Arteriovenous Fistula ; therapy ; Child ; Embolization, Therapeutic ; Humans ; Male ; Pulmonary Artery ; abnormalities ; Pulmonary Veins ; abnormalities

Adolescent ; Attention ; drug effects ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; physiopathology ; Child ; Electroencephalography ; drug effects ; Female ; Follow-Up Studies ; Humans ; Male ; Psychomotor Performance ; Treatment Outcome

Insulin resistance and insulin secretion deficiency are main machanisms in inducing type 2 diabetes mellitus (T2DM), and mitochondria damage plays an important role in them. Research shows that autophagy is a self-protective mechanism of cells, which plays an important role in maintaining the normal structure and function of pancreatic β cells and improving insulin resistance. Previous studies show that traditional Chinese medicine can regulate cell autophagy to influence β cells and insulin resistance, type 2 diabetes mellitus and its complications. Thus this review will talk about the process of the relationship between autophagy and T2DM and the intervention effect of traditional Chinese medicine.
Animals ; Autophagy ; drug effects ; Diabetes Mellitus, Type 2 ; drug therapy ; metabolism ; physiopathology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Insulin ; metabolism ; Insulin Resistance ; Insulin-Secreting Cells ; cytology ; drug effects ; metabolism

Objective:To compare the accuracy and timeliness of 3-lead electrocardiography (ECG) and pulse oximetry (POX) in neonatal heart rate (HR) monitoring after birth.Methods:This prospective study recruited 42 high-risk newborns with gestational age ≥37 weeks and birth weight >1 500 g who were born through cesarean section without resuscitation requirement in Xi'an People's Hospital (Xi'an Fourth Hospital) from October 2019 to August 2020. 3-lead ECG electrodes and POX sensors were attached to the neonates immediately after drying to continuously monitor the HR within 10 min after birth. All procedure was recorded by video camera, and data were independently analyzed by a clinician after the procedure was completed. Differences in time required to connect the devices, time to obtain a reliable HR and the interval between them, the time needed for obtaining a reliable HR after birth, the proportion of neonates with reliable HR obtained within 5 min after birth and the consistency in the reliable HR readings between the two devices were compared using Wilcoxon signed-rank test, McNemar test, Spearman's correlation coefficient, intraclass correlation coefficient or Bland-Altman bias analysis.Results:The median time required to connect POX and 3-lead ECG and to acquire a reliable HR were 13.0 s (10.0-17.0 s) vs 23.0 s (18.0-28.3 s) ( Z=-5.050, P<0.001), and 79.5 s (56.2-128.0 s) vs 11.0 s (10.0-13.3 s) ( Z=-5.646, P<0.001), respectively. The total time from the beginning of connecting the devices and birth to acquiring a reliable HR were both longer for POX than those for 3-lead ECG [92.0 s (71.3-139.0 s) vs 35.0 s (30.0-39.5 s), Z=-5.579, P<0.001; 110.5 s (85.8-153.5 s) vs 52.0 s (45.0-66.3 s), Z=-5.579, P<0.001]. Reliable HRs were obtained in 69.1% (29/42) and 2.4% (1/42) of the infants by 3-lead ECG and POX within 1 min after birth, respectively. The percentage of infants for obtaining a reliable HR detected by 3-lead ECG within 5 min after birth were more than those by POX, but with statistically significant differences only at the first 60 s, 90 s, 120 s and 150 s (all P<0.001). The median HRs obtained by 3-lead ECG and POX within 10 min after birth were 161 beats/min (147-175 beats/min) and 160 beats/min (146-176 beats/min), respectively ( r=0.966, P<0.001). The mean difference of HR detected by the two devices was 0.56 beats/min (95% CI:-4.3 to 5.4 beats/min). The intraclass correlation coefficient was 0.961, showing good internal consistency. Conclusions:Neonatal HR can be assessed accurately by 3-lead ECG within 1 min after birth, which is far earlier than that by POX. Therefore, 3-lead ECG can be an option for continuously HR monitor in neonatal resuscitation.

Objective Little research has been done on the risk factor analysis of BK virus(BKV) infection in renal transplant recipients in Chinese population.The article aimed to investigate BKV infection and analyze its risk factors in renal transplant recipients in China.Methods Renal transplant recipients who had received the detection of BKV DNA in urine and blood samples in Nanjing General Hospital from June 2015 to July 2016 were selected, while the patients with uremia hemodialysis and healthy living donors were included as control group.According to the detection results of BKV DNA in urine and blood samples, renal transplant recipients were divided into BKV DNA positive group(n=89, positive urine or blood and urine BKV DNA) and BKV DNA negative group(n=359, negative blood and urine BKV DNA).Analysis was made on BKV infection in renal transplant recipients in order to investigate the effects of factors including clinical condition, postoperative complications and immunosuppressive regimen on BKV infection.Results The positive rate of BKV DNA in urine samples of renal transplant recipients was 19.9%, which was higher than those of patients with dialysis and healthy living donors(6.3% and 4.2% respectively, P<0.001).Multivariate logistic regression analysis showed BKV infection was associated with pulmonary infection(OR[95%CI], 3.468[1.227-9.802];P=0.019) , acute rejection (OR[95%CI], 2.645[1.142-6.127];P=0.023), and FK506 (OR[95%CI], 2.408[1.104-5.254];P=0.027).Conclusion The incidence of BKV infection in renal transplant recipients increases significantly.Pulmonary infection, acute rejection and FK506-based immunosuppressive regimen are risk factors leading to BKV infection.

Objective To compare the RIFLE and AKIN diagnosis criteria for acute kidney injury ( AKI) in patients undergoing cardiac surgery. Methods Patients undergoing cardiac surgery from January 2004 to June 2007 were retrospectively evaluated. RIFLE and AKIN criteria were employed for the diagnosis and staging of AKI which occurred 7 d after cardiac surgery. The diagnosis sensitivity and precision for prediction of hospital mortality were compared between these two criteria. Results One thousand and fifty-six patients were included in this study. There was no significant difference between the prevalence of AKI after cardiac surgery diagnosed by RIFLE criteria and that diagnosed by AKIN criteria (29.55% vs 31.06%, P>0.05). There was no significant difference between the total hospital mortality and the hospital mortality of each stage of AKI diagnosed by RIFLE criteria and those diagnosed by AKIN criteria ( P > 0. 05). Logistic regression analysis suggested that the relative risk of hospital mortality for AKI was similar between patients diagnosed by AKIN criteria and those diagnosed by RIFLE criteria. The area under the ROC curve for hospital mortality was 0. 856 for RIFLE and 0.865 for AKIN in all patients (P<0.001). Conclusion Compared to RIFLE criteria, AKIN criteria do not improve the sensitivity of diagnosis and predictive ability of hospital mortality of AKI after cardiac surgery.

Objective To observe the therapeutic effect of catgut-embedding (CE) therapy based on respiration-induced reinforcing and reducing and electro-acupuncture (EA) therapy in treating simple obesity with spleen deficiency and dampness retention. Methods Sixty simlpe obesity patients with spleen deficiency and dampness retention were randomized into CE group and EA group, 30 cases in each group. The acupoints selected for the two groups were the same, and the points were Zhongwan, Shuifen, Qihai, Guanyuan, Tianshu, Liangmen, Daheng, Fujie, Quchi, Xuehai, Yinlingquan, Fenglong, and Ashi. CE group was given CE therapy with the needling for CE therapy referred to the respiration-induced reinforcing and reducing method, and EA group was given EA therapy for 2 continuous treatment courses, 4 weeks constituting one course. Body mass and body mass index (BMI) of the two groups before and after treatment were observed, and the clinical efficacy was also evaluated after treatment. Results (1) After treatment for 2 courses, body mass and BMI of the two groups were obviously decreased(P<0.05 compared with those before treatment), but the differences between the two groups were insignificant (P > 0.05). (2) The total effective rate of CE group was 90.0% and that of EA group was 86.7%, and the difference between the two groups was insignificant (P > 0.05). Conclusion The therapeutic effect of CE therapy based on respiration-induced reinforcing and reducing in treating simple obesity with spleen deficiency and dampness retention is similar to that of EA therapy, and the patients can choose anyone of them for loosing body weight according to the preference.

Objective To evaluate the clinical diagnostic value of pelvic floor sEMG in pelvic floor dyssynergia (PFD) by using receiver operating characteristic curve (ROC curve). Methods The pelvic floor sEMG of 90 patients with PFD and 101normal controls were determined by the Glazer protocol.Parameters including amplitude (AVG),coefficient of variance (CV),onset time and median frequency (MF),and the ROC curve werealso investigated. Results Compared to the control group,the PFD group had a higher AVG of pre-baseline (P < 0.05), a lower AVG during Flick and Tonic steps(P < 0.05), and ahigher CV duringTonic and Endurance steps(P < 0.05).The area under curve(AUC) of CV duringthe tonic step was 0.883 withthe best cut-off of 0.355, and with sensitivity of 88.4%and the specificity of 71.1%, respectively; The AUC of CV duringEndurance step was 0.825 withthe best cut-off of 0.305, and with the sensitivity of 84.9%and the specificity of 67.8% , respectively. Conclusion The CVs of the tonic and the endrnace phases can be used as valuable clinical values in diagnosis of PFD.

Objective To observe the effect of low arsenic sub-chronic exposure on blood routine test index in rabbits to pave a way for screening early injury of the low arsenic exposure. Methods Twelve healthy male rabbits were randomly divided into four groups. They were administrated with As at the concentration of 0(control), 10, 50 and 250 μg/L in the drinking water. Blood samples were collected from the vein of the ear edge in 8 weeks, and blood test routine including leukocyte (WBC), lymphocyte (LYM), lymphocyte percentage (LYM%), neutrophil (GRA), neutrophil percentage (GRA%), monocyte (MON), monocyte percentage (MON%), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration(MCHC), RDW, platelets(PLT), mean platelet volume(MPV), platelet hematocrit(PCT) and platelet distribution width (PDW), were detected by the ABX-60 hemocyte analyzer. Results Compared with the control group, the WBC, GRA and GRA% increased in 0, 50 and 250 μg/L groups, but there was no significance(P > 0.05). PLT and MPV had a statistical significance in 4 groups(F = 4.07,4.20, all P < 0.05). Compared with the control group[(292.00±16.97)×109/L, (7.10±0.99)fL], PLT decreased in the 250 μg/L group [(221.33±22.50)×109/L] and MPV decreased in the 50μg/L group [(5.57±0.46)fL] significantly (P < 0.05). The other index didn't change obviously. Conclusions Sub-chronic low level arsenic exposure may lead to the change in the blood system. The blood routine test may be considered for early injury of the arsenic poisoning.

Objective BK virus-associated nephropathy ( BKVAN) after kidney transplantation is a key factor that influence the prognosis of transplant kidney .To our knowledge , it is believed to be associated with immune suppression .We observed the cura-tive effect and influencing factorsof anti-rejection scheme that Leflunomide was administered instead of Mycophenolate Mofetil ( MMF) on transplant kidney BKVAN .. Methods This study included 15 kidney transplant recipients with pathologically confirmed BKVAN in Nanjing General Hospital of Nanjing Military Region form March 2007 to March 2013 .Leflunomide was administered instead of Myco-phenolate Mofetil ( MMF) .Serum creatinine level , renal allograft loss rate and side effects of leflunomide were monitored after medica-tion switch.The patients were divided into two groups , which were renal allograft loss group and renal allograft survival group , for fur-ther analyses . The differences between each groups in clinical characteristics as well as histochemical features of the transplanted kidneys were analyzed to determine the cause of renal allograft loss in patients with BKVAN . Results Six patients experienced renal al-lograft loss after switching to leflunomide and needed hemodialysis , and 9 patients had stable renal allograft function , renal allograft loss rate was 40.0%.Hyperuricemia occurred in 8 patients in the period before the medication switch and in 5 patients after the switch;a decrease in blood white cell orplateletcount was found in 2 patients during both periods;an increase in Alanine aminotransferase ( ALT) level occurred in one patient after the medication switch .There were no statistically significant differences in any of the above parame-ters before and after the medication switch.Compared to allograft survival group, serum creatinine level[(1.80 ±0.53)mg/dL vs (2.74 ±0.58)mg/dL, P=0.007], the number of B lymphocytes [(206.44 ±144.96) vs (439.67 ±267.77), P=0.047] and CD68[(588.44 ±271.80) vs (944.67 ±259.32), P=0.025] in renal allograft tissue were significantly higherin the allograft loss group. ConclusionLeflunomide is a safe and effective medication for BKVAN .Patients with significantly increased serum creatinine level might have a poorer prognosis .Significantly increased B lymphocytes and CD 68 cells in renal allograft tissue might indicate a poor prognosis.