Adult ; Empyema, Pleural ; complications ; etiology ; Humans ; Male ; Neck Injuries ; complications ; Tracheoesophageal Fistula ; complications ; etiology

Objective:To evaluate the value of cardiac MR feature tracking (CMR-FT) on the early assessment of left ventricular subclinical myocardial dysfunction in patients of hypertensive heart disease (HHD).Methods:From October 2018 to November 2019, 16 HHD patients with left ventricular hypertrophy (HHD-LVH), 24 HHD patients without left ventricular hypertrophy (HHD-nonLVH) and 24 age-and gender-matched normotensive controls who underwent 3.0 T CMR examination were retrospectively enrolled. Imaging protocol included cine sequence and late gadolinium enhancement. Left ventricular function variables were measured using Argus software, mainly including left ventricular end-diastolic volume index (LVEDVI), left ventricular mass index (LVMI), left ventricular maximal wall thickness (LVMWT), the ratio of left ventricular mass to left ventricular end-diastolic volume (M/V). CMR-FT was performed using commercial software CVI 42, with parameters including global radial, circumferential, longitudinal strains (GRS, GCS, GLS), peak systolic radial, circumferential, longitudinal strain rate (SRSR peak, SCSR peak, SLSR peak) and peak diastolic radial, circumferential, longitudinal strain rate (DRSR peak, DCSR peak, DLSR peak) derived. One-way analysis of variance with scheffe correction or Kruskal-Wallis test was performed for multiple comparisons. Pearson or Spearman analysis was used for linear or monotonic nonlinear correlations. Results:HHD-LVH group had higher LVEDVI, LVMI, LVMWT and M/V than HHD-nonLVH group and control group ( P<0.05). Compared with control group, GRS, GCS and GLS were statistically impaired in HHD-LVH group, and DRSR peak, DCSR peak and DLSR peak were statistically reduced in HHD-LVH group and HHD-nonLVH group(all P<0.05). Correlation analysis showed that LVMI correlated linearly with GRS ( r=-0.384, P=0.002), GCS ( r=0.392, P=0.001) and GLS ( r=0.491, P<0.0001),LVMWT correlated nonlinearly with GRS ( r=-0.362, P=0.003), GCS ( r=0.384, P=0.002) and GLS ( r=0.422, P=0.001), LVEDVI correlated nonlinearly with GRS ( r=-0.295, P=0.018) and GCS ( r=0.264, P=0.035). Conclusion:CMR-FT derived left ventricular strain parameters could be served as early indicators for the assessment of subclinical myocardial dysfunction in HHD patients, which have great potential in guiding appropriate intervention therapy and improving cardiac remodeling.

Objective To investigate the clinical effect of pulmonary rehabilitation therapy including respiratory exercise and vibration expectoration on patients with pulmonary infection after abdominal surgery.Methods A retrospective case control study was conducted.Seventy-six patients with pulmonary infection after abdominal surgery admitted to the First Affiliated Hospital of Hunan Normal University from September 2015 to September 2016 were enrolled.According to whether accept the pulmonary rehabilitation therapy or not,the patients were divided into two groups.In the control group (n =35),the convemional expectoration method was adopted.The patients in pulmonary rehabilitation group (n =41) received both methods of the control group and pulmonary rehabilitation treatment,including respiratory exercise (effective cough,lip reduction breathing),respiratory exercise device (respiratory exerciser tri-ball),and vibrated expectoration.The 24-hour sputum volume,degree of comfort,inflammatory and pulmonary function parameters,and recovery situation were recorded in the two groups.Results ① There were no significant differences in the parameters of inflammation and pulmonary function before treatment between the two groups.After treatment,the white blood cell (WBC) and C-reactive protein (CRP) in both groups were significantly decreased,and the forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) were significantly increased.The above changes in pulmonary rehabilitation group were more significant than those of the control group [WBC (× 109/L):11.12 ± 2.88 vs.13.42 ± 2.62 at 3 days,8.22 ± 1.48 vs.9.27 ± 1.92 at 5 days;CRP (mg/L):13.47 ± 4.77vs.16.03±4.94 at 3 days,9.69±1.56 vs.11.77±1.41 at 5 days;FEV1 (L):2.48±0.14 vs.2.29±0.16 at 3 days,FEV1/FVC:0.78±0.04 vs.0.75±0.04 at 3 days;all P ＜ 0.05].② The 24-hour sputum volume within 3 days of pulmonary rehabilitation group were significantly higher than that of the control group (mL:30.51 ± 4.15 vs.18.30 ± 3.64at 1 day,31.08±3.22 vs.20.37±3.20 at 2 days,29.03±2.55 vs.19.03±2.51 at 3 days,all P ＜ 0.01].③ In the pulmonary rehabilitation group,the recovery time of pulmonary infection symptoms (days:5.44 ± 1.45 vs.6.20 ± 1.55),the days of antibiotic use (days:12.61 ± 3.15 vs.15.03 ± 3.78),the time of getting out of the bed (days:4.05 ± 0.74vs.4.51±0.89),and the hospital days (days:19.95±3.90 vs.22.00±4.42) were significantly shorter than those of the control group (all P ＜ 0.05),and the degree of comfort was significantly better than that of the control group (comfort score:2.71 ±0.90 vs.2.14±0.91,P ＜ 0.01).Conclusion The application of pulmonary rehabilitation including respiratory exercise and vibration expectoration in abdominal surgery patients with pulmonary infection can promote recovery,and it has a good clinical and practical application value.

Objective To observe the effect of different thyroid hormone level on the expression of synaptotagmin Ⅰ(Syt Ⅰ) in adult rat hippocampus. Methods All 28 adult male SD rats were assigned randomly into hypothyroid, hyperthyroid and control group, hypothyroid group was established by daily intraperitoneal injections with propylthiou raci(PTU, 10.0 mg/kg body weight) for 6 weeks and hyperthyroid group with L-Thyroxine (L-T4, 0.5 mg/kg body weight) for 3 weeks. Radioimmunity method was used to assay the levels of serum T3 and T4, immunohistochemical S-P technology to assay the levels of Syt Ⅰ protein in hippoeampus CA1, CA3 and dentate gyrus (DG). The layers analyzed in the different subfields include the polymorphic cell layer(the stratum oriens, SO), pyramidal cell layer(PCL), stratum radiatum (SR), lacunosum-molecular layer (SLM) in CA1 and CA3, granular cell layer(GL) and molecular layer(ML) in DG. Results The levels of serum T3 and T4[(0.34±0.12), (41.03± 11.37)nmol/L]in the hypothyroid rats were significantly lower than those in the control group[(0.65±0.15), (55.20±10.68)nmol/L, P < 0.01 or < 0.05], and the positive granule of Syt Ⅰ was significantly lower in PCL and SR of CA1 and CA3, GL of DG. The average optical value responsible for Syt Ⅰ immunoreactivity was obviously reduced in SO(0.048±0.007), PCL(0.299±0.035), SR(0.042±0.007), SLM(0.038±0.006) of CA1, PCL(0.085± 0.019), SR(0.040±0.011), SLM (0.038±0.006) of CA3, GL (0.076±0.019) of DG than normal controls (0.068± 0.014, 0.376±0.053, 0.053±0.008,0.056±0.009,0.118±0.026,0.052±0.010,0.053±0.009,0.099±0.015; P< 0.01 or < 0.05). Serum T3 and T4 levels [(1.43±0.30), (157.18±19.95)nmol/L]of hyperthyroid rats were significantly higher than those of control group(P < 0.01). The value was reduced in PCL(0.322±0.050), SR(0.039±0.006), SLM (0.042±0.006) of CA1, PCL(0.098±0.034), SR(0.046±0.013), SLM(0.046±0.010) of CA3 and GL(0.085± 0.024), ML (0.042±0.009) of DG (P < 0.05 or < 0.01). Conclusion Adult-onset of hypothyroidism and hyperthyroidism can reversibly decrease the expression of Syt Ⅰ in CA1, CA3 and DG regions of hippocampus.

OBJECTIVE To establish an in vitro cell model based on patient-specific human neural stem cells to study the pathomechanism of sporadic AD as well as screen candidate drugs.METHODS The peripheral blood cells from sporadic AD patients and cognitive normal controls were repro-grammed into inducedpluripotent stem cells(iPSCs),which were further induced into neural stem cells and neurons. The cell growth curve during the differentiation process was recorded by the IncuCyte ZOOM, and neural stem cells and neurons were identified by immunofluorescence. The apoptosis of neural stem cells and neurons was detected by Click-iT?Plus TUNEL Assay. RESULTS Neural stem cells derived from AD patients and cognitive normal controls can express neural stem cell markers Nes-tin,Sox1,Sox2 and Ki67.TUNEL assay results showed that the number of TUNEL-positive cells in neu-ral stem cells derived from AD patients was significantly higher than that of cognitive normal controls (P<0.01). When neural stem cells were differentiated into neurons, the percentage of MAP2 positive cells in the neural stem cell-derived culture dish of AD patients was significantly higher than the cogni-tive normal controls at day 16 of neuronal differentiation (P<0.01); the TUNEL assay showed that the number of TUNEL-positive cells in AD-derived neurons was significantly greater than that in cognitive normal controls (P<0.01) at day 16 of neuronal differentiation. CONCLUSION Our study revealed that AD-iPSC-derived neural stem cells exhibit premature neuronal differentiation and increased neural apoptosis,which might be relevant to the neuronal loss of AD,thus may provide valuable new tools to screen candidate drugs for the disease and to discover the mechanisms underlying AD pathogenesis.

OBJECTIVE To explore the effect and mechanisms of LW-AFC,a new formula derived from Liuwei Dihuang decoction,on chronic unpredictable mild stress(CUMS)-induced mood and cogni-tion impairment in mice. METHODS C57BL/6J mice were randomly placed into seven groups (n=10):normal control group,CUMS group,Fluoxetine(10 mg·kg-1,once per day)group,Liuwei Dihuang de-coction group(LW,10 g·kg-1,once per day),and LW-AFC(0.8 g·kg-1,1.6 g·kg-1,3.2 g·kg-1,once per day) group. The stressed group was given CUMS for 4 weeks to set up a chronic multiple-stressed model.LW and LW-AFC was oral administered a week prior to CUMS and until the end of the study(a total of 35 d),while fluoxetine was administrated orally for 4 weeks.The anxiety behavior was analyzed using the open field test(OFT)and elevated plus maze test(EPM).The depression behavior was ana-lyzed using the sucrose preference test (SPT) and forced swimming test (FST). Spatial cognition was evaluated using Morris water maze (MWM) test and working memory was evaluated using new object recognition test(NORT). RESULTS CUMS for 28 d increased depressive-and anxiety-like behaviors. LW-AFC (1.6 g·kg-1) significantly increased the numbers of entries into the open arm and time in the open arm of CUMS mice (P<0.05). LW-AFC (3.2 g·kg-1) increased sucrose consumption and de-creased the immobility time of FST (P<0.01) of CUMS mice. The MWM test showed that spatial learning andmemory in CUMS mice were remarkably affected relative to controls,whereas LW-AFC(3.2 g·kg-1)im-proves cognitive functions(P<0.05).CONCLUSION The mood and theability of learning and memory of thestressed group can be affected after exposure to CUS.Oral administration of LW-AFC significant-ly improved CUMS-induced impairments of mood and cognition in mice.

OBJECTIVETo study the effect of coixenolide on Foxp3+ CD4+ CD25+ regulatory T cells (Treg) in collagen induced arthritis (CIA) mice, and to explore its possible mechanism for treating rheumatiol arthritis.

METHODSFive mice were recruited as a normal control group from 25 mice, and the rest 20 were used in CIA modeling. After successful modeling they were randomly divided in the model control group and the coixenolide group, 10 in each group. Coixenolide injection at 25 mL/kg was intraperitoneally injected to mice in the coixenolide group, while normal saline at 25 mL/kg was intraperitoneally injected to mice in the normal control group and the model control group. The injection lasted for 21 days. Scoring for CIA was performed after injection and arthritis index was calculated. The peripheral blood Foxp3+ CD4+ CD25+ Treg ratio was determined by flow cytometry (FCM).

RESULTSCompared with the normal control group, the arthritis index obviously increased in the model control group (P < 0.01). The arthritis index obviously decreased more in the coixenolide group than in the model control group (P < 0.01). Foxp3+ CD4+ CD25+ Treg levels obviously decreased more in the model control group than in the normal control group (P < 0.01 ). Foxp3+ CD4+ CD25+ Treg levels obviously increased more in the coixenolide control group than in the model control group (P < 0.01).

CONCLUSIONCoixenolide could up-regulate Foxp3+ CD4+ CD25+ Treg ratios in CIA mice, which might play certain immunoregulation roles in the incidence of CIA.

Animals ; Arthritis, Experimental ; drug therapy ; Drugs, Chinese Herbal ; pharmacology ; Mice ; Random Allocation ; T-Lymphocytes, Regulatory ; drug effects

Objective:To investigate the antiviral efficacy of direct-acting antiviral agents (DAAs) in the treatment of liver transplantation (LT) recipients with hepatitis C virus (HCV) infection.Methods:Twenty-two HCV-infected LT recipients treated with DAAs at Fifth Medical Center of Chinese PLA General Hospital from December 2014 to June 2018 were retrospectively analyzed, Twenty cases of HCV RNA gene type 1b were treated with sofosbuvir (400 mg/d) + ledipasvir (90 mg/d) or sofosbuvir (400 mg/d) + daclatasvir (60 mg/d) for 12 weeks or 24 weeks; 2 cases of gene type 2a were treated with sofosbuvir (400 mg/d) for 12 weeks. The effect of antiviral treatment, adverse reactions during treatment, and laboratory indicators such as HCVRNA quantification, blood routine, liver and kidney function during treatment and follow-up were studied.Results:The LT recipients of HCV infection included 16 males and 6 females, with a median age of 61.5 (36-71) years old, and the median time of antiviral treatment was 48 (2-117) months after transplantation. Among the 22 patients, 16 received a 12-week course of treatment. Except for 2 patients who did not get HCVRNA negative conversion at 4-week, all achieved a negative HCV RNA at 4-week and the end of the treatment. Six LT recipients received a 24-week course of treatment (gene type 1b), and HCVRNA was negative at 4-week and the end of treatment. All patients achieved end of treatment virological response and a sustained virological response (SVR) rate of 100% at 12 weeks and 24 weeks after the end of treatment. The serum levels of alanine aminotransferase (ALT) and creatinine were 71.5 (30, 110) U/L and (89.4±25.7) mmol/L before treatment, respectively. ALT decreased to 22 (17.8, 28.5) U/L after 4 weeks of treatment, and serum creatinine decreased to (77.4±11.5) mmol/L at 24 weeks after the end of treatment. The differences before and after treatment were statistically significant (all P<0.05). No serious adverse events occurred during the treatment. Conclusions:DAAs have a definite antiviral effect in the treatment of LT recipients with HCV infection, and long-term SVR can be obtained.

OBJECTIVETo analyse the video-oculographic findings of positional tests and evaluate the efficacy of canalith repositioning procedure (CRP) in patients with paroxysmal positional vertigo ( BPPV) of the anterior semicircular canal (ASC).

METHODSA retrospective study of 31 patients with ASC BPPV. Then the CRP was performed.

RESULTSTwenty-two individuals (70.97%) presented a unilateral positional nystagmus during the Dix-Hallpike test, in 17 individuals had torsional nystagmus component, 5 individuals only had pure positional down beat nystagmus. Nine patients presented bilateral positional nystagmus, 7 individuals had torsional component positional nystagmus, in 2 patients the direction of the torsional component were the same during right and left Dix-Hallpike test, in 4 patients the torsional component were concurrent with positional down beat nystagmus but the direction could not be ascertained clinically, in 2 patients had pure positional down beat nystagmus. Nineteen patients (61.29%) had unilateral lesion, 11 patients had the left ASC BPPV, 8 patients had right ASC BPPV. Eleven patients had with both ASC and PSC BPPV in the ipsilateral. Twenty-one patients (67.74%) were cured, 29 patients (93.55%) were improved, 2 (6.45%) patients were inefficacy. CRP effectively resolved the nystagmus and vertigo in 14 patients (45.16%) when applied only once, The average number of CRP was 1.7 times, there were 5 patients recurrence during the follow-up.

CONCLUSIONSASC BPPV was not a common condition. The torsional nystagmus component of ASC BPPV might be weak during the Dix-Hallpike test. The positional nystagmus of ASC BPPV was triggered bilaterally. Based on these findings, CRP could be one of the most effective treatment methods for ASC BPPV.

Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Semicircular Canals ; Vertigo ; diagnosis ; therapy

Objective To explore the effect of secondary brain injury(SBI) in high-risk factors and brain malignant encephaiocele during surgical operation for severe traumatic brain injury. Methods Carried on the grouping graduation to 112 patients with severe traumatic brain injury according to SBI's high-risk factors:non-high-risk factors group (pure group) 23 cases, high-risk factors group (SBI group) 89 cases, 1 level of high-risk factors group had 27 cases, 2 level of high-risk factors group had 28 cases, 3 level of high-risk factors group had 34 cases. Results Carried on the comprehensive therapy regarding the above patients, the brain malignant encephalocele rate in the SBI group and the pure group was 59.55% (53/89) and 13.04%(3/23) respectively, there was significant statistics differences in the two groups,1 level and 2 level of high-risk factors group of brain malignant encephalocele rate was 40.74% (11/27) and 53.57% (15/28) respectively, the difference was not obvious statistics significance, 2 level and 3 level of high-risk factors group of brain malignant eneephalocele rate was 53.57%(15/28) and 79.41%(27/34) respectively, the difference was obvious statistics significance. Conclusions The SBI's high-risk factors are the important factors affecting severe craniocerebral injury encephalocele. Taking adequate pre-operative assessment, carrying a comprehensive treatment on the patients combine with high-risk factors of SBI can greatly reduced the incidence of brain malignant encephalocele during surgical operation if the high-risk factors of SBI is controlled.