Objective To observe the clinical efficacy and safety of cattle encephalon glycoside and ignotin injection combined with reduced glutathione injection and levodopa and benserazide hydrochloride tablets in the treatment of elderly patients with Parkinson's disease complicated with mild cognitive impairment(PD-MCI).Methods Elderly patients with PD-MCI were randomly divided into control group and treatment group.Two groups were treated with levodopa and benserazide hydrochloride tablet for anti-Parkinson's disease therapy,and on this basis,the control group was given intravenous drip of reduced glutathione 1.2 g(qd),and the treatment group was given intravenous drip of cattle encephalon glycoside and ignotin injection 10 mL(qd)on the basis of the control group.Both groups of patients were treated continuously for 4 weeks.The clinical efficacy,serum regulated upon activation,normal T cell expressed and secreted(RANTES),α-synuclein(α-syn),brain-derived neurotrophic factor precursor protein(pro-BDNF),catalase(CAT),total superoxide dismutase(T-SOD),cognitive function and quality of life were compared between both groups,and the adverse drug reactions were observed.Results In treatment group,48 cases were enrolled but 3 cases were lost,thus 45 cases were finally included in the analysis.In control group,48 cases were enrolled but 6 cases were lost,thus 42 cases were included in the analysis.After treatment,the total effective rates in treatment and control groups were 93.33％(42 cases/45 cases)and 76.19％(32 cases/42 cases)respectively(P＜0.05).After treatment,RANTES levels in treatment group and control group were(25.57±4.62)and(30.29±4.92)pg·mL-1;α-syn levels were(3.08±0.76)and(3.74±1.09)μg·L-1;pro-BDNF levels were(144.65±17.54)and(182.26±15.75)ng·mL-1;CAT levels were(168.54±10.64)and(160.48±9.74)kU·L-1;T-SOD levels were(123.75±20.54)and(110.18±22.66)kU·L-1;Montreal Cognitive Assessment Scale scores were(25.08±2.75)and(23.14±2.64)points;and 39-item Parkinson's Disease Quality of Life Questionnaire scores were(45.84±8.42)and(50.34±7.62)points,respectively.The differences of above indexes were statistically significant between two groups(all P＜0.05).The adverse drug reactions in treatment group were arrhythmia,dizziness,chills and gastrointestinal discomfort.The adverse drug reactions in control group were transient thrombocytopenia and arrhythmia.The total incidences of adverse drug reactions in treatment group and control group were 8.89％and 4.76％wthout significant difference(P＞0.05).Conclusion Cattle encephalon glycoside and ignotin injection combined with reduced glutathione injection and levodopa and benserazide hydrochloride tablets has exact clinical efficacy in the treatment of elderly patients with PD-MCI,and it can significantly enhance the neuroprotective and antioxidant effects and improve the cognitive function and quality of life of patients,and it does not increase the incidence rate of adverse drug reactions.

Neonatal seizures are the most common clinical manifestations of critically ill neonates and often suggest serious diseases and complicated etiologies. The precise diagnosis of this disease can optimize the use of anti-seizure medication, reduce hospital costs, and improve the long-term neurodevelopmental outcomes. Currently, a few artificial intelligence-assisted diagnosis and treatment systems have been developed for neonatal seizures, but there is still a lack of high-level evidence for the diagnosis and treatment value in the real world. Based on an artificial intelligence-assisted diagnosis and treatment systems that has been developed for neonatal seizures, this study plans to recruit 370 neonates at a high risk of seizures from 6 neonatal intensive care units (NICUs) in China, in order to evaluate the effect of the system on the diagnosis, treatment, and prognosis of neonatal seizures in neonates with different gestational ages in the NICU. In this study, a diagnostic study protocol is used to evaluate the diagnostic value of the system, and a randomized parallel-controlled trial is designed to evaluate the effect of the system on the treatment and prognosis of neonates at a high risk of seizures. This multicenter prospective study will provide high-level evidence for the clinical application of artificial intelligence-assisted diagnosis and treatment systems for neonatal seizures in the real world.
Artificial Intelligence ; Electroencephalography/methods* ; Epilepsy/diagnosis* ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/diagnosis* ; Intensive Care Units, Neonatal ; Multicenter Studies as Topic ; Prospective Studies ; Randomized Controlled Trials as Topic ; Seizures/drug therapy*

Objective: To evaluate the efficiency of internal carotid artery (ICA) embolization technology in endoscopic salvage surgery for recurrent nasopharyngeal carcinoma (rNPC) invading the ICA. Methods: From January 2016 to March 2021, 83 patients with rNPC who invaded the ICA and underwent endoscopic extended nasopharyngectomy were retrospectively collected from the Eye & ENT Hospital in Fudan University, including 60 males and 23 females. The age of the patients ranged from 27 to 77 years. The standard of ICA invasion was that the distance from the lesion to the ICA on enhanced MRI was ≤ 1.8 mm. The clinical characteristics, ICA management strategy and survival prognosis of patients were analyzed, and the effectiveness of ICA embolization was evaluated. Kaplan-Meier method was used to calculate the survival rate and Log-rank test was used to compare the difference. Results: In 83 patients with rNPC, there were 13 patients with rT2, 38 patients with rT3, 32 patients with rT4, and 16 patients had lymph node metastasis. A total of 37 patients (44.6%) underwent ICA coil embolization before surgery, of which 2 cases underwent external carotid-middle cerebral artery artery bypass grafting and ICA embolization due to positive balloon occlusion test (BOT). Patients with positive surgical margin accounted for 24.1% (20/83). Among them, patients with rT4 and patients without ICA embolization had a higher positive rate of surgical margin (P value was 0.001, 0.043, respectively). The 3-year overall survival (OS) and progression free survival (PFS) rate of all patients was 46.5% and 26.7%, respectively. In addition, the 3-year OS and PFS of patients with ICA embolization was significantly higher than those without ICA embolization, respectively (69.1% vs 27.8%, P=0.003; 33.9% vs 18.9%, P=0.018). Only 2 patients (2/37, 5.4%) had cerebral infarction complications after coil embolization of the affected ICA due to negative BOT. Conclusion: Preoperative ICA embolization can be used to treat patients with rNPC invading the ICA, improve the total removal rate and survival rate of patients, which is an effective salvage treatment.
Humans ; Male ; Female ; Adult ; Middle Aged ; Aged ; Nasopharyngeal Carcinoma ; Salvage Therapy ; Retrospective Studies ; Carotid Artery, Internal ; Neoplasm Recurrence, Local/surgery* ; Nasopharyngeal Neoplasms/pathology*

OBJECTIVE: To construct an acute myeloid leukemia cell line stably expressing CD123-CLL1 so as to provide an "in vitro" model for studying the role of CD123 and CLL-1 in leukemia and the treatment targeting CD123 and CLL-1. METHODS: The recombinant plasmid of lentivirus was constructed by synthesizing CD123 and CLL-1 sequences and PCR homologous recombination. The lentivirus vector was packaged by three-plasmid packaging system. After collecting the supernatant of lentivirus, the virus titer was determined by quantitative PCR. K562 leukemia cells were collected and transtected with virus supernatant. Leukemia cell line stably expressing the target gene were screened by purinomycin. The expression levels of CD123 and CLL-1 were detected by RT-PCR and flow cytometry. RESULTS: The lentiviral vector was successfully constructed, and identified by agarose gel electrophoresis and gene sequencing, then the virus titer of the supernatant was up to 5.81×10 CONCLUSION Lentiviral vector expressing CD123-CLL1 has been successfully constructed, and K562 leukemia cell line stably expressing CD123 and CLL-1 has been successfully obtained.
Cell Line, Tumor ; Genetic Vectors ; Humans ; Interleukin-3 Receptor alpha Subunit ; K562 Cells ; Lentivirus/genetics* ; Leukemia, Lymphocytic, Chronic, B-Cell/genetics* ; Plasmids ; Transfection

Objective:To investigate the effect of target-controlled infusion propofol combined with inhalation sevoflurane to maintain anesthesia on the postoperative changes of serum β-amyloid protein (β-AP), neuron specific enolase (NSE) and cognitive function in elderly patients with non-small cell lung cancer (NSCLC).Methods:The clinical data of 78 elderly patients with NSCLC who underwent thoracoscopic surgery from December 2017 to December 2019 in Jinhua Hospital of Traditional Chinese Medicine of Zhejiang Province were retrospectively analyzed. Among them, target-controlled infusion propofol to maintain anesthesia was in 39 cases (control group), and target-controlled infusion propofol combined with inhalation sevoflurane to maintain anesthesia was in 39 cases (study group). The serum levels β-AP, NSE and cognitive function (assessed by mini mental state examination, MMSE) before and after operation, the postoperative recovery (eye opening time, response time and extubation time) and incidence of adverse reactions were compared between 2 groups.Results:There were no statistical differences in β-AP and NSE before operation between 2 groups ( P>0.05); the β-AP and NSE immediately and 6 h after operation in study group were significantly lower than those in control group, β-AP: (416.13 ± 22.81) μg/L vs. (510.73 ± 24.27) μg/L and (373.53 ± 21.72) μg/L vs. (430.68 ± 22.15) μg/L, NSE: (8.35 ± 0.66) μg/L vs. (11.13 ± 0.73) μg/L and (7.81 ± 0.61) μg/L vs. (9.12 ± 0.68) μg/L, and there were statistical differences ( P<0.01); there were no statistical differences in β-AP and NSE 24 h after operation between 2 groups ( P>0.05). There was no statistical difference in MMSE score before operation between 2 groups ( P>0.05); the MMSE score 6, 24 and 72 h after operation in study group was significantly higher than that in control group: (22.32 ± 2.05) scores vs. (20.54 ± 2.31) scores, (25.19 ± 1.33) scores vs. (23.61 ± 1.08) scores and (26.84 ± 0.97) scores vs. (25.01 ± 1.15) scores, and there was statistical difference ( P<0.01); there was no statistical difference in MMSE score 7 d after operation between 2 groups ( P>0.05). The eye opening time, response time and extubation time in study group were significantly shorter than those in control group: (14.15 ± 3.20) min vs. (19.32 ± 3.14) min, (18.08 ± 3.52) min vs. (24.63 ± 4.10) min and (16.21 ± 4.40) min vs. (22.31 ± 4.71) min, and there were statistical differences ( P<0.01). There was no statistical difference in the incidence of adverse reactions between 2 groups ( P>0.05). Conclusions:Target-controlled infusion propofol combined with inhalation sevoflurane to maintain anesthesia in elderly patients with NSCLC can reduce the increase of serum levels of β-AP and NSE, reduce the damage to cognitive function, make patients recover quickly after operation, and will not increase the incidence of adverse reactions. Its security is higher.

BACKGROUND: Although a variety of risk factors of pneumonia after clipping or coiling of the aneurysm (post-operative pneumonia [POP]) in patients with aneurysmal subarachnoid hemorrhage (aSAH) have been studied, the predictive model of POP after aSAH has still not been well established. Thus, the aim of this study was to assess the feasibility of using admission neutrophil to lymphocyte ratio (NLR) to predict the occurrence of POP in aSAH patients. METHODS: We evaluated 711 aSAH patients who were enrolled in a prospective observational study and collected admission blood cell counts data. We analyzed available demographics and baseline variables for these patients and analyzed the correlation of these factors with POP using Cox regression. After screening out the prognosis-related factors, the predictive value of these factors for POP was further assessed. RESULTS: POP occurred in 219 patients (30.4%) in this cohort. Patients with POP had significantly higher NLR than those without (14.11 ± 8.90 vs. 8.80 ± 5.82, P < 0.001). Multivariate analysis revealed that NLR remained a significant factor independently associated with POP following aSAH after adjusting for possible confounding factors, including the age, World Federation of Neurosurgical Societies (WFNS) grade, endovascular treatment, and ventilator use. And the predictive value of NLR was significantly increased after WFNS grade was combined with NLR (NLR vs. WFNS grade × NLR, P = 0.011). CONCLUSIONS Regardless of good or poor WNFS grade, patients having NLR >10 had significantly worse POP survival rate than patients having NLR ≤10. NLR at admission might be helpful as a predictor of POP in aSAH patients.
Humans ; Lymphocytes ; Neutrophils ; Pneumonia/etiology* ; Prognosis ; Subarachnoid Hemorrhage ; Treatment Outcome

PURPOSE: To explore the influence of S100 calcium binding protein A4 (S100A4) knockout (KO) on methionine-choline-deficient (MCD) diet-induced non-alcoholic fatty liver disease (NAFLD) in mice. MATERIALS AND METHODS: S100A4 KO mice (n=20) and their wild-type (WT) counterparts (n=20) were randomly divided into KO/MCD, Ko/methionine-choline-sufficient (MCS), WT/MCD, and WT/MCS groups. After 8 weeks of feeding, blood lipid and liver function-related indexes were measured. HE, Oil Red O, and Masson stainings were used to observe the changes of liver histopathology. Additionally, expressions of S100A4 and proinflammatory and profibrogenic cytokines were detected by qRT-PCR and Western blot, while hepatocyte apoptosis was revealed by TUNEL staining. RESULTS: Serum levels of aminotransferase, aspartate aminotransferase, triglyceride, and total cholesterol in mice were increased after 8-week MCD feeding, and hepatocytes performed varying balloon-like changes with increased inflammatory cell infiltration and collagen fibers; however, these effects were improved in mice of KO/MCD group. Meanwhile, total NAFLD activity scores and fibrosis were lower compared to WT+MCD group. Compared to WT/MCS group, S100A4 expression in liver tissue of WT/MCD group was enhanced. The expression of proinflammatory (TNF-α, IL-1β, IL-6) and profibrogenic cytokines (TGF-β1, COL1A1, α-SMA) in MCD-induced NAFLD mice were increased, as well as apoptotic index (AI). For MCD group, the expressions of proinflammatory and profibrogenic cytokines and AI in KO mice were lower than those of WT mice. CONCLUSION: S100A4 was detected to be upregulated in NAFLD, while S100A4 KO alleviated liver fibrosis and inflammation, in addition to inhibiting hepatocyte apoptosis.
Animals ; Apoptosis ; Aspartate Aminotransferases ; Blotting, Western ; Calcium ; Carrier Proteins ; Cholesterol ; Collagen ; Cytokines ; Fibrosis ; Hepatocytes ; In Situ Nick-End Labeling ; Inflammation ; Liver ; Liver Cirrhosis ; Mice* ; Non-alcoholic Fatty Liver Disease* ; Triglycerides

Objective:To investigate the effect of early enteral nutrition on ventilator-associated pneumonia in patients with severe cerebrovascular disease,and to evaluate nutritional status,intestinal nutrition tolerance,pH value of gastric juice and incidence of gastrointestinal bleeding.Methods:This study was a prospective study.The subjects were 72 patients with severe cerebrovascular disease in the intensive care unit of Neurology Department of our hospital from March 2014 to May 2017.All patients were treated with nasal feeding and mechanical ventilation.Among them,36 patients received enteral nutrition support treatment within 24 hours (early group),and 36 patients received enteral nutrition support treatment after 24 hours (control group).The two groups were compared with the incidence of ventilator-associated pneumonia,weaning success rate,complications of enteral nutrition rate,and gastrointestinal bleeding within 7 days,serum albumin and serum prealbumin level after 7 days,survival rate after 28 days.We also analyzed the changes in pH of the gastric juice at admission,1 day,3 days,7 days,and 14 days after treatments.Results:In the early group,the incidence of ventilator-associated pneumonia,gastrointestinal bleeding,complications of enteral nutrition,were lower than the control group.The serum level of albumin and prealbumin,the rate of successful weaning and 28 day survival rate were higher than the control group.After the early enteral nutrition,the pH value of gastric juice increased significantly.Conclusion:Early application of enteral nutrition support therapy can improve the nutritional status of patients,reduce the incidence of ventilatorassociated pneumonia,improve the success rate of weaning,reduce the fatality rate and improve the prognosis of patients.Early enteral nutrition support treatment can also increase pH value of gastric juice and reduce the incidence of gastrointestinal complication and gastrointestinal bleeding.

BACKGROUNDIt is important to achieve the definitive pathogen identification in hospital-acquired pneumonia (HAP), but the traditional culture results always delay the target antibiotic therapy. We assessed the method called quantitative loop-mediated isothermal amplification (qLAMP) as a new implement for steering of the antibiotic decision-making in HAP.

METHODSTotally, 76 respiratory tract aspiration samples were prospectively collected from 60 HAP patients. DNA was isolated from these samples. Specific DNA fragments for identifying 11 pneumonia-related bacteria were amplified by qLAMP assay. Culture results of these patients were compared with the qLAMP results. Clinical data and treatment strategies were analyzed to evaluate the effects of qLAMP results on clinical data. McNemar test and Fisher's exact test were used for statistical analysis.

RESULTSThe detection of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Stenotrophomonas maltophilia, Streptococcus pneumonia, and Acinetobacter baumannii by qLAMP was consistent with sputum culture (P > 0.05). The qLAMP results of 4 samples for Haemophilus influenzae, Legionella pneumophila, or Mycoplasma pneumonia (MP) were inconsistent with culture results; however, clinical data revealed that the qLAMP results were all reliable except 1 MP positive sample due to the lack of specific species identified in the final diagnosis. The improvement of clinical condition was more significant (P < 0.001) in patients with pathogen target-driven therapy based on qLAMP results than those with empirical therapy.

CONCLUSIONqLAMP is a more promising method for detection of pathogens in an early, rapid, sensitive, and specific manner than culture.

Anti-Bacterial Agents ; therapeutic use ; Cross Infection ; drug therapy ; microbiology ; Pilot Projects ; Pneumonia ; drug therapy ; microbiology ; Prospective Studies ; Pseudomonas aeruginosa ; drug effects ; pathogenicity

BACKGROUND/AIMS: Recent papers have highlighted the role of diet and lifestyle habits in irritable bowel syndrome (IBS), but very few population-based studies have evaluated this association in developing countries. The aim of this study was to evaluate the association between diet and lifestyle habits and IBS. METHODS: A food frequency and lifestyle habits questionnaire was used to record the diet and lifestyle habits of 78 IBS subjects and 79 healthy subjects. Cross-tabulation analysis and logistic regression were used to reveal any association among lifestyle habits, eating habits, food consumption frequency, and other associated conditions. RESULTS: The results from logistic regression analysis indicated that IBS was associated with irregular eating (odds ratio [OR], 3.257), physical inactivity (OR, 3.588), and good quality sleep (OR, 0.132). IBS subjects ate fruit (OR, 3.082) vegetables (OR, 3.778), and legumes (OR, 2.111) and drank tea (OR, 2.221) significantly more frequently than the control subjects. After adjusting for age and sex, irregular eating (OR, 3.963), physical inactivity (OR, 6.297), eating vegetables (OR, 7.904), legumes (OR, 2.674), drinking tea (OR, 3.421) and good quality sleep (OR, 0.054) were independent predictors of IBS. CONCLUSIONS: This study reveals a possible association between diet and lifestyle habits and IBS.
Adult ; Case-Control Studies ; China ; Diet/*adverse effects ; Female ; *Food Habits ; Healthy Volunteers ; Humans ; Irritable Bowel Syndrome/*etiology ; *Life Style ; Logistic Models ; Male ; Middle Aged ; Surveys and Questionnaires