Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Compartment Syndromes ; complications ; therapy ; Female ; Humans ; Radial Artery

Ectodermal Dysplasia 1, Anhidrotic ; diagnosis ; genetics ; Ectodysplasins ; genetics ; Heterozygote ; Humans ; Infant, Newborn ; Male ; Mutation, Missense

Objective To investigate the effects of ulinastatin with parecoxib sodium on early cellular immunology function and cognitive function in elderly patients undergoing total hip replacement.Methods One hundred patients (aged 65-80 years,ASA grade Ⅱ) undergoing elective total hip replacement were randomly assigned into 4 groups: group W(n=25),group P(n=25),group WP(n=25) and group C(n=25).The patients in group W received intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation.Patients in group P accepted intravenous injection of parecoxib sodium of 40 mg before anesthesia and at a 12 h intervals for six times.Patients in group WP accepted intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation,and accepted intravenous injection of parecoxib sodium with a dose of 40 mg before anesthesia and at a 12 h interval for six times.Patients in group C were given normal saline at the same time as placebo.The operation time,the volume of bleeding and autologous blood receiving and the intraoperative fentanyl consumption were recorded in four groups.Blood samples were obtained before induction (T0),at the end of operation (T1),on 6 h (T2),24 h (T3),72 h (T4) after operation for determination of plasma concentration of S100β protein,neuron-specific enolase(NSE),IL-6,TNF-α.The percentages of T lymphocyte subsets (CD3+,CD4+,CD8+) and CD4+/CD8+ ratio were detected with flow cytometry.The Mini-Mental State Examination (MMSE) was used to test the cognitive function of the patients at T0,T4 and 7 d after operation (T5).Results Compared with T0,the percentages of CD3+,CD4+ cells and CD4+/CD8+ in groups C,W and P were significantly decreased,the plasma concentrations of IL-6 and TNF-α significantly increased at T1-T4,concentration of NSE and S100 protein were significantly increased at T2 and T3 (P<0.05).the percentages of CD3+,CD4+T lymphocyte and CD4+/CD8+ ratio in groups W and P at T2,T3 and group WP at T1-T4 was significantly higher than that of group C,the concentration of IL-6,TNF-α,NSE and S100β protein content was significantly lower than in group C (P<0.05);the percentages of CD3+,CD4+T lymphocyte and CD4+/CD8+ ratio in group WP was significantly higher than those of groups W and P,the concentrations of TNF-α,IL-6,NSE and S100β protein content was significantly lower than those of group W and P at T2,T3 (P<0.05).Compared with T0,MMSE score in group C was significantly lower at T4,T5 (P<0.05).MMSE score of groups W,P and WP was significantly higher than that of group C at T4 (P<0.05).MMSE score of group WP was significantly higher than those of groups W and P at T4 (P<0.05).Conclusion Ulinastatin combined with parecoxib sodium ameliorates early cellular immunology function and cognitive function in elderly patients undergoing total hip replacement,and it is more effective than using ulinastatin or parecoxib sodium alone.

OBJECTIVETo investigate the effect and safety of imaging-guided percutaneous catheterization drainage and alcohol sclerosis for treatment of renal cysts.

METHODSThirty-six patients with primary renal cysts, including 22 men and 14 women aged 18-65 years (mean 42.5 years), were treated with imaging-guided percutaneous puncture catheterization drainage and alcohol sclerosis treatment. The location of the renal cysts and puncture route, angle and depth were determined by ultrasound or CT scan. Paracentesis and catheterization external drainage were carried out under fluoroscope. Absolute alcohol was used as the sclerosis agent.

RESULTSThirty-eight cysts were detected in the 36 patients, locating at the upper pole (n=21), subtus pole (n=10) and intermediate pole (n=7). The length of renal cysts was 4.5-8.5 cm (mean 5.5 cm). Puncture was performed through the lumbar back and the success rate was 100%. Thirty-eight multi-lateral holes 5-7F drainage catheters were placed in the 38 cysts. Alcohol was injected for 169 times through the drainage tube and the average volume was 25 ml, with an average injection of 4.45 times. During the follow-up for 1 to 6 years (mean 3.5 years), 37 renal cysts disappeared and 1 cyst was reduced in a patient with polycystic kidney. The total cure rate was 97% in this series, and no serious complications occurred after the operation.

CONCLUSIONImaging-guided percutaneous puncture catheterization drainage and alcohol sclerosis is effective and safe for treatment of renal cysts.

Adolescent ; Adult ; Aged ; Catheterization ; Drainage ; methods ; Ethanol ; administration & dosage ; Female ; Humans ; Kidney Diseases, Cystic ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Sclerosing Solutions ; administration & dosage ; therapeutic use ; Sclerotherapy ; methods ; Ultrasonography ; Young Adult

BACKGROUNDThe microemboli produced during spontaneous plaque rupture and ulceration and during coronary intervention will reduce coronary reserve and cause cardiac dysfunction. It is though that inflammation caused by the microinfarction induced by the microembolization may play an essential role. It is known that the activation of p38 mitogen-activated protein kinases (MAPK) in both infected and non-infected inflammation in myocardium may cause a contractile dysfunction. But the relation between the activation of p38 MAPK and microembolization is still unknown.

METHODSSprague-Dawley rats were randomly divided into three groups: Sham group, coronary microembolization (CME) group and SB203580 group (n = 10 per group). CME rats were produced by injection of 42 µm microspheres into the left ventricle with occlusion of the ascending aorta. SB203580, a p38 MAPK inhibitor, was injected into the femoral vein after the injection of microspheres to make the SB203580 group. Left ventricular ejection fraction (LVEF) was determined by echocardiography. The protein concentration of P38 MAPK in the myocardium was assessed by Western blotting. The relative expression of mRNA for tumor necrosis factor (TNF)-α was assessed by the technique of semi-quantitative polymerase chain reaction amplification.

RESULTSLVEF was depressed at three hours up to 12 hours in the CME group. Increased p38 MAPK activity and TNF-α mRNA expression were observed in the CME group. The administration of SB203580 partly inhibited p38 MAPK activity, but did not fully depress the TNF-α expression, and partly preserved cardiac contractile function.

CONCLUSIONSp38 MAPK is significantly activated by CME and the inhibition of p38 MAPK can partly depress the TNF-α expression and preserve cardiac contractile function.

Animals ; Blotting, Western ; Coronary Disease ; drug therapy ; etiology ; metabolism ; Echocardiography ; Embolism ; complications ; Imidazoles ; pharmacology ; therapeutic use ; Immunohistochemistry ; Microcirculation ; drug effects ; Myocardial Contraction ; drug effects ; physiology ; Myocardium ; metabolism ; Pyridines ; pharmacology ; therapeutic use ; Random Allocation ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha ; genetics ; p38 Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism

To study the variation of six ester-type alkaloids and characteristic fingerprints in the process from Radix Aconite Lateralis to Heishunpian and lay a foundation for the study of the processing principle of Heishunpian, HPLC. analysis was performed on a Phenomenex Gemini C18 (4.6 mm x 250 mm, 5 microm) with acetonitrile and 40 mmol x L(-1) ammonium acetate (adjusted to pH 10 with concentrated ammonia water) as mobile phase. The detection wavelength was set at 235 nm. The flow rate was set at 0.8 mL x min(-1) and the injection volume was 10-20 microL. Six ester-type alkaloids were determined and characteristic fingerprints of the process were established. As the process continues, the contents of diester diterpene alkaloids were decreased step by step, while the contents varia tion of monoester diterpene alkaloids were not obvious. Each sample showed significant difference in characteristic fingerprints. With the exception of 6 known monoester diterpene alkaloids and diester diterpene alkaloids, 13 peaks were marked in the characteristic fingerprints, of which the total change rule of the other 7 unknown peaks were similar with 3 diester diterpene alkaloids. The established method is accurate, reliable and repeatable, and can provide reference for revealing change rule of index components and illuminating processing principle in the process of Heishunpian.
Aconitine ; chemistry ; Aconitum ; chemistry ; Alkaloids ; chemistry ; Chemistry, Pharmaceutical ; methods ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Esters ; chemistry ; Molecular Structure

Objective To investigate risk factors of medication non-adherence in elderly patients with hypertension through Meta-analysis.Methods Literatures on medication non-adherence in elderly patients with hypertension were systematically reviewed across various databases,from inception to September 1st 2023,including CNKI,VIP,Wangfong Database,SinoMed,PubMed,Web of Science,Cochrane Library、EMbase.Meta-analysis was conducted using RevMan 5.4.Results A total of 19 articles were included,comprising a total of 18 220 patients in sample size.Meta analysis identified 10 risk factors,showed significant association(P<0.05)with:age[OR=1.36,95%CI=(1.00,1.86)],place of residence[OR=1.91,95%CI=(1.33,2.75)],method of payment for medical expenses[OR=1.60,95%CI=(1.38,1.86)],income level[OR=1.68,95%CI=(1.45,1.95)],occupational status[OR=1.79,95%CI=(1.37,2.36)],social support[OR=1.43,95%CI=(1.27,1.60)],comorbidity[CI=0.33,95%(0.19,0.58)],frequency of blood pressure measurement[CI=1.53,95%(1.14,2.05)],disease awareness[OR=1.70,95%CI=(1.44,2.00)]and dedication frequency[OR=1.44,95%CI=(1.16,1.79)].In addition,the number of influencing factors such as gender,marital status,depression,cognitive impairment,and complications was included in<3 articles,and only descriptive analysis was conducted.Conclusion Healthcare providers should focus on the identification and management of the risk factors associated with medication non-adherence in elderly patients with hypertension,therefore to reduce the incidence of medication non-adherence.

Carcinoma, Hepatocellular ; virology ; DNA, Viral ; metabolism ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Liver Cirrhosis ; virology ; Liver Neoplasms ; virology ; Virus Integration ; physiology

OBJECTIVETo evaluate the clinical aspects of mature ovarian teratoma.

METHODWe retrospectively studied 695 patients operated in PUMC Hospital between January 1990 and December 2000.

RESULTSLaparoscopy surgery had shorter hospitalization day, less blood loss during surgery, shorter operation time compared with laparotomy (P < 0.001). Routine contralateral wedge resection was done in 601 cases, among which 459 had normal inspection and palpatation. Only one (0.22%) was pathologically confirmed bilateral tumor. Torsion was the major complication (7.5%). Average tumor size of torsion was (10.2 +/- 4.5) cm. Probability of torsion increased as the tumor enlarged, which was less than 4.4% when the tumor size was less than 6 cm and greater than 10% if size greater than 8 cm. Rupture, infection, and malignant transformation were rare.

CONCLUSIONSLaparoscopy is superior to laparotomy in the treatment of mature ovarian teratoma. If the contralateral ovarian is within normal configuration, contralateral wedge resection is unnecessary. When the tumor size is greater than 8 cm in diameter, it will have more chance to twist.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Laparoscopy ; Laparotomy ; Middle Aged ; Ovarian Neoplasms ; complications ; pathology ; surgery ; Retrospective Studies ; Teratoma ; complications ; pathology ; surgery ; Torsion Abnormality ; etiology ; surgery

OBJECTIVETo investigate the protective effects of irbesartan against cardiac inflammation associated with diabetes and obesity in the db/db mouse model of type 2 diabetes and explore the underlying mechanisms.

METHODSTwenty- four 10-week-old diabetic db/db mice were equally randomized into irbesartan treatment (50 mg/kg per day) group and model group, using 12 nondiabetic littermates (db/+) as the controls, The mice were treated with irbesartan or saline vehicle for 16 consecutive weeks, after which the heart pathology was observed and the heart weight, body weight, and serum levels of fasting blood glucose (FBG), total cholesterol(TC), and triglycerides(TG) were measured. The expression of nuclear factor-kappaB (NF-κB) p65 in the myocardium was assessed with immunohistochemistry, the protein levels of P-IκBα ,IκBα and β-actin were analyzed with Western blotting, and the pro-inflammatory cytokines IL-6 and TNF-α mRNA were detected using quantitative real-time PCR (qPCR).

RESULTSCompared with db/+ mice, the saline-treated db/db mice developed obesity, hyperglycemia and hyperlipidemia (P<0.01). Histopathological examination of the heart tissue revealed inflammatory cell infiltration, increased myocardial interstitium and disorders of myocardial fiber arrangement. The diabetic mice showed increased P-IαBα and decreased IκBα protein levels, enhanced activity and expression of NF-κB in the hearts, and increased mRNA expression of IL-6 and TNF-α in the myocardium. These abnormalities were all associated with increased inflammatory response. Treatment with irbesartan improved the heart architecture and attenuated high glucose-induced inflammation in the diabetic mice.

CONCLUSIONTreatment with irbesartan attenuates cardiac inflammation in type 2 diabetic db/db mice, and this effect was probably associated with the suppression of cardiac angiotensin II and NF-κB signaling pathway.

Actins ; metabolism ; Angiotensin II ; metabolism ; Animals ; Biphenyl Compounds ; pharmacology ; Cardiovascular Diseases ; drug therapy ; Diabetes Mellitus, Experimental ; complications ; Diabetes Mellitus, Type 2 ; complications ; Inflammation ; drug therapy ; Interleukin-6 ; metabolism ; Mice ; Obesity ; complications ; Random Allocation ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; Tetrazoles ; pharmacology ; Transcription Factor RelA ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism