Objective To observe the preventing effect of optimal programs (improving turn over postures and elongating the turn over intervals)in preventing pressure sore occurrence in patients with acute stroke. Methods Acute stage stroke patients (time from on-set less than or equal to one week)were selected and divided randomly into 4 groups, one group adopted 2.0 hours turn over intervals as the routine group, others adopted 2.5 hours, 3.0 hours, 3.5 hours turn over intervals as the study groups. The incidence of pressure sores and complications were recorded. Results None of the groups (2.0 h, 2.5 h,3.0 h, 3.5 h)suffered from pressure sores. The incidence of complications including malnutrition, pulmonary infections and constipations was not increased in the study groups either. Conclusions Optimal turn over nursing programs including elongating turn over intervals to 2.5h, 3.0h, 3.5h and adopting 30 degree lateral posture can effectively prevent occurrence of pressure sores in acute stroke patients.

OBJECTIVE:To observe clinical efficacy of Shenshao capsules in the treatment of unstable angina(UA)of coro-nary heart disease,and its effects on heart rate,blood pressure,myocardial consumption of oxygen (MCO),serum levels of hs-CRP and MMP-9. METHODS:77 UA patients with coronary heart disease selected from our hospital during May 2014-May 2016 were divided into observation group (39 cases) and control group (38 cases) according to random number tablet. Control group received rountine treatment. Observation group was additionally given Shenshao capsule 1.2 g,tid,on the basis of control group. Both groups were treated for 4 weeks. The heart rate,blood pressure,myocardial oxygen consumption,serum levels of hs-CRP and MMP-9 in 2 groups were observed before and after treatment;stopping and reduced rate of nitroglycerin,and therapeu-tic efficacy of ECG ST segment were compared between 2 groups. RESULTS:There was no statistical significance in heart rate, blood pressure,myocardial oxygen consumption,serum levels of hs-CRP and MMP-9 between 2 groups before treatment (P>0.05). After treatment,above indexes of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). The stopping and reduced rate of nitroglycerin,total response rate of ECG ST segment were 82.1%,87.2%in observation group,which were better than 63.2%,78.9%in control group,with statis-tical significance(P<0.05). CONCLUSIONS:Shenshao capsules is effective for coronary heart disease UA,and can effectively re-duce heart rate,blood pressure,myocardial oxygen consumption,serum levels of hs-CRP and MMP-9.

OBJECTIVETo investigate the effects of Hydroxy Safflor yellow A (HSYA) on the growth of blood vessel of transplantation tumor of gastric adenocarcinoma cell line BGC-823 in nude mice and its underlying mechanism of antagonizing tumor angiogenesis.

METHODThe BGC-823 cells was subcutaneouly injected into the right anterior armpit of BALB/C nu/nu nude mice and established the animal model of transplantation tumor. Then nude mice were divided into 4 groups at random: model group, control group, high or low dosage of HSYA group. The model group were treated with normal sodium by intraperitoneal injection, HSYA groups were treated with HSYA at concentration of 0.056 g x L(-1) and 0.028 g x L(-1) by intraperitoneal injection, and in these groups each mouse was injected 2 times everyday with 0.2 mL by 4-6 hours interval. The control group were injected in enterocoelia 1 times every 2 days starting from the third day with cytoxan at 2 g x L(-1). 20 days later, the volume and weight of nude mice were observed. The pathological change of tumor tissue was observed under optical microscope. The mRNA expression of VEGF and bFGF of transplantation tumor were detected by real time quantitative PCR.

RESULTThe volume (607.42 +/- 252.96) mm3, weight (0.88 +/- 0.14) g of transplantation tumor, the mRNA expression level of VEGF 0.49 +/- 0.13 and bFGF 0.60 +/- 0.48 are reduced significantly after treatment with HSYA at the concentration of 0.028 g x L(-1) compared with physiologic saline-treated group (P < 0.05 or P < 0.01). The tumor pathological angiogenesis of HSYA group is also less obvious than the normal sodium-treated group.

CONCLUSIONHSYA in given concentration can inhibit the growth of BGC-823 transplantation tumor, and decreasing the mRNA expression of VEGF and bFGF, which suggests that inhibiting tumor angiogenesis may be one of the mechanisms of HSYA antagonizing tumor.

Adenocarcinoma ; drug therapy ; genetics ; metabolism ; Angiogenesis Inhibitors ; administration & dosage ; Animals ; Blood Vessels ; drug effects ; Cell Line, Tumor ; Chalcone ; administration & dosage ; analogs & derivatives ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fibroblast Growth Factors ; genetics ; metabolism ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Quinones ; administration & dosage ; Random Allocation ; Stomach Neoplasms ; drug therapy ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

OBJECTIVETo investigate the effects of hydroxy safflor yellow A (HSYA) on the expression of bFGF protein and MMP-9 mRNA or protein of transplantation tumor of gastric adenocarcinoma cell line BGC-823 in nude mice.

METHODThe BGC-823 cells were subcutaneously injected into the right anterior armpit of BALB/C nu/nu nude mice, and the animal model of transplantation tumor was established. The experimental groups were treated with HSYA at concentration of 0.056 and 0.028 g x L(-1) and cyclophosphamide at 2 g x L(-1), or with physiologic saline. The tumor inhibitory effect was observed, and the mRNA expression of MMP-9 of transplantation tumor was detected by real time-fluorescent quantitation PCR and the protein expression of MMP-9 and bFGF were detected by enzyme linked immunosorbent assay.

RESULTThe IR in the group with HSYA at the concentration of 0.028 g x L(-1) is higher than in the group with normal sodium. After treatment with HSYA, the mRNA expression of MMP-9 has significant difference at the concentration of 0.028 g x L(-1) as compared with physiologic saline-treated group (P < 0.05), but the protein expression of MMP-9 and bFGF is obviously less than that in the physiologic saline-treated group (P < 0.05).

CONCLUSIONThe possible mechanism of HSYA in given concentration to antagonize tumor angiogenesis may be related with inhibiting the protein expression of MMP-9 and bFGF or the mRNA expression of MMP-9 in tumor tissue to reduce the degradation of blood vessel basilar membrane, and to restrain the migration of blood vessel and decrease the tumor vascularization.

Animals ; Cell Line, Tumor ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fibroblast Growth Factor 2 ; genetics ; metabolism ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Matrix Metalloproteinase 9 ; genetics ; metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Neovascularization, Pathologic ; Stomach Neoplasms ; drug therapy ; genetics ; metabolism ; pathology

Objective:To investigate the clinical treatment options for cavernous transformation of portal vein (CTPV).Methods:Data of 65 CTPV patients receiving invasive treatment and followed up at the First Affiliated Hospital of Zhengzhou University between Apr 2011 and Apr 2021 were collected. Patients were divided into four groups based on different treatment option, 24 patients were treated with transjugular intrahepatic portosystemic stent-shunt (TIPS) and 11 patients with splenopneumopexy, while 22 patients underwent splenectomy and devascularization , 8 were treated by endoscopic variceal ligation . The difference of postoperative upper gastrointestinal bleeding and hepatic encephalopathy between the four groups were analyzed,Results:There were no difference between four groups in sex, age, preoperative serum aspartate aminotransferase, total bilirubin, albuminand Child-Turcotte-Pugh grade. The incidence of hepatic encephalopathy in the TIPS group was 33.3%±9.6%、46.5%±10.3% and 64.4%±13.1% in half year, 1 year, and 3 years , respectively. Postoperative hepatic encephalopathy rate was higher in TIPS group( χ2=31.191, P=0.000). Three patients in the TIPS group developed upper gastrointestinal hemorrhage within 6 months after the operation, and postoperative upper gastrointestinal bleeding rate was higher in splenopneumopexy group( χ2=7.542, P=0.006), Conclusion:The clinical treatment options for CTPV patients are complicated ,we should make individual treatment options depend on the etiology, clinical symptoms and site of blood flow obstruction.

Objective:To investigate the diagnosis and treatment strategies as well as prognostic factors of Budd-Chiari syndrome(B-CS)patients complicated with liver cirrhosis and hepatocellular carcinoma(HCC). Methods:Clinical data of 42 B-CS patients complicated with HCC admitted to Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020 were retrospectively analyzed,and the association between the clinical characteristics of patients and whether they had undergone B-CS treatment or not before HCC diagnosis was analyzed.Kaplan-Meier method was used to plot the survival curve of the patients.COX regression model was used to analyze the risk factors affecting the prognosis of B-CS patients complicated with HCC. Results:All 42 B-CS patients complicated with HCC had liver cirrhosis,their median survival time was 28 months,and the 1-,3-and 5-year survival rates were 76.2％,50.0％and 42.9％,respectively.The maximum tumor diameter,multiple tumor ratio and total bilirubin level in patients who had not received B-CS treatment before HCC diagnosis were higher than those in patients who had.Serum albumin level(hazard ratio:0.866,95％confidence interval:0.771-0.972,P=0.015)and not receiving B-CS treatment before HCC diagnosis(hazard ratio:2.796,95％confidence interval:1.020-7.666,P=0.046)were independent risk factors for the prognosis of B-CS patients complicated with HCC. Conclusion:The prognosis of B-CS patients complicated with HCC is relatively good.Serum albumin level and not receiving B-CS treatment before HCC diagnosis are independent risk factors for the prognosis of B-CS patients complicated with HCC.

Objective:To investigate the predictive value of controlled nutritional status (CONUT) score for overt hepatic encephalopathy (OHE) after transjugular intrahepatic portosys-temic stent-shunt (TIPSS) in Budd-Chiari syndrome patients.Method:The retrospective case-control study was conducted. The clinicopathological data of 48 Budd-Chiari syndrome patients who underwent TIPSS in the First Affiliated Hospital of Zhengzhou University from August 2014 to March 2021 were collected. There were 26 males and 22 females, aged (46±13)years. Observation indicators: (1) surgical situations and follow-up; (2) analysis of influencing factors of OHE after TIPSS; (3) predic-tion of OHE after TIPSS. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was performed using the t test. Measurement data with skewed distribution were represented by M( Q1, Q3), and comparison between groups was performed using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was performed using the chi-square test or Fisher exact probability. Multivariate analysis was performed using the Logistic regression model with forward method. The receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to evaluate the efficacy. Comparison among AUC was performed using the Delong test. Results:(1) Surgical situations and follow-up. All 48 patients underwent TIPSS successfully, and the operation time of the 48 patients was (131±29)minutes. All patients were implanted with 8 mm covered stent. All 48 patients were followed up for 46(25,71)months, and there were 14 cases with OHE and 34 cases without OHE after TIPSS. Of the 14 cases with OHE, 12 cases were evaluated as West-Haven Ⅱ grade and 2 cases were evaluated as West-Haven Ⅲ grade. (2) Analysis of influencing factors of OHE after TIPSS. Results of multivariate analysis showed that history of hepatic encephalo-pathy and CONUT score were independent factors influencing the incidence of OHE of Budd-Chiari syndrome patients who underwent TIPSS ( odds ratio=8.36, 1.74, 95% confidence interval as 1.02?68.75, 1.12?2.69, P<0.05). (3) Prediction of OHE after TIPSS. Results of ROC curve showed that the AUC of the CONUT score, the Child-Pugh score of liver function and the integrated model of end-stage liver disease (iMELD) score in predicting the incidence of OHE after TIPSS was 0.77(95% confidence interval as 0.64?0.91, P<0.05), 0.71(95% confidence interval as 0.56?0.87, P<0.05) and 0.71(95% confidence interval as 0.53?0.88, P<0.05), respectively, and there was no significant difference between the AUC of the CONUT score and the Child-Pugh score of liver function or the iMELD score ( Z=0.84, 0.59, P>0.05). The optimal cutoff value of CONUT score in predicting the incidence of OHE after TIPSS was 7, with the sensitivity, specificity and Yodon index as 78.6%, 61.8% and 0.40, respectively. Conclusion:The CONUT score can be used to predict the incidence of OHE in Budd-Chiari syndrome patients who underwent TIPSS, and the discrimination of CONUT score is equivalent to the Child-Pugh score of liver function and the iMELD score.