Humans ; Nutrition Surveys ; Diabetes Mellitus, Type 2/chemically induced* ; Environmental Exposure/analysis* ; Environmental Monitoring ; Phthalic Acids/toxicity* ; Environmental Pollutants/toxicity*

Objective: To analyze the treatment and clinical prognosis of lower extremity arterial injury caused by trauma. Methods: The clinical data of 77 patients with traumatic lower extremity arterial injury admitted to Department of Vascular Surgery,Yichang Central People's Hospital from January 2013 to June 2021 were collected retrospectively. There were 65 males and 12 females, with an average age of 47.4 years (range: 7 to 75 years). Among the 77 patients, 56 cases (72.7%) had open injury and 21 cases (27.3%) had closed injury. Iliac artery was injured in 9 cases (11.7%), common femoral artery in 7 cases (9.1%), superficial femoral artery in 1 case (1.3%), popliteal artery in 11 cases (14.3%) and inferior knee artery in 49 cases (63.6%). The treatment methods and clinical effects were analyzed. Results: One case with pelvic fracture combined the internal iliac artery injury and 1 case with multiple injuries involving the common femoral artery died of circulatory failure before surgery. Seventy-five cases received vascular-related operations, including arterial ligation in 24 cases, arterial reconstruction in 40 cases, stent graft implantation in 1 case, primary amputation in 2 cases, and arterial embolization in 8 cases. The overall mortality rate was 6.5% (5/77), all of which were closed injuries. Except for 2 cases who died before surgery, 3 cases with pelvic fracture combined the internal iliac artery injury died of multiple organ failure after internal iliac artery embolization. There were 8 cases received amputation (10.4%, 8/77), 5 cases with closed injury and 3 cases with open injury. In addition to 2 cases with primary amputation, 6 cases underwent secondary amputation due to ischemia-reperfusion injury after revascularization (4 cases with popliteal artery injury and 2 cases with subpatellar artery injury). The average followed-up time was 17 months (range: 2 months to 8 years). One patient with femoral artery injury underwent autologous great saphenous vein bypass, and lower limb artery CT angiography was re-examined 6 months after the operation, and 30% distal anastomotic stenosis was found. Ankle brachial index<0.8 was found in two patients 1 year after popliteal artery repair, but none of the patients had intermittent claudication symptoms, and no further intervention was performed. Five patients suffered delayed healing due to severe lower limb injury, fracture and skin injury. Among them, 2 cases had poor wound healing at the stump of amputation, which gradually healed 3 to 5 months after several debridements. The other 3 vascular injury combined with tibial fracture patients had delayed tibial healing after surgery, but no symptoms of vascular ischemia occurred. All the other patients recovered well and no other serious complications occurred. Conclusions: The proportion of death and disability in patients with lower limb artery injury caused by trauma is high. Active and orderly surgical repair according to the site and type of injury can reduce the mortality, save the function of the affected limb, and promote the healing of injury.
Amputation ; Female ; Femoral Artery ; Humans ; Lower Extremity ; Male ; Middle Aged ; Popliteal Artery/surgery* ; Retrospective Studies ; Treatment Outcome ; Vascular System Injuries/surgery*

Objective:To evaluate the clinical effect of integrated traditional Chinese and Western medicine on common type of coronavirus disease 2019 (COVID -19) in Henan Province. Methods:A prospective single arm clinical study was performed. Patients with common type of COVID -19 admitted to seven designated hospitals for COVID -19 in Henan Province from January 25th to February 26th, 2020 were enrolled, and treated with integrated traditional Chinese and Western medicine. The negative transformation of 2019 novel coronavirus (2019 -nCoV) nucleic acid, disease outcome, hospital stay, clinical symptoms and signs scores, and chest imaging performance were observed. Results:Totally 86 cases were included in the analysis, including 48 males (55.8%), aged 43.5 (35.0, 53.3) years old, 24 patients (27.9%) with previous medical history. Fifty-eight patients were primarily diagnosed COVID -19 and 28 patients were transferred. The 2019 -nCoV nucleic acid of 86 cases (100%) turned negative, and the median time of turning negative was 10 (7, 14) days. Eighty-six cases (100%) were discharged from hospital, and none turned into the severe type; the average length of hospital stay was (13.8±5.6) days. The scores of fever, cough, chest tightness, shortness of breath, and fatigue decreased with the treatment time, and the scores of 7 days and 14 days after treatment were significantly lower than those before treatment [fever (points): 0 (0, 0), 0 (0, 0) vs. 1 (0, 1); cough (points): 1 (0, 1), 0 (0, 1) vs. 1 (0, 2); chest tightness (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); shortness of breath (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); fatigue (points): 0 (0, 1), 0 (0, 1) vs. 1 (0, 1); all P < 0.05]. The improvement rate of X ray and CT image was 42.9% (12/28) and 81.0% (64/79), respectively. Conclusions:The treatment with integrated traditional Chinese and Western medicine has good curative effect on common type of COVID -19 in 7 designated hospitals of Henan Province. It can improve the clinical symptoms, promote the absorption of pulmonary inflammation, and to some extent control the progress of disease and shorten the time of turning negative of virus nucleic acid and hospital stay.

The clinical evaluation methods of facial paralysis can be divided into functional evaluation scales,neuro-electrophysiologi-cal tests and computer evaluation systems.The commonly used function evaluation scales include House-Brackmann Grading Scale(HB-GS),Burres-Fisch Facial Nerve Scoring System,Nottingham System,Sunnybrook facial grading System(SFGS),Degree of Facial Nerve Paralysis Hierarchical Scale,Facial Disability Index(FDI)and Facial Clinimetric Evaluation(FaCE)Scale,etc.Neuro-electrophysiological tests mainly consist of facial electromyography (EMG), electroneurography (ENoG), blink reflex (BR), and neural excitatory test (NET), etc.The computer evaluation system based on the sensor is mainly divided into the computer evaluation system based on infrared thermal image technology and the computer evaluation system based on biomedicine image recognition.This article briefly summarized the existing methods of facial paralysis evaluation in terms of sensitivity,stability,accuracy,ease of operation and economics.

OBJECTIVETo evaluate the effects of ginsenoside Rg-1 on the proliferation and osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) and to explore the possible application on the alveolar bone regeneration.

METHODSTo determine the optimum concentration, the effects of ginsenoside Rg-1 ranging from 10 to 100 μmol/L were evaluated by 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide, alkaline phosphatase activity and calcium deposition. Expressions of runt-related transcription factor 2, collagen alpha-2(I) chain, osteopontin, osteocalcin protein were examined using real-time polymerase chain reaction.

RESULTSCompared with the control group, a certain concentration (10 μmol/L) of the Rg-1 solution significantly enhanced the proliferation and osteogenic differentiation of hPDLSCs (P<0.05). However, concentrations that exceeds 100 μmol/L led to cytotoxicity whereas concentrations below 10 nmol/L showed no significant effect as compared with the control.

CONCLUSIONGinsenoside Rg-1 can enhance the proliferation and osteogenic differentiation of hPDLSCs at an optimal concentration of 10 μmol/L.

Adolescent ; Alkaline Phosphatase ; metabolism ; Biomarkers ; metabolism ; Calcification, Physiologic ; drug effects ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cell Separation ; Cell Shape ; drug effects ; Cells, Cultured ; Flow Cytometry ; Ginsenosides ; pharmacology ; Humans ; Osteoblasts ; drug effects ; metabolism ; Osteogenesis ; drug effects ; genetics ; Periodontal Ligament ; cytology ; Real-Time Polymerase Chain Reaction ; Stem Cells ; cytology ; drug effects ; enzymology ; Time Factors ; Young Adult

OBJECTIVETo investigate the effect of recombinant adenovirus (phosphatidylinositol-3-kinases(PI3K)(I()-RNAi-AD which blocks the class I( PI3K signaling pathway on gastric carcinoma cells xenografts in nude mice.

METHODSSubcutaneous tumor models of nude mice were established with SGC7901 cells and randomly divided into PI3K(I()-RNAi-AD group, NC-RNAi-GFP-AD group and control group. The tumor size and the inhibitory rate of tumor growth on days 3, 6, and 9 after cell transplantation were measured. The expression of TNF-α, COX2, P53, PCNA, E-cadherin and nm23/DNPK in tumor tissues were detected by immunohistochemistry.

RESULTSTumor growth was significantly inhibited in the PI3K(I()-RNAi-AD group(14.2%, 21.0%, and 28.1%) on days 3, 6, 9 compared with NC-RNAi-GFP-AD group(1.3%, 1.9%, and 2.0%, all P<0.05). The expressions of TNF-α, P53, E-cadherin and nm23/DNPK were up-regulated, and the expressions of COX2 and PCNA were down-regulated in the PI3K(I()-RNAi-AD group by immunohistochemical staining(all P<0.05).

CONCLUSIONSPI3K(I()-RNAi-AD can inhibit the growth of SGC7901 cell transplantation tumor in vivo in nude mice by inhibiting cell growth, reducing the capacity of tumor invasion and inhibiting tumor angiogenesis.

Adenoviridae ; Animals ; Cell Line, Tumor ; Cell Proliferation ; Class I Phosphatidylinositol 3-Kinases ; Heterografts ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Phosphatidylinositol 3-Kinases ; Phosphatidylinositols ; Stomach Neoplasms

BACKGROUNDThis meta-analysis evaluated the effect of noninvasive, positive pressure ventilation on severe, stable chronic obstructive pulmonary disease (COPD).

METHODSPUBMED, CNKI, Wanfang, EMBASE and the Cochrane trials databases were searched. Randomized controlled trials of patients with severe, stable COPD and receiving noninvasive positive pressure ventilation, compared with sham ventilation or no ventilation, were reviewed. The mortality, physiological and health related parameters were pooled to yield odds ratio (OR), weighted mean differences or standardized mean differences (SMD), with 95% confidence interval (CI).

RESULTSEight parallel and three crossover randomized controlled trials met the inclusion criteria. Pooled analysis for parallel, randomized controlled trials showed noninvasive positive pressure ventilation: (1) Did not affect the 12- or 24-month mortality (OR 0.82, 95%CI: 0.48 to 1.41); (2) Improved the arterial carbon dioxide tension (SMD -0.88, 95%CI: -1.43 to -0.34); (3) Did not improve forced expiratory volume in one second (SMD 0.20, 95%CI: -0.06 to 0.46), maximal inspiratory pressure (SMD 0.01, 95%CI: -0.28 to 0.29) or 6-minute walk distance (SMD 0.17, 95%CI: -0.16 to 0.50); (4) Subgroup analysis showed noninvasive positive pressure ventilation improved the arterial carbon dioxide tension in hypercapnic patients. Pooled analysis for crossover randomized controlled trials did not show improvement in arterial blood gas or forced expiratory volume in one second with noninvasive positive pressure ventilation.

CONCLUSIONSNoninvasive positive pressure ventilation improves the arterial carbon dioxide tension but does not improve the mortality, pulmonary function, or exercise tolerance and should be cautiously used in severe stable chronic obstructive pulmonary disease.

Carbon Dioxide ; blood ; Forced Expiratory Volume ; Humans ; Positive-Pressure Respiration ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; psychology ; therapy ; Quality of Life ; Randomized Controlled Trials as Topic

Background This meta-analysis evaluated the effect of noninvasive,positive pressure ventilation on severe,stable chronic obstructive pulmonary disease (COPD).Methods PUBMED,CNKI,Wanfang,EMBASE and the Cochrane trials databases were searched.Randomized controlled trials of patients with severe,stable COPD and receiving noninvasive positive pressure ventilation,compared with sham ventilation or no ventilation,were reviewed.The mortality,physiological and health related parameters were pooled to yield odds ratio (OR),weighted mean differences or standardized mean differences (SMD),with 95％ confidence interval (C/).Results Eight parallel and three crossover randomized controlled trials met the inclusion criteria.Pooled analysis for parallel,randomized controlled trials showed noninvasive positive pressure ventilation:(1) Did not affect the 12-or 24-month mortality (OR 0.82,95％ C/:0.48 to 1.41); (2) Improved the arterial carbon dioxide tension (SMD-0.88,95％C/:-1.43 to-0.34); (3) Did not improve forced expiratory volume in one second (SMD 0.20,95％ C/:-0.06 to 0.46),maximal inspiratory pressure (SMD 0.01,95％ C/:-0.28 to 0.29) or 6-minute walk distance (SMD 0.17,95％ C/:-0.16 to 0.50); (4) Subgroup analysis showed noninvasive positive pressure ventilation improved the arterial carbon dioxide tension in hypercapnic patients.Pooled analysis for crossover randomized controlled trials did not show improvement in arterial blood gas or forced expiratory volume in one second with noninvasive positive pressure ventilation.Conclusions Noninvasive positive pressure ventilation improves the arterial carbon dioxide tension but does not improve the mortality,pulmonary function,or exercise tolerance and should be cautiously used in severe stable chronic obstructive pulmonary disease.

BACKGROUNDChromosomal abnormalities have been shown to play an important prognostic role in multiple myeloma (MM). Interphase fluorescence in situ hybridization (i-FISH) has been much more effective to identify cytogenetic aberrations in MM than conventional cytogenetic technique (CC). To clearly determine the cytogenetic features of Chinese MM patients and identify their prognostic implications, we designed a multicenter study based on i-FISH including 672 patients from 52 hospitals in China.

METHODSAll 672 patients were systematically screened for the following genomic aberrations: del(13q), IgH rearrangement, del(p53) and 1q21 amplifications.

RESULTSThe analysis showed that the chromosomal changes were detected in 22.1% patients by CC and in 82.3% patients by i-FISH. The most common abnormalities by CC were chromosome 1 aberrations (48.4%), -13/13q- (37.6%), hyperdiploidy (36.6%), hypodiploidy (30.1%) and IgH rearrangements (23.7%). The most frequent abnormalities by FISH was del(13q), which was found in 60.4% patients, whereas IgH rearrangement, 1q21 amplification and p53 deletions were detected in 57.6%, 49.0% and 34.7% cases, respectively. By statistical analysis, -13/13q- by CC was associated with low level of platelet (P = 0.015), hyperdiploidy was associated with low level of serum albumin (P = 0.028), and IgH rearrangement by FISH was associated with high level of β2 microglobulin (P = 0.019). Moreover, 1q21 amplification and del(p53) by FISH conferred a high incidence of progressive disease (PD) after initial therapy. Metaphase detection of IgH rearrangements and chromosome 1 aberrations concurrently was associated with a short progression free survival (PFS) (P = 0.036). No significant prognostic implications of other cytogenetic abnormalities were found associated with overall survival and PFS.

CONCLUSIONSChinese MM patients had similar cytogenetic abnormalities compared with the previous reported studies. However, the prognostic significance of FISH aberrations were not clearly determined and further study is required.

Adult ; China ; Chromosome Aberrations ; Chromosomes, Human, Pair 1 ; genetics ; Cytogenetic Analysis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Middle Aged ; Multiple Myeloma ; genetics ; pathology

Objective To investigate the effect of L-camitine on renal ischemia-reperfusion (IR) injury (IRI) and Nrf2-ARE signaling pathway in rats.Methods Rats were randomly separated into the following experimental groups:control group (group C),IRI group (group I) and L-carnitine group (group L).Rats accepted no treatment of ischemic reperfusion in group C.In groups I and group L,the renal IRI model was established.L-carnitine was injected through the tail vein in group L,while the equal volume of saline was injected in group C and group I.Rats were killed at 3,6,and 24 h after IR.The levels of serum creatinine (Cr) and blood urea nitrogen (BUN),the activity of superoxide dismutase (SOD) and the content of malonaldehyde (MDA) in serum were measured.The histopathological lesions were observed in renal tissues after 24-h IR.RT-PCR was used to detect the levels of Nrf2,HO-1 and γ-GCS mRNA.Western blotting and immunohistochemistry were used to detect the levels and localization of Nrf2 protein in renal tissues after 6-h IR.Results The levels of Cr and BUN in group I and group L were higher than those in group C at 3 h after IR.At 6 h after IR,the levels of Cr and BUN in group L were lower than those in group I (P＜0.01 ).At 24 h after IR,the levels of Cr and BUN in group L were still lower than those in group I though both of them were reduced (P＜0.05).At all time points,the activity of SOD in group L was higher and the content of MDA was lower than those in group I (P＜ 0.05). As compared with group I,the renal histopathological lesions were alleviated in group L at 24 h after IR.At 6 h after IR,levels of Nrf2,HO-1,γ-GCS mRNA and Nrf2 protein in group I were increased as compared with group C,but decreased as compared with group L.Beyond that,the expression of nuclear Nrf2 protein in group L was higher than that in group I.Conclusion L-carnitine can protects the kidney against IRI significantly,which may be due to the up-regulated expression of antioxidant genes by activating the Nrf2-ARE signaling pathway.