An untargeted urinary metabonomics method based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry ( UPLC-Q-TOF-MS ) has been established to investigate the mechanism of Schisandra chinensis in treating diabetes and its complications. The urinary biomarkers related to the therapeutic effects of Schisandra chinensis on the diabetes rats were analyzed. In urine, 28 kinds of endogenous metabolites were identified as potential biomarkers, including 13 endogenous metabolites in positive ion mode, 15 endogenous metabolites in negative ion mode, and hippuric acid detected both in positive and negative ion modes. The results revealed that Schisandra chinensis mainly affected the pathways of pentose and glucuronate interconversions, riboflavin metabolism, pantothenate and CoA biosynthesis, arginine and proline metabolism, intestinal bacteria metabolism, ascorbate and aldarate metabolism and tryptophan metabolism in diabetic rats. Combined with biological analysis of these pathways, the therapeutic mechanism of Schisandra chinensis on diabetes and its complications was verified. Based on the biological function of each pathway, the effect of Schisandra chinensis on diabetic nephropathy is stronger. Moreover, it also has the effects of protecting liver, decreasing fat and antioxidant activity.

Objective: To identify Tongren Wujibaifeng Pills and Xiaoshuanzaizao Pills respectively by analysis of IR fingerprint. Methods: Both drugs were extracted with hexane, ether and butanone and then the extracts obtained were measured with FT IR spectrometer. Results: By analizing IR fingerprint of 25 batches Tongren Wujibaifeng Pills and 31 batches Xiaoshuanzaizao Pills, we found that different batches of the same drug have stable and repeatable fingerprint. Conclusion: By using IR fingerprint, either Tongren Wujibaifeng Pills and Xiaoshuanzaizao Pills can be identified. It provides a rapid method for drug identification and quality control.

AIM: To identify the Chinese medicinal granule by measuring IR fingerprints. METHODS: 13 kinds of granules were extracted with butanone respectively and then the obtained extracts were measured with the FT IR spectrometer. RESULTS: By IR fingerprint of 13 kinds of granules drugs, different batches of the same crude drug had a stable and repeatable fingerprint. CONCLUSION: By using IR fingerprint, Chinese medicinal granule can be identified and provides a rapid method for drug identification and quality control.

OBJECTIVETo detect potential mutations of COL1A1 and COL1A2 genes in four Chinese pedigrees affected with osteogenesis imperfecta (OI) and provide prenatal diagnosis for a fetus at 18th gestational week.

METHODSAll coding regions and exon/intron boundaries of the COL1A1 and COL1A2 genes were analyzed with targeted next-generation sequencing (NGS). Suspected mutations were confirmed with Sanger sequencing in the probands, unaffected relatives and 200 unrelated healthy individuals. Prenatal diagnosis for a high-risk fetus was carried out through Sanger sequencing.

RESULTSThe probands of families 1 and 2 have respectively carried a c.760G>A (p.Gly254Arg) and a c.608G>T (p.Gly203Val) mutation of the COL1A1 gene. For family 3, the proband and his daughter have carried a novel c.299-1G>C splicing mutation of the COL1A1 gene. The same mutation was not found in the fetus of this family. For family 4, the proband has carried a novel c.1990G>C (p.Gly664Arg) mutation of the COL1A2 gene. The four mutations were not found in the unaffected relatives and 200 unrelated healthy individuals.

CONCLUSIONThe mutations of the COL1A1 and COL1A2 genes probably underlie the disease in the four families. NGS combined with Sanger sequencing can provide an effective and accurate method for their genetic and prenatal diagnosis.

Adult ; Child, Preschool ; Collagen Type I ; genetics ; DNA Mutational Analysis ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Infant, Newborn ; Male ; Mutation ; Osteogenesis Imperfecta ; genetics ; Prenatal Diagnosis

Objective:To investigate the clinical characteristics of cerebellopontine angle (CPA) tumors with hemifacial spasm (HFS) or trigeminal neuralgia (TN) as first symptoms.Methods:From May 2015 to November 2018, 70 patients with CPA tumors found in preoperative imaging examination or during operation and with TN or HFS as first symptoms, were enrolled into experimental group; 66 patients with CPA tumors without TN or HFS were chosen as control group. Gender, age, course of the disease, pathological types of the tumors, and tumor sizes were retrospectively analyzed and compared between the two groups.Results:In the experimental group, 54 patients were with TN as first symptom and 16 were with HFS as first symptom. The ratio of male to female in the experimental group was about 1∶2.18, and the difference was not statistically significant as compared with that in the control group (1∶3.00, P>0.05). The median course of disease in the experimental group was 36 (24, 84) months, which was significantly longer than that in the control group (9 [2, 24] months, P<0.05). In the experimental group, 34 patients (48.6%) had cholesteatoma, 24(34.3%) had meningioma, 8 (11.4%) had acoustic neuroma, 2 (2.9%) had lipoma, and 2 (2.9%) had jugular bulb tumor. In the control group, 39 patients (59.1%) had acoustic neuroma, 18 (27.3%) had meningioma, 5 (7.6%) had cholesteatoma, 3 (4.5%) had jugular bulb tumor, and one (1.5%) had lipoma. The tumor size in the experimental group (2.00 [1.60, 4.25] cm 2) was significantly smaller than that in the control group (5.60 [4.00, 8.50] cm 2, P<0.05). In the experimental group, 53 patients (75.7%) were found to have offending arteries compressing on corresponding cranial nerves during surgery; the offending artery of patients with TN was superior cerebellar artery; that of 14 patients with HFS was anterior inferior cerebellar artery and that of 2 patients with HFS was posterior inferior cerebellar artery. All patients with confirmed offending arteries underwent microvacular decompression (MVD) after tumor resection. The patients in the experimental group were followed up for 2-48 months after surgery, and the TN or HFS symptoms disappeared. Conclusions:The female patients with CPA tumors with TN or HFS as first symptoms are more common, and TN is far more common than HFS. Cholesteatoma is the most common tumor. As compared with patients with CPA tumors without TN or HFS, CPA tumors patients with TN or HFS have longer course of disease and smaller tumor volume. Most patients have offending vascular compression on the corresponding cranial nerves, tumor resection+MVD is safe and effective treatment for these patients.

Objective:To compare the treatment efficacy of microvascular decompression (MVD) in hemifacial spasm (HFS) patients with stable disappearance of abnormal muscle response (AMR) and recurrence of AM.Methods:A total of 1705 HFS patients who received MVD and accepted AMR monitoring during the whole process were selected in our hospital from January 2014 to January 2019. According to the intraoperative AMR monitoring results, these patients were divided into AMR stable disappearance group and AMR recurrence group. All patients were followed up for 12-68 months; the delayed cure rate and total cure rate were compared between the two groups.Results:Among the 1158 patients from AMR stable disappearance group, 1086 patients were cured immediately after surgery, 48 were cured within 0.2-3 months of surgery, and 24 patients were not effective. Among the 547 patient from AMR recurrence group, 301 patients achieved immediate cure after surgery, 232 patients had delayed cure in the follow up period (ranged from 0.5 to 6 months), and 14 patients were not effective. The total cure rate showed no significant difference between the two groups (97.9% vs. 97.4%, P>0.05), but the delayed cure rate in patients from AMR recurrence group was significantly higher than that from AMR stable disappearance group (42.4% vs. 4.1%, P<0.05). Re-examination of AMR at the end of surgery showed that AMR disappeared again in 294 patients from the AMR recurrence group without intracranial intervention, and AMR continued to exist in 253 patients at the end of surgery. Conclusion:After complete intraoperative decompression of HFS by MVD, the AMR recurrence does not require immediate re-operative exploration and decompression, which can still ensure excellent curative effect and has a relatively high probability of delayed cure; and the evaluation of its curative effect should be extended to at least one year after surgery.

OBJECTIVE: The purpose of this study was to prospectively investigate the value of the myocardial extracellular volume fraction (ECV) in predicting myocardial functional outcome after revascularization of coronary chronic total occlusion (CTO). MATERIALS AND METHODS: Thirty patients with CTO underwent cardiovascular magnetic resonance (CMR) before and 6 months after revascularization. Three baseline markers of functional outcome were evaluated in the dysfunctional segments assigned to the CTO vessels: ECV, transmural extent of infarction (TEI), and unenhanced rim thickness (RIM). At the global level, the ECV values of the whole myocardium with and without a hyperenhanced region (global and remote ECV) were respectively measured. RESULTS: In per-segment analysis, ECV was superior to TEI and RIM in predicting functional recovery (area under receiver operating characteristic curve [AUC]: 0.86 vs. 0.75 and 0.73, all p values < 0.010), and it emerged as the only independent predictor of regional functional outcome (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.77–0.89; p < 0.001) independent of collateral circulation. In per-patient analysis, global baseline ECV was indicative of ejection fraction (EF) at the follow-up examination (β = −0.61, p < 0.001) and changes in EF (β = −0.57, p = 0.001) in multivariate regression analysis. A patient with global baseline ECV less than 30.0% (AUC, 0.93; sensitivity 94%, specificity 80%) was more likely to demonstrate significant EF improvement (OR: 0.38; 95% CI: 0.17–0.85; p = 0.019). CONCLUSION: Extracellular volume fraction obtained by CMR may provide incremental value for the prediction of functional recovery both at the segmental and global levels in CTO patients, and may facilitate the identification of patients who can benefit from revascularization.
Collateral Circulation ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Myocardial Infarction ; Myocardial Ischemia ; Myocardium ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity

Objective:To investigate the value of brainstem auditory evoked potential (BAEPs) combined with cochlear electrogram (ECochG) monitoring in the protection of auditory function during microvascular decompression (MVD) for patients with facial spasm (HFS).Methods:Clinical data of 908 patients with HFS who received MVD treatment in our hospital from January 2018 to December 2020 were retrospectively analyzed. The patients were divided into BAEPs group ( n=309), ECochG group ( n=301) and BAEPs+ECochG group ( n=298) according to the different methods of auditory nerve function monitoring. Waveform extraction rate, mean extraction time, amplitude, latency, intraoperative warning effect of 3 monitoring methods, as well as hearing status immediately after surgery and during follow-up were compared in patents from the 3 groups. Results:(1) The overall waveform extraction rate in ECochG group and BAEPs+ECochG group was significantly higher than that in BAEPs group, and the average waveform extraction time in ECochG group and BAEPs+ECochG group was significantly shorter than that in BAEPs group ( P<0.05). The amplitude of compound action potential (CAP) wave in ECochG group was significantly higher than that of V wave in BAEPs group, and the latency of CAP wave was also significantly earlier than that of V wave ( P< 0.05). (2) A total of 48 patients of the 288 patients in the BAEPs group showed warning signs; a total of 73 of the 292 patients in the ECochG group showed warning signs; and a total of 65 of the 292 patients in the BAEPs+ECochG group showed warning signs. (3) There was significant difference in hearing grading (American Association of Otolaryngology Head and Neck Surgery [AAO-HNS] grading) among the 3 groups immediately after surgery ( H=18.041, P=0.000), and the average rank suggested that the hearing of patients in the BAEPs+ECochG group was superior to the other two groups. All patients were followed up for an average of 15 months (ranged 3-24 months); there was still a significant difference in AAO-HNS grading among the 3 groups ( H=29.625, P=0.000), and the hearing of patients in the BAEPs+ECochG group was still superior to the other two groups. Conclusion:The combined application of ECochG and BAEPs monitoring can reflect the changes of intraoperative hearing impairment comprehensively, accurately and timely, which is of great significance for the protection of auditory function in HFS patients during MVD.

Objective:To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients.Methods:We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed.Results:There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex( P=0.023), ILD( P=0.001), COPD( P=0.027) were independent risk factors for postoperative morbidity. ILD( P=0.023) and postoperative morbidity( P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. Conclusion:Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients.