cardiac function. The increase of left atrial diameter after operation is an independent risk factor for AF recurrence.
The "2022 AHA/ACC/HFSA guideline for the management of heart failure" replaces the "2013 ACCF/AHA guideline for the management of heart failure" and the "2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure". The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose and manage patients with heart failure. Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to manage patients with heart failure, with the intent to improve quality of care and align with patients’ interests. New recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses. This article summarized and interpreted the new concept of heart failure in 2022 guidelines, especially the new evidence and suggestions related to cardiac surgery.
Objective To investigate the role of transbronchial lung biopsy ( TBLB) in the diagnosis and prognosis evaluation of idiopathic interstitial pneumonia ( IIP) . Methods Clinical data of IIP patients admitted to Peking University First Hospital from January 2005 to April 2009 were analyzed retrospectively. The pathologic manifestations of TBLB samples of these patients had been reviewed by pathologists and respirologists. Chest high-resolution computer tomography ( HRCT) of the patients had been reviewed, and subsequent follow-ups were performed. The influence factors on diagnosis value of TBLB were analyzed. The relationship between TBLB findings and prognosis were observed. Results 29 IIP patients had been investigated, among them 21 were male and 8 were female, ranging in age from 43 to 79 years, with an average of 63 ±10 years.16 TBLB samples had diagnostic value, among themthe total number of the samples was from 2 to 7, with an average of 4.2 ±1.8. 13 TBLB samples had no diagnostic value, among them the total number of the samples was from0 to 5, with an average of 2.1 ±1.6. There was significant differences between two groups( P lt;0.005) . Among the 16 cases with diagnostic value of TBLB, non-specific interstitial pneumonia ( NSIP) pattern was showed in 9 cases, usual interstitial pneumonia ( UIP) pattern in 6 cases and organizing pneumonia ( OP) in 1 case. Among 29 cases, UIP-like pattern was showed on HRCT in 14 cases, while non-UIP pattern showed on HRCT in 15 cases. On follow-up of the 16 patients, 1 patient aggravated and 5 patients died among 6 cases with UIP pattern, 8 patients got better and 1 patient died among 9 cases with NSIP pattern, and the patient with OP got better. The patients who show non-UIP pattern in TBLB survived longer than UIP pattern with significant difference between two groups ( P lt; 0.005) . Conclusions The diagnosis value of TBLB is bly related to the number of samples and the patterns of HRCT. When the number of samples is more than or equal to 3, the diagnosis value of TBLB is better. It is easier to get valuable TBLB samples in patients with non-UIP pattern on HRCT than that with UIP pattern. The patients with non-UIP pattern in TBLB have better prognosis than those with UIP pattern. TBLB is useful in diagnosis and prognosis evaluation of IIP.
Objective To perform a cross-sectional study on mental situations of parents of student victims in Wenchuan earthquake and analysis the data to produce best evidences for the government on their decision-making. Methods By the use of questionnaires, interviewer, and observation, we performed field study on 225 student victims’ parents selected by simple random sampling to collect their demographic characteristics, economic and mental status. Results (1) Of the 123 student victims the only child of the family account for 91.87%, female account for 50.41%, the pupil and below, the middle school student, and the college account for 48.78%, 50.41%, 0.81% respectively. (2) Mental and behavior differences between fathers and mothers were significant. (3) The parents declining to accept the death of their children are not in a good social support. (4) The parents with good family economics and high education are more likely to accept the death of children. Conclusion (1) We should build a ‘Mutual Aid’ organization to help those parents construct a good social support net. (2) To take the advantage of rural hospitals to build the long-acting mechanism of the psychological intervention. (3) To perform the psychological intervention corresponding to right period and right aimed group.