Objective:To analyze therapeutic effect of amiodarone combined RAS inhibitors on hypertensive patients with atrial fibrillation(AF),and its influence on serum levels of uric acid(SUA)and silent information regulator 2-related enzymes 1(SIRT1).Methods:A total of 186 hypertensive patients with AF were selected from our hospital. They were randomly and equally divided into amiodarone group(group A),amiodarone + telmisartan group(A+T group)and amiodarone + ramipril group(A+ R group).Left atrial diameter(LAD),P wave dispersion(Pd),lev-els of high sensitive C reactive protein(hsCRP),brain natriuretic peptide(BNP)and SUA,SIRT1 mRNA and pro-tein expression and blood pressure variability(BPV)were observed and compared among three groups before and 45d after treatment.Results:Compared with before treatment,there were significant improvement in all index ex-cept SUA after treatment in three groups,P=0.001 all;compared with group A after treatment,there were signif-icant reductions in 24hSBPV[(0.112 ± 0.022)vs.(0.092 ± 0.020)vs.(0.091 ± 0.021)],24hDBPV[(0.143 ±0.031)vs.(0.130 ± 0.040)vs.(0.129 ± 0.039)],levels of hsCRP[(8.3 ± 0.3)mg/L vs.(5.3 ± 0.6)mg/L vs. (3.6 ± 0.4)mg/L],BNP[(64.9 ± 9.4)ng/dl vs.(61.1 ± 7.6)ng/dl vs.(58.2 ± 8.3)ng/dl]and SUA[(498.85 ± 89.54)μmol/L vs.(298.54 ± 56.12)μmol/L vs.(278.32 ± 54.09)μmol/L],SIRT1 mRNA[(2.20 ± 0.34)%vs.(1.87 ± 0.30)% vs.(1.76 ± 0.31)%]and protein[(29.54 ± 8.12)% vs.(26.31 ± 7.43)% vs.(23.21 ± 6.90)%]expression in A+T group and A+ R group,P<0.05 or <0.01. Compared with group A,there were sig-nificant rise in Pd[(39.3 ± 4.2)ms vs.(40.9 ± 4.1)ms,(41.2 ± 5.1)ms],and significant reduction in LAD [(37.8 ± 3.4)mm vs.(35.1 ± 4.6)mm,(35.7 ± 4.5)mm]in A+T group and A+R group,P<0.05 or <0.01. Conclusion:Amiodarone combined RAS inhibitors can significantly improve blood pressure variability,and reduce inflammatory factor,SUA and serum SIRT1 level in hypertensive patients with AF.

Adult ; Aged ; Anthracosis ; diagnostic imaging ; therapy ; Bronchoalveolar Lavage ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Radiography

Malignant tumor is one of the important reasons threatening human health and safety at present. The application of antiangiogenic drugs and immune checkpoint inhibitors has brought great hope for tumor treatment, but the complex interlaced relationship between tumor blood vessels and immune microenvironment leads to unsatisfactory efficacy. In addition,VEGF, a key driver of tumor angiogenesis, interferes with the maturation of dendritic cells, thereby inhibiting the initiation of T cells. VEGF also induces depletion of CD8+T cells. At the same time, various innate and acquired immune cells secrete angiogenic factors that accelerate uncontrolled angiogenesis and promote vascular immaturity. Therefore targeting tumor blood vessels and immunity is a potential strategy for enhancing tumor immunotherapy. In recent years numerous studies have found that using the blood vessels and the immune intervention strategies combined with antitumor immune therapy has achieved good results. In this review the immune and vascularized tumor microenvironment are reviewed and discussed, and the research progress of vascularized immune interintervention strategy for tumor treatment in recent years is reviewed so as to provide reference for further improving the efficacy of tumor immunotherapy.

OBJECTIVE: To study effects of postoperative regular training of core muscle strength guided by the concept of enhanced recovery after surgery (ERAS) on the rehabilitation of elderly patients with osteoporotic lumbar vertebral compression fracture after vertebroplasty (PVP) and kyphoplasty(PKP). METHODS: Ninety-four elderly patients with osteoporotic lumbar compression fractures who underwent PKP or PVP from January 2016 to January 2018 and met inclusion criteria were divided into observation group and control group. All the patients were treated with routine anti osteoporosis therapy after operation. There were 47 patients in the observationgroup, including 18 males and 29 females, with an average age of (62.62±3.21) years old;in the control group, there were 47 cases, including 17 males and 30 females, with an average age of (62.38±2.84) years old. The patients in the control group were trained by traditional way, and the patients in observation group were instructed to conduct regular training of core muscle strength according to ERAS concept. The patients were followed up for 1, 3 and 6 months after operation. Patients' conditions were quantitatively evaluated according to Barthel scale, JOA low back pain score and Oswestry Disability Index, and the differences in treatment effects between two groups were statistically analyzed and compared. RESULTS: All the patients were followed up, and the Barthel scale, JOA low back pain score and Oswestry Disability Index score of the observation group were all better than those of the control group on the 1st and the 3rd months after surgery( CONCLUSION Early regular core strength training has a positive effect on early functional recovery and improvement of life ability after PKP or PVP for elderly patients with osteoporotic lumbar compression fractures, which is in line with the concept of accelerated rehabilitation surgery.
Aged ; Enhanced Recovery After Surgery ; Female ; Fractures, Compression/surgery* ; Humans ; Kyphoplasty ; Male ; Middle Aged ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Treatment Outcome ; Vertebroplasty

OBJECTIVE: By comparing the clinical efficacy of short-segment and long-segment fixation for single-segment thoracic and lumbar spine III stage Kümmell disease to explore a more suitable fixed segment for the disease. METHODS: The clinical data of 46 patients with single-segment thoracic and lumbar spine III stage Kümmell disease treated from July 2013 to December 2016 were retrospectively analyzed. Forty-six patients were divided into short-segment fixation group(one vertebra above and below the diseased vertebra) and long-segment fixation group(two vertebrae on the upper and lower of the diseased vertebra) according to different methods of cement stick fixation. There were 25 patients in the short-segment fixation group, including 9 males and 16 females, with an average age of (75.3±4.5) years old, lumbar spine bone mineral density T-value of (-3.1±0.3) g/cm³, follow-up time of (13.0±2.3) months; there were 21 patients in long-segment fixation group, 6 males and 15 females, with an average age of (74.5±3.9) years old, lumbar spine bone mineral density T-value of (-3.2±0.3) g/cm³, follow-up time of (14.7±3.6) months.The gender, age, follow-up time, operation time, intraoperative blood loss, cement leakage, and the rate of adjacent vertebrae fractures were compared between two groups, as well as pain VAS score, ODI, and kyphosis angle before and after surgery. RESULTS: There were no significant differences in age, gender, bone density, pain VAS score, ODI, and kyphosis between two groups before surgery. The operation time and intraoperative blood loss of short-segment fixation group were less than that of long-segment fixation group. The pain VAS score, ODI and kyphosis of the two groups were significantly improved at 7 days after the operation and at the latest follow-up, there was no significant difference between two groups. There were no significant differences in bone cement leakage(9/25 vs 11/21) and adjacent vertebrae fractures(4/25 vs 3/21). CONCLUSIONS Both long-segment fixation and short-segment fixation can effectively relieve pain, correct kyphosis, improve functional index, and achieve better clinical results, but short-segment fixation has less operation time and less intraoperative blood. So single-segment thoracic and lumbar spine III stage Kümmell disease does not need to extend the fixed segment, short-segment fixation is more in line with clinical needs and worthy of further study.
Aged ; Female ; Fracture Fixation, Internal ; Humans ; Kyphosis ; Lumbar Vertebrae ; Male ; Retrospective Studies ; Spinal Fractures ; Thoracic Vertebrae ; Treatment Outcome

OBJECTIVE: From the perspective of clinical application to analyze the effectiveness and reliability of CPC/PMMA bone cement in percutaneous kyphoplasty (PKP) for the treatment of elderly patients with osteoporotic thoracolumbar fractures. METHODS: A retrospective analysis was performed on 62 patients with osteoporotic compression fracture of single-vertebral thoracic or lumbar segment who underwent PKP surgery and had a bone density less than or equal to -3.0 SD from February 2016 to December 2016. Among them, 23 patients were in CPC/PMMA group, with an average age of (77.6±2.2) years old, 39 patients in PMMA group, with an average age of (77.1±1.1) years old. The indexes between two groups were compared, including the visual analogue scale (VAS), height ratio of anterior vertebra (AVHR), local Cobb angle, cement leakage, new adjacent vertebral fracture(NAVF). RESULTS: There were no significant difference in gender, age, follow-up time and preoperative VAS, AVHR, local Cobb angle between two groups (>0.05), at the 1 day after operation, VAS, AVHR, local Cobb angle in all patients got obvious improvement (<0.05), which was no significant difference at 1 day after operation and final follow-up (>0.05). At the same time, there was no statistically significant difference in the incidence of new adjacent vertebral fracture and cement leakage (>0.05). The pain in both groups continued to improve at follow up after operation (<0.05), the local Cobb angle increased (<0.05) and AVHR decreased slightly (<0.05). However, the images of conventional methods (X-ray or CT) could not find signs about CPC degeneration and new bone ingrowth. CONCLUSION CPC/PMMA composite bone cement is safe and reliablein PKP for treatment of elderly patients with osteoporotic thoracolumbar fractures, which can effectively relieve pain and maintain vertebral body stability. It has the same curative effect as PMMA bone cement. It was worthy to research more in future, although no direct evidences support the CPC/PMMA composite bone cement can reduce the incidence of adjacent vertebral fracture, CPC degeneration or new bone ingrowth.
Aged ; Bone Cements ; Dinucleoside Phosphates ; Fractures, Compression ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Polymethyl Methacrylate ; Reproducibility of Results ; Retrospective Studies ; Spinal Fractures ; Treatment Outcome ; Vertebroplasty

This study screened excellent carriers for co-loading tanshinone Ⅱ_A(TSA) and astragaloside Ⅳ(As) to construct antitumor nano-drug delivery systems for TSA and As. TSA-As microemulsions(TSA-As-MEs) were prepared by water titration. TSA-As metal-organic framework(MOF) nano-delivery system was prepared by loading TSA and As in MOF by the hydrothermal method. Dynamic light scattering(DLS), transmission electron microscopy(TEM), and scanning electron microscopy(SEM) were used to characterize the physicochemical properties of the two preparations. Drug loading was determined by HPLC and the effects of the two preparations on the proliferation of vascular endothelial cells, T lymphocytes, and hepatocellular carcinoma cells were detected by the CCK-8 method. The results showed that the particle size, Zeta potential, and drug loading of TSA-As-MEs were(47.69±0.71) nm,(-14.70±0.49) mV, and(0.22±0.01)%, while those of TSA-As-MOF were(258.3±25.2) nm,(-42.30 ± 1.27) mV, and 15.35%±0.01%. TSA-As-MOF was superior to TSA-As-MEs in drug loading, which could inhibit the proliferation of bEnd.3 cells at a lower concentration and improve the proliferation ability of CTLL-2 cells significantly. Therefore, MOF was preferred as an excellent carrier for TSA and As co-loading.
Mice ; Animals ; Endothelial Cells ; Abietanes ; Cell Line