Objective To determine the influence of viral factors and host cellular immunity on the response to interferon in the patients with chronic hepatitis C. Methods Forty patients with chronic hepatitis C were treated with interferon ?. The relationships between response to interferon a and HCV genotype, quasispecies heterogeneity, HCV RNA level and HCV specific cytotoxic T lymphocyte (HCV CTL) activity in the liver were analyzed. Results After 6 months of therapy, 21 patients had obtained end of treatment response (ETR), 10 Patients of which had obtained sustained response (SR). The other 19 patients got no response (NR). ETR rate in patients with genotype HCV1 infection (43.3%, 13/30) was significantly lower than that in patients with non HIV1 infection (80%, 8/10) [ P

Objective To evaluate the effect of dexmedetomidine on the quality of recovery from sevoflurane-based anesthesia in the patients undergoing abdominal surgery.Methods Eighty patients of both sexes, aged 30-64 yr, weighing 45-80 kg, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective abdominal surgery, were randomly assigned into 2 groups (n =40 each) using a random number table: control group (group C) and dexmedetomidine group (group D).After routine induction of anesthesia, all the patients were tracheally intubated, and mechanically ventilated.Anesthesia was maintained with sevoflurane inhalation and intermittent iv boluses of sufentanil and cisatracurium besylate, and bispectral index values were maintained at 45-60.After induction of anesthesia, dexmedetomidine was infused in a dose of 1 μg/kg over 15 min, followed by a continuous infusion of 0.6 μg · kg-1 · h-1 until 30 min before the end of surgery in group D.Group C received normal saline instead.Heart rate (HR) and mean arterial pressure (MAP) were recorded at the end of surgery, and at 1 min before and after extubation.The emergence time, extubation time, and occurrence of bucking during extubation, and nausea and vomiting, respiratory depression, and agitation during recovery from anesthesia were recorded.Results Compared with group C, MAP and HR were significantly decreased at 1 min before and after extubation, the emergence time and extubation time were shortened, the incidence of bucking, nausea and vomiting, and agitation was decreased, and no significant change was found in the incidence of respiratory depression in group D.Conclusion Dexmedetomidine infused in a dose of 1 μg/kg after routine induction of anesthesia, followed by a continuous infusion of 0.6 μg · kg-1 · h-1 until 30 min before the end of surgery, can significantly increase the quality of recovery from sevoflurane-based anesthesia in the patients undergoing abdominal surgery.

AIM: To explore the change and the possible role of MAPKs in rat hippocampus neuron after sleep deprivation. METHODS: The morphology of hippocampus neuron after sleep derivation was observed by TUNEL and HE staining, the activity of ERK was assayed by ?-liquid scintillation counting and the expression of JNK was detected by Western blot. RESULTS: In paradoxical sleep deprivation (PSD) group, the number of apoptotic cells in hippocampus was increased. The scores of ERK activity were (1 764.00)?941.56. Compared with control groups, the ERK activity was obviously decreased (P

BACKGROUND: Mitogen-activated protein kinases (MAPKs) is a group of protein kinase related with neuronal apoptosis. Sleep derivation can lead to neuronal apoptosis.OBJECTIVE: To observe change and possible significance of MAPKs in rats after sleep deprivation.DESIGN: Prospective study with complete randomization.SETTING:Research Room of Nerve, Department of Physiology, Zhengzhou University.MATERIALS: The experiment was performed at Zhengzhou University from June 2000 to October 2002. Totally 24 adult healthy SD rats were selected.METHODS: A total of 24 rats were randomly assigned into rapid eye movement (REM) sleep deprivation group, REM sleep deprivation control group and normal control group with 8 rats in each group. The rats in the sleep deprivation group received successive sleep deprivationfor 72 hours from 8:00in the morning. The rats in the normal control group were fed in the rearing cage, having normal sleep-awareness cycle. Their morphological change was observed. Another 24 rats were grouped as above and determined with MAPKs. Morphological change of neurons in hippocampus of rats after sleep deprivation was observed with terminal dUTP nick end-labelling (TUNEL)staining. Changes of activity of extracellular signal-regulated kinase (ERK)and expression of c-Jun N-terminal kinase (JNK) were observed.MAIN OUTCOME MEASURES: ①Morphological change of hippocampal neuron in rats after sleep derivation was observed. ②Changes of expressions of ERK and JNK in hippocampal neuron were observed.RESULTS: ①Morphological change of hippocarnpal neuron: A mass of apoptotic positive cells appeared in CA1 and CA3 regions of rats in the REM sleep deprivation group, mainly distributed in pyramidal layer of hippocampus. A few apoptotic cells appeared in CA2 region. Seldom apoptotic cells appeared in the CA4 region. There was no significant positive cell in hippocampal tissue sections of the normal control group and REM sleep deprivation control group. ②Change of ERK activity: It was significantly lower in the REM sleep deprivation group than the REM sleep deprivation control group and normal control group (1 764.00±941.56,6 139.67±2 863.62,566.700±2 763.41 ,t=3.211 1,0.986 3,P ＜ 0.05). ③JNK positive expression: It was markedly higher in the REM sleep deprivation group than the REM sleep deprivation control group and normal control group (87.5%, 25%, 75%, t=3.412 1, P＜0.05).CONCLUSION: The sleep deprivation can cause change of MAPKs activity, which may be related with neuron apoptosis.

OBJECTIVETo investigate the mechanisms of baicalin on anti-cerebral ischemic through observing the effect of baicalin on human brain microvascular endothelial cell under the glucose deprivation combined with hypoxia condition.

METHODSHuman brain microvascular endothelial cells (HBMVECs) cultured in vitro were divided into the following groups: normal group, model group, baicalin high dose group, baicalin middle dose group, baicalin low dose group, nimodipine group. The kits were used to detect the cell viability, leakage rate of lactate dehydrogenase (LDH), Na(+)-K(+)-ATPase, Ca(2+)-ATPase, the concentration of Ca2+ in each group, and apoptosis rates of each group were analyzed by flow cytometry (FCM).

RESULTSCompared with the normal group, the cell viability, Na(+)-K(+)-ATPase and Ca(2+)-ATPase in model group decreased significantly (P < 0.01, P < 0.05). But the leakage rate of LDH, Ca2+ in cells and apoptosis rates increased remarkably (P < 0.01). Compared with the model group, the cell viability, Na(+)-K(+)-ATPase and Ca(2+)-ATPase increased obviously (P < 0.01, P < 0.05) in baicalin high dose group. But the leakage rate of LDH and Ca2+ in cells in baicalin high dose group decreased significantly comparing with that of model group (P < 0.05, P < 0.01). And the reduction of intracellular Ca2+ was superior to that of nimodipine group. Meanwhile, the apoptosis rates decreased significantly in both baicalin high and middle dose groups (P < 0.01).

CONCLUSIONBaicalin could improve the cell viability of HBMVECs under the glucose deprivation combined with hypoxia condition. And the mechanisms were related with improving the energy metabolism, inhibiting intracellular calcium overload and decreasing the apoptosis rate of cells further.

Apoptosis ; Brain ; blood supply ; Calcium ; metabolism ; Capillaries ; cytology ; Cell Hypoxia ; Cell Survival ; Cells, Cultured ; Endothelial Cells ; cytology ; drug effects ; metabolism ; Flavonoids ; pharmacology ; Glucose ; chemistry ; Humans

Objective:To investigate the effect of nonalcoholic fatty liver disease (NAFLD) on glucose and lipid metabolism during pregnancy.Methods:A retrospective analysis was performed in women who gave birth in Minhang Hospital Affiliated to Fudan University from January 2013 to June 2020. The data on demographic, clinical examination, and delivery were obtained via electronic medical record abstraction. According to the ultrasound imaging, all pregnant women were divided into NAFLD group and control group. The difference of glucose and lipid metabolism indexes, incidence of gestational diabetes mellitus, and gestational hypertension between two groups were compared. Logistic regression model was used to examine potential associations between NAFLD and metabolic related adverse pregnancy outcomes.Results:A total of 14 708 pregnant women with a mean age of (29.1±4.7) years and a mean body mass index of (21.0±2.8) kg/m 2 were included in our study. Of those eligible women, 554 (3.8%) were confirmed by ultrasound as NAFLD. Pregnant women with NAFLD presented higher circulating levels of fasting glucose [(4.2±0.5)mmol/L vs (4.1±0.5)mmol/L, P<0.01], 1 h plasma glucose [(7.4±1.7)mmol/L vs (6.6±1.6)mmol/L, P<0.01] and 2 h plasma glucose [(6.2±1.4)mmol/L vs (5.7±1.3)mmol/L, P<0.01] after glucose loading, HbA 1C [(5.2±0.4)% vs (5.1±0.5)%, P<0.01], triglyceride [(2.1±1.1)mmol/L vs (1.6±0.7)mmol/L, P<0.01], total cholesterol [(4.8±0.8)mmol/L vs (4.7±0.9)mmol/L, P<0.01], low density lipoprotein-cholesterol [(2.6±0.7)mmol/L vs (2.5±0.7)mmol/L, P<0.01], uric acid [(224.1±51.8)μmol/L vs (203.0±45.9)μmol/L, P<0.01] level. After adjusting for potential confounders, NAFLD significantly increased the risk of gestational diabetes mellitus ( OR=1.722, 95% CI 1.079-2.747, P=0.023) and gestational hypertension ( OR=3.845, 95% CI 2.247-6.582, P<0.001). Conclusions:Compared to non NAFLD, women with a diagnosis of NAFLD had more significant glucose and lipid metablic aberrations during pregnancy and increased incidence of gestational diabetes and gestational hypertension. Pregnant women with NAFLD should be closely monitored on glucose and lipid metabolism and blood pressure to prevent gestational diabetes mellitus and hypertension.

Objective To observe the effect on clinical efficacy and renal microcirculation(RMC)of Shenshuai Ⅱ Prescription Granules in the treatment of patients with stage 3-4 chronic kidney disease(CKD)caused by primary glomerulonephritis(PGN)with deficiency of spleen and kidney qi syndrome.Methods Using a randomized,double-blind clinical trial design,70 patients with CKD stage 3-4 were divided into the treatment group and the control group,with 35 cases in each group.The control group was given CKD integrated treatment combined with placebo granules,and the treatment group was given CKD integrated treatment combined with Shenshuai Ⅱ Prescription Granules.The clinical efficacy of both groups was observed.TCM symptom scores,renal function indexes and RMC indexes before and after treatment of the two groups were compared.Safety indexes of both groups were monitored.Results The total effective rate was 82.86％(29/35)in the treatment group and 54.29％(19/35)in the control group,with statistical significance(P<0.05).Compared with before treatment,all the TCM symptom scores of the 2 groups were reduced after treatment(P<0.05,P<0.01);after treatment,the 5 spleen and kidney qi deficiency symptom scores and the total score of the treatment group were lower than those of the control group(P<0.05).The mean values of renal cortical and medullary blood flow were elevated in the treatment group after treatment compared with the pre-treatment period in this group(P<0.05,P<0.01);the mean values of renal cortical and medullary blood flow were elevated in the treatment group compared with the control group in the post-treatment period(P<0.05,P<0.01).Compared with before treatment,the serum content of NO increased(P<0.01),ET-1 and VEGF decreased(P<0.01);after treatment,the serum content of NO in the treatment group was higher than that in the control group(P<0.05),and ET-1 and VEGF in the treatment group were lower than those in the control group(P<0.01).Compared with before treatment,SCr,BUN,24 hUP decreased and eGFR increased in the treatment group(P<0.05,P<0.01);after treatment,SCr,BUN,and 24 hUP in the treatment group were lower than those in the control group,and eGFR in the treatment group was higher than that in the control group(P<0.01).Compared with this group before treatment and between groups after treatment,the difference in Uric acid between the 2 groups was not statistically significant(P>0.05).There was no abnormal change in safety indexes before and after treatment in both groups(P>0.05).Conclusion Shenshuai Ⅱ Prescription Granules combined with CKD integrated treatment can effectively improve clinical symptoms and renal function related indexes of CKD stage 3-4 patients with spleen and kidney qi deficiency syndrome,increase renal blood flow,improve RMC disorder,and improve clinical efficacy.

Objective To explore the current status and willingness of using physical activity Apps on smartphones in patients with cardio-cerebral vascular diseases .Methods Totally 120 outpatients with cardio-cerevral vascular diseases from a tertiary hospital in Beijing were investigated about their status and willingness of using physical activity Apps on smartphones by a self-designed questionnaire .Results 90.8%of the patients were using smartphones at present; 30.8% of the patients had used physical activity Apps; and 43.2%of patients were using physical activity Apps .69.2%of the patients had not use physical activity Apps , and among those patients, there were 62.7%of patients were interested in using physical activity Apps .50%of the patients were willing to use Apps to promote physical activities .47.5%of patients were not sure and said it depends , and 2.5%of patients showed the unwillingness of using Apps .Gender, whether need guidance on the movement, whether the disease require medical professional support , whether they had used sport Apps were significantly correlated with the willingness of using physical activities (P<0.05).Conclusions Physical activity Apps provide chronic disease patients a new approach to manage their physical activity , and chronic disease patients can use Apps to do more exercises .

Objective·To systematically integrate relevant influencing factors of advanced cancer patients'engagement behavior in advance care planning(ACP).Methods·The systematic search of Chinese and English literature on factors influencing ACP engagement behavior in advanced cancer patients from inception to December 2022 in China National Knowledge Infrastructure(CNKI),Wanfang,China Biomedical Literature Database(Sinomed),PubMed,Cochrane Library,Embase,CINAHL,and PsycINFO was conducted.After the literature quality evaluation,content extraction and summary were conducted by two researchers,and the data of quantitative research and qualitative research were extracted and integrated respectively.The final influencing factors of ACP engagement behavior of advanced cancer patients were obtained.With the help of the theoretical domain,they were mapped to the capability,opportunity,motivation-behavior(COM-B)model step by step.Results·A total of 21 studies were included and 27 factors were summarized,including 9 theoretical domains.Mapping to the COM-B model included 9 capability factors(knowledge of ACP,education level,accurate knowledge of prognosis,knowledge of the time of disease diagnosis,prior experience,subjective life expectancy,age,cancer site,and disease symptom burden),13 opportunity factors(gender,marital status,race/ethnicity,religious belief,dependent children,family economic condition,place of living,housing type,family support,social support,doctor-patient relationship,acculturation,and whether or not to establish a hospice service center)and 5 motivational factors(ACP attitude,ACP belief,ACP motivation,anxiety and depression,and death attitude).Among them,doctor-patient relationship,religious belief,ACP attitude,educational level,marital status,family support,knowledge of ACP,accurate knowledge of prognosis,age,place of living,attitude toward death,prior experience,and race/ethnicity were more influential factors on ACP engagement behavior.Conclusion·Based on the COM-B model,the influencing factors of ACP engagement behavior in advanced cancer patients can be comprehensively summarized.Future studies can use the above factors as an entry point to design continuous,multifaceted,and comprehensive interventions based on the COM-B model to promote the practice of ACP engagement behavior in advanced cancer patients.

BACKGROUND: The combination of polycaprolactone and hyaluronic acid creates an ideal environment for wound healing. Hyaluronic acid maintains a moist wound environment and accelerates the in-growth of granulation tissue. Polycaprolactone has excellent mechanical strength, limits inflammation and is biocompatible. This study evaluates the safety and efficacy of bio-conjugated polycaprolactone membranes (BPM) as a wound dressing. METHODS: 16 New Zealand white rabbits were sedated and local anaesthesia was administered. Two 3.0x3.0 cm full-thickness wounds were created on the dorsum of each rabbit, between the lowest rib and the pelvic bone. The wounds were dressed with either BPM (n=12) or Mepitel (n=12) (control), a polyamide-silicon wound dressing. These were evaluated macroscopically on the 7th, 14th, 21st, and 28th postoperative days for granulation, re-epithelialization, infection, and wound size, and histologically for epidermal and dermal regeneration. RESULTS: Both groups showed a comparable extent of granulation and re-epithelialization. No signs of infection were observed. There was no significant difference (P>0.05) in wound size between the two groups. BPM (n=6): 8.33 cm2, 4.90 cm2, 3.12 cm2, 1.84 cm2; Mepitel (n=6): 10.29 cm2, 5.53 cm2, 3.63 cm2, 2.02 cm2; at the 7th, 14th, 21st, and 28th postoperative days. The extents of epidermal and dermal regeneration were comparable between the two groups. CONCLUSIONS: BPM is comparable to Mepitel as a safe and efficacious wound dressing.
Bandages* ; Granulation Tissue ; Hyaluronic Acid ; Inflammation ; Membranes* ; Pelvic Bones ; Rabbits ; Re-Epithelialization ; Regeneration ; Ribs ; Skin ; Wound Healing ; Wounds and Injuries*