Objective To analyze the correlation between right atrial strain at various stages and various influencing factors in patients with pulmonary hypertension,and to explore the role of right atrial strain in the assessment of pulmonary hypertension.Methods A total of 239 cases diagnosed with pulmonary hypertension who underwent echocardiography and complete right heart catheterization at hospital from October 2021 to December 2023 were included.Conventional ultrasound parameters such as right heart strain,right atrial area(RA area),inferior vena cava diameter(IVC diameter),and collapse rate of the inferior vena cava(IVC diameter changes)were measured.The heart rate(HR)corresponding to the ultrasound images were recorded.General information such as age and gender,as well as catheter data including mean right atrial pressure(mRAP),mean pulmonary artery pressure(mPAP),and pulmonary vascular resistance(PVR),were collected.The relationship between right atrial strain and its influencing factors was analyzed,and further analysis was conducted by dividing into shunt group and non-shunt group based on the presence or absence of left-to-right shunt disease.Results The correlation with RA reservoir strain(RASr)from high to low is RV global strain(RV4CSL),RV free wall strain(RVFWSL),RA area,IVC diameter,mRAP,age,HR,and PVR;the correlation with RAconduit strain(RAScd)from high to low is RV4CSL,RVFWSL,RA area,IVC diameter,mRAP,age,PVR,and HR;the correlation with RA contraction strain(RASct)from high to low is RA area,RV4CSL,RVFWSL,mRAP,IVC diameter,and HR.The collapse rate of the inferior vena cava is correlated with strain at various stages of the right atrium;gender is correlated with RASr and RASct.Conclusions Right atrial strain can reflect changes in right atrial function,with the highest correlation to right ventricular strain and right atrial area.Right atrial strain can indicate the severity of right ventricular function and right atrial remodeling,serving as an evaluative index for the condition and treatment outcomes of pulmonary arterial hypertension.

OBJECTIVE: To compare clinical effect of anterior tibial plateau fracture line and anterior tibial fenestration reduction in treating anterolateral tibial plateau column fracture combined with posterior lateral column collapse. METHODS: Fifty-two patients with Schatzker typeⅡ tibial plateau anterolateral column fracture combined with posterolateral column collapse admitted from January 2016 to December 2021 were retrospectively analyzed and divided into two groups according to fracture reduction methods. There were 27 patients in fracture line group, including 19 males and 8 females, aged from 26 to 62 years old with an average of (43.2±11.4) years old;the time from injury to operation ranged from 4 to 8 days with an average of (5.8±1.5) days;treated with reduction and internal fixation via fracture line of lateral platform front. There were 25 patients in fenestrate group, including 13 males and 12 females, aged from 22 to 69 years old with an average of (40.8±11.1) years old;the time from injury to operation ranged from 4 to 8 days with an average of (6.0±1.4) days;treated with tibial fenestration reduction and internal fixation. The amount of bone graft, operation time, fracture healing time and complications were compared between two groups. Posterior slope angle (PSA) and posterior slope angle of the lateral tibial plateau was compared before surgery, 2 days and 6 months after surgery. The knee function was evaluated by Hospital for Speical Surgery (HSS) at 2 days and 6 months after surgery, respectively. Fracture reduction was evaluated by Rasmussen anatomic score of knee joint. RESULTS: Both of group were followed up from 12 to 24 months (16.0±3.4) months. No redisplacement of fracture, internal and external inversion deformity of knee joint, or instability of knee joint were found between two groups during follow-up. In fracture line group, 1 patient occurred wound fat liquefaction and 2 patients occurred lower limb intermuscular venous thrombosis occurred. In fenestration group, 1 patient occurred joint stiffness, 1 patient occurred lower limb intermuscular venous thrombosis, and 1 patient occurred superficial wound infection;there were no significant difference in complications between two groups (P>0.05). Bone graft volume, operative time and fracture healing time in fracture line group were (3.6±2.3) cm³, (123.4±18.2) min and (13.8±1.8) weeks, while in feneplast group were (4.8±1.8) cm³, (135.5±22.5) min and (15.2±2.0) weeks, respectively;the difference between two groups was statistically significant (P<0.05). The collapse depth of lateral platform articular surface at 2 days and 6 months after surgery were (0.8±0.1) and (0.9±0.1) mm in fracture line group, which were lower than those in fenestration group (0.9±0.1) and (1.1±0.1) mm, respectively (P<0.05). After 2 days and 6 months, , PSA in fracture line group were (9.4±1.5) ° and (10.1±1.9) °, respectively, which were lower than those in fenestration group (10.5±1.5) ° and (11.3±1.9) ° (P<0.05). Rasmussen anatomical scores in fracture line group at 2 days and 6 months were 16(16, 18) and 16(14, 16) points, respectively, which were better than those in fenestrated group (16, 16) and 14(14, 16) points (P< 0.05). The collapse depth, PSA and Rasmussen anatomical score between two groups were better than those before surgery (P<0.05). There was no significant difference in HSS score between two groups at 2 days after surgery (P>0.05). At six months after surgery, HSS score in fracture line group (86.7±3.6) was higher than that in fenestration group (84.1±3.91) (P<0.05). HSS score at 6 months after surgery was better than that at 2 days after surgery (P<0.05). CONCLUSION Both anterior tibial plateau fracture line and anterior tibial fenestration could be used to treat anterolateral tibial plateau column fracture with posterior lateral column collapse. Compared with fenestration group, transfracture line group had advantages of less intraoperative bone grafting, shorter operative time, shorter fracture healing time, better articular surface reduction effect and better knee functional recovery.
Humans ; Male ; Female ; Middle Aged ; Tibial Fractures/physiopathology* ; Adult ; Fracture Fixation, Internal/methods* ; Aged ; Retrospective Studies ; Tibia/injuries* ; Tibial Plateau Fractures

Objective To investigate the effects of galangin on the proliferation,apoptosis,and 5-fluorouracil (5-FU) resistance of colorectal cancer (CRC) cells by regulating the FOXO3-FOXM1 axis. Methods CRC cells HCT8 and its drug-resistant cell lines HCT8/5-FU were cultured in vitro,and then treated with different concentrations (0,5,10,20,40 μmol/L) of galangin to screen experimental concentra-tions. HCT8 cells were divided into the ctrl group (without special treatment),NC group (transfected with empty plasmid),L-galangin group (treated with 10 μmol/L of galangin ),H-galangin group (treated with 20 μmol/L of galangin),and H-galangin+sh-FOXO3 group (trans-fected with FOXO3 shRNA plasmid after 20 μmol/L of galangin treatment). HCT8/5-FU cells were divided into the control group (without special treatment),5-FU+NC group (treated with empty plasmid after 5 μg/mL of 5-FU treatment),5-FU group (treated with 5 μg/mL of 5-FU),5-FU+L-galangin group (treated with 10 μmol/L of galangin after 5 μg/mL of 5-FU treatment),5-FU+H-galangin group (transfected with 20 μmol/L galangin after 5 μg/mL of 5-FU treatment),and 5-FU+H-galangin+sh-FOXO3 group (transfected with FOXO3 shRNA plasmid after 5 μg/mL of 5-FU and 20 μmol/L of galangin treatment). The cell proliferation ability was detected by CCK-8 assay;the cell clone formation ability was detected by clone formation assay;the cell apoptosis was detected by flow cytometry;the expression of related proteins were detected by Western blot.Results In HCT8 cells,compared with 0 μmol/L of galangin treatment,10,20,40 μmol/L of galangin treatment decreased the cell survival rate (P<0.05). In HCT8/5-FU cells,compared with 0 μmol/L galangin treatment,40 μmol/L of galangin treatment decreased the cell survival rate (P<0.05). After 10 and 20 μmol/L of galangin treatment,the apoptosis rate,and the expression of FOXO3 and Bax proteins were increased (P<0.05),while cell survival rate,clone formation number,and expression of FOXM1 and PCNA proteins decreased in HCT8 and HCT8/5-FU cells (P<0.05),and the MRP-1 protein expression in HCT8/5-FU cells decreased (P<0.05). Knocking down sh-FOXO3 could attenuate the effects of high dose of galangin on HCT8 and HCT8/5-FU cells (P<0.05). Conclusion Galangin may inhibit the proliferation,promote apoptosis,and reduce 5-FU resistance of CRC cells by regulating the FOXO3-FOXM1 axis.

Objective To analyze the correlation between right atrial strain at various stages and various influencing factors in patients with pulmonary hypertension,and to explore the role of right atrial strain in the assessment of pulmonary hypertension.Methods A total of 239 cases diagnosed with pulmonary hypertension who underwent echocardiography and complete right heart catheterization at hospital from October 2021 to December 2023 were included.Conventional ultrasound parameters such as right heart strain,right atrial area(RA area),inferior vena cava diameter(IVC diameter),and collapse rate of the inferior vena cava(IVC diameter changes)were measured.The heart rate(HR)corresponding to the ultrasound images were recorded.General information such as age and gender,as well as catheter data including mean right atrial pressure(mRAP),mean pulmonary artery pressure(mPAP),and pulmonary vascular resistance(PVR),were collected.The relationship between right atrial strain and its influencing factors was analyzed,and further analysis was conducted by dividing into shunt group and non-shunt group based on the presence or absence of left-to-right shunt disease.Results The correlation with RA reservoir strain(RASr)from high to low is RV global strain(RV4CSL),RV free wall strain(RVFWSL),RA area,IVC diameter,mRAP,age,HR,and PVR;the correlation with RAconduit strain(RAScd)from high to low is RV4CSL,RVFWSL,RA area,IVC diameter,mRAP,age,PVR,and HR;the correlation with RA contraction strain(RASct)from high to low is RA area,RV4CSL,RVFWSL,mRAP,IVC diameter,and HR.The collapse rate of the inferior vena cava is correlated with strain at various stages of the right atrium;gender is correlated with RASr and RASct.Conclusions Right atrial strain can reflect changes in right atrial function,with the highest correlation to right ventricular strain and right atrial area.Right atrial strain can indicate the severity of right ventricular function and right atrial remodeling,serving as an evaluative index for the condition and treatment outcomes of pulmonary arterial hypertension.

Objective To investigate the effects of galangin on the proliferation,apoptosis,and 5-fluorouracil (5-FU) resistance of colorectal cancer (CRC) cells by regulating the FOXO3-FOXM1 axis. Methods CRC cells HCT8 and its drug-resistant cell lines HCT8/5-FU were cultured in vitro,and then treated with different concentrations (0,5,10,20,40 μmol/L) of galangin to screen experimental concentra-tions. HCT8 cells were divided into the ctrl group (without special treatment),NC group (transfected with empty plasmid),L-galangin group (treated with 10 μmol/L of galangin ),H-galangin group (treated with 20 μmol/L of galangin),and H-galangin+sh-FOXO3 group (trans-fected with FOXO3 shRNA plasmid after 20 μmol/L of galangin treatment). HCT8/5-FU cells were divided into the control group (without special treatment),5-FU+NC group (treated with empty plasmid after 5 μg/mL of 5-FU treatment),5-FU group (treated with 5 μg/mL of 5-FU),5-FU+L-galangin group (treated with 10 μmol/L of galangin after 5 μg/mL of 5-FU treatment),5-FU+H-galangin group (transfected with 20 μmol/L galangin after 5 μg/mL of 5-FU treatment),and 5-FU+H-galangin+sh-FOXO3 group (transfected with FOXO3 shRNA plasmid after 5 μg/mL of 5-FU and 20 μmol/L of galangin treatment). The cell proliferation ability was detected by CCK-8 assay;the cell clone formation ability was detected by clone formation assay;the cell apoptosis was detected by flow cytometry;the expression of related proteins were detected by Western blot.Results In HCT8 cells,compared with 0 μmol/L of galangin treatment,10,20,40 μmol/L of galangin treatment decreased the cell survival rate (P<0.05). In HCT8/5-FU cells,compared with 0 μmol/L galangin treatment,40 μmol/L of galangin treatment decreased the cell survival rate (P<0.05). After 10 and 20 μmol/L of galangin treatment,the apoptosis rate,and the expression of FOXO3 and Bax proteins were increased (P<0.05),while cell survival rate,clone formation number,and expression of FOXM1 and PCNA proteins decreased in HCT8 and HCT8/5-FU cells (P<0.05),and the MRP-1 protein expression in HCT8/5-FU cells decreased (P<0.05). Knocking down sh-FOXO3 could attenuate the effects of high dose of galangin on HCT8 and HCT8/5-FU cells (P<0.05). Conclusion Galangin may inhibit the proliferation,promote apoptosis,and reduce 5-FU resistance of CRC cells by regulating the FOXO3-FOXM1 axis.

Antibiotic-associated diarrhea(AAD)in children is a type of diarrhea that occurs after the use of antibiotics in children,and its pathogenesis is closely related to the intestinal flora.The medication of antibiotics can affect the metabolic function of the intestinal flora and the immune function of the body,and then leads to the occurrence of AAD.In the view of Chinese medicine,AAD in children is mainly involved the spleen,and the etiology of the disease is due to the weakness of the spleen and stomach of the body constitution together with the attack of the pestilential pathogen and the accumulation of drug toxin.The pathogenesis of ADD in children is characterized by spleen deficiency with predominant dampness,deficiency of spleen qi,and insufficiency of spleen yang.Spleen deficiency is the root cause of pediatric AAD,and spleen and intestinal flora have commonality,so the treatment of pediatric AAD can be performed from the perspective of the spleen.The treatment of pediatric ADD from the spleen follows the principle of strengthening and activating the spleen,and the regulation of the spleen for achieving the purpose of treating the disease from the root can be achieved by the methods of strengthening spleen and draining dampness,strengthening spleen and replenishing qi,and strengthening spleen and warming yang separately with the fundamental prescriptions of Shenlin Baizhu Powder,Sijunzi Decoction,and Fuzi Lizhong Pills.

Objective To investigate the association between right atrial strain-area index(RASAI,the ratio of right atrial reservoir strain to right atrial area)and the prognosis of pulmonary arterial hypertension(PAH).Methods A total of 91 PAH patients who received treatment at Guangdong Provincial People's Hospital from October 2021 to April 2023 were included.Echocardiographic parameters,including right atrial strain and right atrial area,were measured.The association between the RASAI and PAH prognosis was analyzed.Results After a median follow-up of 17(12,26)months,19 adverse events occurred.Cox regression analysis revealed that for per unit increase in RASAI,the risk of adverse outcomes decreased by 40％(unadjusted model,HR 0.60,95％CI 0.40-0.91,P=0.016).This association remained statistically significant after multivariable adjustment(HR 0.50,95％CI 0.29-0.84,P=0.009).Results from tertile grouping and restricted cubic spline analysis further confirmed that RASAI has a dose-response relationship with adverse prognosis.Patients in the high RASAI group had significantly better prognosis than those in the low RASAI group(multivariable adjusted model,HR 0.21,95％CI 0.06-0.70,P=0.011).Conclusions The right atrial strain-area index is closely related to adverse prognosis and may serve as a potential indicator for therapeutic assessment and prognostic prediction.

Objective To investigate the association between right atrial strain-area index(RASAI,the ratio of right atrial reservoir strain to right atrial area)and the prognosis of pulmonary arterial hypertension(PAH).Methods A total of 91 PAH patients who received treatment at Guangdong Provincial People's Hospital from October 2021 to April 2023 were included.Echocardiographic parameters,including right atrial strain and right atrial area,were measured.The association between the RASAI and PAH prognosis was analyzed.Results After a median follow-up of 17(12,26)months,19 adverse events occurred.Cox regression analysis revealed that for per unit increase in RASAI,the risk of adverse outcomes decreased by 40％(unadjusted model,HR 0.60,95％CI 0.40-0.91,P=0.016).This association remained statistically significant after multivariable adjustment(HR 0.50,95％CI 0.29-0.84,P=0.009).Results from tertile grouping and restricted cubic spline analysis further confirmed that RASAI has a dose-response relationship with adverse prognosis.Patients in the high RASAI group had significantly better prognosis than those in the low RASAI group(multivariable adjusted model,HR 0.21,95％CI 0.06-0.70,P=0.011).Conclusions The right atrial strain-area index is closely related to adverse prognosis and may serve as a potential indicator for therapeutic assessment and prognostic prediction.

Urethral stricture is characterized by the chronic formation of fibrous tissue, leading to the narrowing of the urethral lumen. Despite the availability of various endoscopic treatments, the recurrence of urethral strictures remains a common challenge. Postsurgery pharmacotherapy targeting tissue fibrosis is a promising option for reducing recurrence rates. Although drugs cannot replace surgery, they can be used as adjuvant therapies to improve outcomes. In this regard, many drugs have been proposed based on the mechanisms underlying the pathophysiology of urethral stricture. Ongoing studies have obtained substantial progress in treating urethral strictures, highlighting the potential for improved drug effectiveness through appropriate clinical delivery methods. Therefore, this review summarizes the latest researches on the mechanisms related to the pathophysiology of urethral stricture and the drugs to provide a theoretical basis and new insights for the effective use and future advancements in drug therapy for urethral stricture.

AIM: Lipopolysaccharide (LPS) on the cell membrane of gram negative bacteria is closely related to the occurrence and development of severe acute pancreatitis (SAP). Local and systemic monocyte / macrophages play an important role in the inflammatory process of SAP. Artesunate (AS) was reported to protect rats with severe acute pancreatitis by reducing the release of proinflammatory cytokines. This study further explored the molecular mechanism of anti-inflammatory effect of AS. METHODS: The release of proinflammatory cytokines in the supernatant were studied by enzyme-linked immunosorbent assay. Then, the mRNA expressions of PI3K-III and its key molecules in signaling pathway were detected by real-time quantitative PCR. Finally, the phosphorylation levels of PI3KIII were detected by Western blot. RESULTS: AS could significantly inhibit the release of proinflammatory cytokines from mouse macrophage induced by LPS. Autophagy inhibitor 3-methyladenine (3-MA) could significantly inhibit the release of TNF-α from mouse macrophages induced by LPS; LPS significantly increased the mRNA expression of PI3KIII and its key molecules in mouse peritoneal macrophages (PMs). Finally, AS could significantly inhibit the increase of PI3K-III phosphorylation induced by LPS in PMs. CONCLUSION: The anti-inflammatory mechanism of AS is closely related to the inhibition of PI3K-III phosphorylation.