AIM:To study the effects of basic fibroblast growth factor (bFGF) on brain edema, nerve function damage and autophagy related proteins in rats with head injury.METHODS:The rat model of craniocerebral injury (CI) was constructed.The rats were divided into control group, CI group, and low-, middle-and high-dose bFGF groups (n=10).The CI model was established in CI group, while the rats in control group were not given epidural impact.The rats in low-dose, middle-dose and high-dose bFGF groups were given bFGF at 2, 4 and 6μg, respectively, by intraperitoneal injection after 30 min.The neurological function in the rats was evaluated by improved neurological function scoring.The rat brain tissues were taken, and the water content was detected.The levels of tumor necrosis factor-α (TNF-α) , interleukin-6 (IL-6) and IL-1βin the brain tissue were measured by ELISA.The malondialdehyde (MDA) content was analyzed by thiobarbituric acid method.The activity of superoxide dismutase (SOD) was examined by WST-8 assay.The glutathine peroxidase (GSH-Px) activity was detected by colorimetric method.The protein levels of autophagy related proteins LC3-II and beclin-1 in the brain tissues were determined by Western blot.RESULTS:The neurological function score was increased significantly of the rats in CI group.The rat model of craniocerebral injury was successfully constructed.Neurological function scores in the rats in low-dose, middle-dose and high-dose bFGF groups were reduced, the water content of the brain tissue was also reduced (P<0.05).The levels of TNF-α, IL-6 and IL-1βwere decreased in the brain tissues (P<0.05) , the content of MDA was declined (P<0.05) , the activities of SOD and GSH-Px were increased (P<0.05) , the protein levels of LC3-II and beclin-1 were decreased, compared with the untreated rats in CI group (P<0.05).CON-CLUSION:bFGF improves the nerve function of the rats with craniocerebral injury, reduces the water content of the brain tissue, reduces the expression of autophagic protein LC3-II and beclin-1.The mechanism is related to the inhibition of inflammatory reaction and oxidative damage.

Objective To summarize the treatment decision-making strategy and its long-term efficacy for advanced elderly patients with severe valvular heart disease and clear indications for surgery.Methods Clinical data of 196 patients aged 75 years and older firmly diagnosed as severe valvular heart diseases were retrospectively analyzed.The patients were divided into the surgical group (a mean age of 77.4±2.0 years,n=126)and the conservative group(a mean age of 80.5±5.0 years,n =70).Factors affecting therapeutic decision-making were analyzed,and the differences in a long-term survival were compared between the two groups.Results The most common reason for choosing conservative treatment was the recommendation of the doctor giving a preliminary diagnosis and worrying about the high-risk surgery for the patients(62.9％,44/70).Only 26(37.1％)patients in the conservative group were evaluated by cardiac surgeons,among whom 12 (17.1％)patients were considered to have surgical contraindications,and 14 (20.0％) patients themselves or their family members chose conservative treatment for the fear of surgical risks.Patients in the operation group were mainly from the outpatient department of cardiac surgery,and only 8 (6.3 ％)cases were referred from department of internal medicine.Logistic regression analysis showed that female,chronic renal insufficiency,advanced age,pneumonia and emergency hospital admissions were independent predictors for the conservative option(P ＜0.01),while patients with isolated aortic valve disease tended to receive surgical treatment.Overall 5-year survival was higher in the surgical group than in the conservative group (76.4％ vs.39.9％,P ＜ 0.01).Cox regression analysis disclosed that the conservative treatment option was the single risk factor for long-term survival in all series.Conclusions Many factors affect the process of therapeutic decision-making for patients with severe valvular heart diseases,and a multidisciplinary collaboration is the best way for the optimal treatment strategy for those patients.

BACKGROUND: Little is known about the risk factors for sudden cardiac death (SCD) in the overall hospitalized cardiac department population. This study was conducted to investigate the risk factors and develop a predictive model for SCD in a hospitalized cardiac department population. METHODS: We conducted a retrospective study of patients admitted to the cardiac department of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to February 2017. We collected the clinical data from medical records. Multiple stepwise logistic regression analysis was carried out to confirm the risk factors for SCD and develop a predictive risk model. The risk score was assessed by the area under receiver operating characteristic (AUROC) curve and the Hosmer-Lemeshow goodness-of-fit test. RESULTS: A total of 262 patients with SCD and 4485 controls were enrolled in our study. Logistic regression modeling identified eight significant risk factors for in-hospital SCD: age, main admitting diagnosis, diabetes, corrected QT interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate. A predictive risk score including these variables showed an AUROC curve of 0.774 (95% confidence interval: 0.744-0.805). The Hosmer-Lemeshow goodness-of-fit test showed the chi-square value was 2.527 (P = 0.640). The incidence of in-hospital SCD was 1.3%, 4.1%, and 18.6% for scores of 0 to 2, 3 to 5 and ≥6, respectively (P < 0.001). CONCLUSIONS Age, main admitting diagnosis, diabetes, QTc interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate are factors related to in-hospital SCD in a hospitalized cardiac department population. We developed a predictive risk score including these factors that could identify patients who are predisposed to in-hospital SCD.
Aged ; Death, Sudden, Cardiac ; epidemiology ; Electrocardiography ; Female ; Glomerular Filtration Rate ; Humans ; Inpatients ; statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors

OBJECTIVE: The association between lipoprotein (a) [Lp(a)] levels and metabolic syndrome (MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort. METHODS: A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS. RESULTS: In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS (30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio (OR) for prevalent MetS [multivariate-adjusted OR 0.45 (95% confidence interval 0.39-0.51); P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups. CONCLUSION Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.
Aged ; Asian Continental Ancestry Group ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Lipoprotein(a) ; blood ; Male ; Metabolic Syndrome ; blood ; epidemiology ; Middle Aged

OBJECTIVE: To explore the effect of selective lumbosacral posterior rhizotomy(SPR) on lower limb spasticity and gross motor function in patients with cerebral palsy. METHODS: From January 2018 to October 2018, 47 patients with cerebral palsy were treated with rehabilitation alone and SPR combined with rehabilitation. According to whether SPR was performed, the patients were divided into group A and group B. Group A was treated with rehabilitation combined with SPR at lumbosacral level, and group B was treated with rehabilitation alone. There were 23 cases in group A, including 15 males and 8 females, with an average age of (7.30±3.25) years old; 24 cases in group B, 13 males and 11 females, with an average age of (7.00±3.09) years old. Forty-seven patients were assessed with modified Ashworth(MAS) and Gross Motor Function Scale(GMFM-88 items) before and after treatment. The changes of MAS and GMFM-88 scores before and after treatment were compared to evaluate the degree of spasm and the improvement of gross motor function in the two groups. RESULTS: All 47 patients were followed up. At 6 months after treatment, the MAS classification of the two groups was significantly improved(<0.05), and the improvement of group A was more obvious than that of group B(<0.05). Six months after treatment, the D, E and total scores of GMFM-88 between two groups were significantly improved compared with those before operation(<0.05). The improvement of D and total scores in group A was more obvious than that in group B. There was no significant difference in the improvement of area E between two groups. CONCLUSIONS Selective posterior rhizotomy combined with rehabilitation can significantly improve the spastic state and gross motor function of lower limbs in children with cerebral palsy, and can effectively promote the reconstruction and recovery of motor function of lower limbs in children with cerebral palsy.
Cerebral Palsy ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Lower Extremity ; Male ; Movement ; Muscle Spasticity ; Rhizotomy

OBJECTIVE: To systematically evaluate the clinical efficacy of acupuncture for dysarthria, and to explore the rules of acupoints selection for dysarthria. METHODS: The clinical randomized control trial literature regarding acupuncture for dysarthria published before January of 2018 were searched in databases, including CNKI, Wanfang, VIP, CBM, PubMed, Ebsco, Science Direct and Cochrane Library. The information of included studies was extract and the quality was assessed. The Meta analysis was performed by using RevMan 5.3 software. The frequency of acupoints was calculated by using Excel software to analyzed the rules of acupoints selection. RESULTS: Totally 21 papers were included, involving 1651 patients. The pooled effects of clinical efficacy: heterogeneity test =0.74, =0%, =6.36, 95% CI: 4.55, 8.88, =10.84 (<0.01), indicating the efficacy in the treatment group was significantly higher than that in the control group. The pooled effects of the symptom score in Frenchay scale: heterogeneity test =0.56, =0%, =3.20, 95% CI: 1.38, 5.02, =3.45 (<0.01), indicating the efficacy in the treatment group was significantly higher than that in the control group. The acupoints with frequency of more than 5 times were Fengchi (GB 20), Yuye (EX-HN 13), Jinjin (EX-HN 12), Lianquan (CV 23), Baihui (GV 20), tongue-three needles and Yamen (GV15). The meridians with frequency of more than 5 times were the extra channels, governor vessel, gallbladder channel, conception vessel and stomach channel. CONCLUSION The clinical efficacy of acupuncture combined with speech training/regular treatment is significantly superior to that of control group (speech training, medication, regular treatment); acupuncture is safe and effective for dysarthria; the majority of selected acupoint is local acupoints around tongue, throat and neck, as well as extra points and empirical points. However, high-quality randomized controlled trials with large sample sizes are still needed to provide further evidence.
Acupuncture Therapy ; Dysarthria ; therapy ; Humans ; Meridians ; Speech Therapy

OBJECTIVE: To evaluate the efficacy and safety of salvianolate in elderly patients with unstable angina pectoris (UAP). METHODS: A prospective double-blind randomized placebo-controlled multicenter trial in elderly patients with UAP from 13 third-grade class-A hospitals in China was performed. A total of 318 patients were randomly allocated in a 1:1 ratio to an experimental group (160 patients) and a control group (158 patients). The experimental group was treated with salvianolate for 14 days on the basis of conventional medicine, and the control group was given a placebo for 14 days with the same criteria. Follow-up was lasted 28 days in both groups. The primary endpoint was biweekly frequency of angina pectoris attacks. The secondary endpoints included biweekly dosage of nitroglycerin, the Seattle Angina Questionnaire, angina pectoris severity and duration, myocardial injury markers, high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as major adverse cardiovascular events (MACEs). Safety was assessed according to adverse events and serious adverse events. RESULTS: Baseline characteristics were similar between treatment groups. Compared with those in the control group, the frequency of biweekly angina attacks (2.92 vs . 4.08, P=0.025), the biweekly dosage of nitroglycerin, as well as the severity and duration of angina attacks (P<0.01) were reduced by salvianolate. The Seattle Angina Questionnaire score was also significantly improved in the experimental group than in the control group (P<0.05). No significant differences were observed between the two groups with respect to the incidence of MACEs. Salvianolate was well tolerated. CONCLUSIONS Salvianolate appear to have efficacy and well tolerated for elderly patients with UAP. [ClinicalTrials.gov identifier: NCT03037047].

Objective: To evaluate the efficacy and safety of nifekalan (NIF) on cardioversion in atrial fibrillation (AF) patients post radiofrequency ablation, and investigate the relevant factors related to the cardioversion efficacy of NIF. Methods: We screened patients with sustained AF rhythm after radiofrequency ablation between November 2016 and July 2018. Participants were treated with intravenous NIF 0.4 mg/kg within 5-10 minutes after ablation. We observed the adverse reaction, and monitored the rhythm, heart rate, QT interval and QTc interval before the medication and at 5, 10, 20, 120 min after the medication. According to the drug outcome of NIF, patients were divided into conversion group and non-conversion group, related factors affecting conversion efficacy were evaluated using logistic regression analysis. Results: (1)A total of 116 patients were enrolled in the study (63 males and 53 females, mean age was (64±18) years). Among them, 72 patients were converted to sinus rhythm, and the overall successful rate was 62.1%. There were 84 patients with persistent AF, of which 50 cases (59.2%) were restored to sinus rhythm. There were 32 patients with paroxysmal AF, 22 cases (68.8%) of them were restored to sinus rhythm. The conversion time was 1.5 to 12 (6.8±3.4)min. (2) In 116 patients, the QT interval and QTc interval were significantly longer after medication than before the drug administration (P<0.01), and peaked at about 10th min, and restored to the level before drug administration at about 120th min. (3) There were 8 cases of bradycardia (6.9%), 3 cases of frequent and short ventricular tachycardia (2.6%). (4) The duration of atrial fibrillation was shorter and left atrial diameter was smaller in the cardioversion group than in the non-cardioversion group (both P<0.05). There were no significant differences in gender, disease history, atrial fibrillation type and structural heart disease between the two groups (P>0.05). (5) Multifactorial logistic regression analysis showed that the duration of atrial fibrillation (OR=0.980, 95%CI 0.966-0.994, P=0.004) and the left atrial diameter (OR=0.888, 95%CI 0.814-0.967, P=0.007) were the factors that influence the cardioversion efficacy of NIF on atrial fibrillation post ablation. Conclusions The total effective rate of NIF was 62.1% in patients witrh sustained AF post radiofrequency ablation, was 68.8% in patients with paroxysmal AF. Besides, NIF has the advantage of short conversion time and few adverse reactions. Left atrium diameter and AF duration were relevant factors that influence the efficacy of NIF of cardioversion in patients with sustained AF after radiofrequency ablation.

Objective: To understand the infection status and genetic characteristics of Norovirus from foodborne diseases in sentinel hospital of Ma′anshan city. Methods: The 911 stool samples and epidemiological data of the patients with foodborne disease were collected from three hospitals of Ma′anshan city during January 2015 to June 2018. The G Ⅰ and G Ⅱ Norovirus were detected by real-time reverse transcription PCR. Some of the positive specimens were amplified by conventional reverse transcription PCR, and the PCR products were sequenced for sequence alignment and phylogenetic analysis. Results: The positive rate of Norovirus was 14.7% (134/911), in which 7 strains were G Ⅰ, 124 strains were G Ⅱ and 3 strains were mixed infection. Norovirus can be detected throughout the year, with high positive rate from December to April of the next year [24.4%(20/82)-45.3%(24/53)]. The 78 males (15.5%) and 55 females (13.7%) were positive for Norovirus (χ²=0.58,P=0.448). There was no significant difference in different age groups (χ²=9.55, P=0.089). A total of 79 strains were successfully sequenced, 4 strains were G Ⅰ group(5.1%), 75 strains were G Ⅱ group (94.9%). The predominant strains were GⅡ.17 and GⅡ.4, aud the number were 35 and 15 respectively. The predominant strains were different in different years. The main strain was GⅡ.17 in 2015 (30, 68.2%),GⅡ.4 in 2016 (5/9) and 2017 (8/16), but GⅡ.3 in 2018 (3/6). Conclusion Norovirus diarrhea was popular in Ma′anshan city throughout the year,especially in winter and spring. The prevalent strain was GⅡ,genotypes were diversified distribution,the dominant strains were GⅡ.17 and GⅡ.4. The predominant strains were different in different years.

BACKGROUND: Either good biocompatibility and biological activity of active biological materials or the potential of multidirectional differentiation of neural stem cells has great application prospect and value. OBJECTIVE: To investigate the effect of neurotrophic factor 3-chitosan active biomaterial scaffolds on the differentiation of neural stem cells and the expression of key proteins of the neurotrophic factor 3 signal pathway in vitro. METHODS: The neural stem cells were extracted and purified, and then divided into pure culture medium group, soluble neurotrophic factor 3 group, pure chitosan group, and neurotrophic factor 3-chitosan group for differentiation induction. The expression of TrkC, Akt / p-Akt and Erk/p-Erk in the neurotrophic factor 3 signaling pathway was detected by western blot after 6 hours of induction. After 7 days of induction, differentiation of neural stem cells was observed by immunocytochemistry of MAP2, MBP, and GFAP. After 14 days of induction, formation of neural network induced by neurotrophic factor 3-chitosan active biomaterials was observed by immunocytochemistry of MAP2, Synapsin-1, and PSD95. RESULTS AND CONCLUSION: The neurotrophic factor 3-chitosan group induced a high proportion of neural stem cells differentiated into neurons, with a ratio of 73.8%, which was significantly higher than that in the other three groups. Meanwhile, the proportion of cells differentiated into glial cells waslower than that in the other three groups. The expression of key proteins TrkC, p-Akt and p-Erk in the neurotrophic factor 3-chitosan group was higher than that in the other three groups. Meanwhile, neurotrophic factor 3-chitosan could induce the in vitro differentiation of neural stem cells to form neural network.