Sarcopenia is an age-related syndrome characterized by progressive and widespread loss of skeletal muscle mass and/or decline in muscle function.Its incidence increases year by year with aging and is influenced by multiple factors,including genetic background,lifestyle,nutritional status,and chronic diseases.Recent studies have revealed a significant correlation between sarcopenia and chronic coronary syndromes(CCS),not only in terms of the frequency of occurrence but also the se-verity of the conditions.Moreover,sarcopenia and CCS share common pathogenic mechanisms,en-compassing various pathophysiological processes such as chronic inflammation,oxidative stress,apop-tosis,and insulin resistance.This article aimed to review the current research progress on comorbidity relationship between sarcopenia and CCS,explore their shared pathophysiological basis,and discuss their impacts on clinical prognosis.

Humans ; Atrial Fibrillation/surgery* ; Left Atrial Appendage Closure ; Heart Atria/surgery* ; Catheter Ablation/methods* ; Atrial Appendage/surgery* ; Treatment Outcome

The radial artery pulse wave contains a wealth of physiological and pathological information about the human body, and non-invasive studies of the radial artery pulse wave can assess arterial vascular elasticity in different age groups.The piezoelectric pulse wave transducers were used to non-invasively acquire radial artery pulse waves at different contact pressures in young and middle-aged and elderly populations. The radial artery waveforms were decomposed using a triangular blood flow model fitting method to obtain forward and reflected waves and calculate reflection parameters. Finally a correlation analysis and regression analysis of the contact pressure P_sensor with the reflection parameters was carried out. The results showed that the reflection parameters RM, RI and R_d had a strong negative correlation with P_sensor in both types of subjects, and the correlation coefficients and slopes of the regression curves were significantly different between the two types of subjects (P<0.05). Based on the results of this study, excessive contact pressure on the transducer should be avoided when detecting radial artery reflection waves in clinical practice. The results also show that the magnitude of the slope of the regression curve between the reflection parameters and the transducer contact pressure may be a potentially useful indicator for quantifying the elastic properties of the vessel.
Middle Aged ; Aged ; Humans ; Blood Pressure/physiology* ; Arteries ; Blood Flow Velocity/physiology* ; Elasticity ; Pulse Wave Analysis ; Radial Artery/physiology*

Objective To analyze the influence of round window lesion on dynamic responses from the middle ear. Methods Based on CT scan images of healthy human ear, the three-dimensional finite element model of human ear was rebuilt by PATRAN software, then NASTRAN software was applied to conduct coupled solid-fluid frequency response analysis. The feedback of round window lesion on dynamic response of the middle ear was investigated by numerical simulation. Results Round window closure caused by sclerosis led to more decline in amplitude of stapes than congenital round window closed, maximally can reach 30.2 dB, and the latter had no obvious influence on velocity of stapes. In term of phase angle, on condition of sclerosis, change of phase for stapes and round window reached 90° at most and kept a difference value of 180°. In contrast, on condition of congenital round window closed, change of phase for stapes reached 270° at most，meanwhile change of phase for round window disappeared. Conclusions The dynamic response of the middle ear showed different feedback to congenital and otosclerotic round window fixation based on amplitude, velocity and phase. The research findings provide the theoretical basis for diagnosing and fixing round window lesion in future.

Objeetive To compare the clinical value of early enteral nutrition (EEN) and combined enteral nutrition (EN) and parenteral nutrition (PN) in patients with hepatocellular carcinoma (HCC) after precise hepatectomy.Methods The prospective study was conducted.The clinical data of 60 HCC patients who underwent precise hepatectomy in the Affiliated Drum Tower Hospital of Nanjing University Medical School between January 2013 and December 2014 were collected.All patients were allocated into the EN group and combined EN+PN group by random number table method.Patients in the EN group and combined EN+PN group respectively received EEN and early combined EN+PN at 24 hours postoperatively for 7 days,total nutrient intakes between groups were consistent,with an average daily intake of nitrogen-feeding of 0.2 g/(kg · d) and an average daily intake of nonprotein calories of 25 kcal/(kg · d).Observation indicators:(1) comparison of nutritional indexes between groups;(2) comparison of liver function between groups;(3) comparison of postoperative conditions between groups.Measurement data with normal distribution were represented as-x±s.Comparisons at the same time between groups were respectively analyzed using the group-design t test.Comparisons of count data were analyzed using the chi-square test.Ordinal data were analyzed by the nonparametric test.Comparison of repeated measurement data were done using the repeated measures ANOVA.Results Sixty patients were screened for eligibility,and 30 in each group.(1) Comparison of nutritional indexes between groups:levels of albumin (Alb),globulin,prealbumin and hemoglobin (Hb) and lymph nodes count in the EN group were respectively (41±4)g/L,(28±4) g/L,(188±37) mg/L,(139± 17) g/L,(1.6±0.6) × 109/L before operation and (32±4) g/L,(23±5)g/L,(114±41)mg/L,(121±19)g/L,(1.1±0.7) ×109/L at 1 day postoperative1y and (34±5)g/L,(26±4) g/L,(169± 41) mg/L,(113 ± 16) g/L,(1.9 ± 1.1) × 109/L at 8 days postoperatively,with statistically significant differences in above indexes (F=2.23,4.45,8.96,5.21,2.18,P＜0.05).There were statistically significant differences in above indexes between pre-operation and 1 day postoperatively (t =9.79,8.53,9.81,4.56,5.77,P＜0.05) and between 1 and 8 days postoperatively (t =5.55,6.31,4.69,3.99,8.26,P＜0.05).There were statistically significant differences in levels of Alb,globulin,prealbumin and Hb between pre-operation and 8 days postoperatively (t=3.48,5.12,6.37,8.20,P＜0.05) and no statistically significant difference in lymph nodes count (t =2.48,P＞0.05).Levels of Alb,globulin,prealbumin and Hb and lymph nodes count in the combined EN+PN group were respectively (42±4)g/L,(28±6)g/L,(188±29)g/L,(142±16)g/L,(1.6±0.6)×109/L before operation and (31±5)g/L,(20±5) g/L,(96±31) g/L,(124± 16) g/L,(0.9±0.4) × 109/L at 1 day postoperatively and (34±4)g/L,(24±4)g/L,(143±18)g/L,(115±18)g/L,(1.4±0.7)×109/L at 8 days postoperatively,with statistically significant differences in above indexes (F=3.21,7.35,4.36,7.78,3.19,P＜0.05).There were statistically significant differences in above indexes between pre-operation and 1 day postoperatively (t =11.95,5.38,9.91,4.84,6.22,P＜0.05) and between 1 and 8 days postoperatively (t =9.45,7.66,4.98,3.15,4.79,P＜ 0.05).There were statistically significant differences in levels of Alb,globulin,prealbumin and Hb between pre-operation and 8 days postoperatively (t=9.31,8.44,6.57,5.25,P＜0.05).There were no statistically significant difference in lymph nodes count (t =3.11,P＞ 0.05) and in changing trends of Alb,globulin,prealbumin,Hb and lymph nodes count (F=8.54,3.83,7.21,6.33,3.91,P＞0.05).Levels of prealbumin at 8 days postoperatively were statistically different between groups (t =3.00,P＜0.05).(2) Comparison of liver function between groups:levels of alanine transaminase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),glutamyl-transpeptidase (GGT),total bilirubin (TBil),direct bilirubin (DBil) and C-reactive protein (CRP) in the EN group were respectively (44±37)U/L,(44±30) U/L,(90± 29) U/L,(85 ± 49) U/L,(15.7± 5.4) μmol/L,(4.6± 2.3) μmol/L,(4.5 ± 3.2) mg/L before operation and (411±375)U/L,(379±323)U/L,(68±26)U/L,(55±49)U/L,(20.3±10.7)μmol/L,(7.8±5.5) μmol/L,(47.9± 30.6) mg/L at 1 day postoperatively and (107± 58) U/L,(43± 21) U/L,(100± 42) U/L,(111±71)U/L,(19.7±10.6) μmol/L,(8.8±5.9) μmol/L,(28.3±23.0) mg/L at 8 days postoperatively,with statistically significant differences in above indexes among pre-operation,1 and 8 days postoperatively (F=5.48,9.44,1.73,5.03,8.42,6.09,6.69,P＜0.05) and between pre-operation and 1 day postoperatively (t=5.12,5.36,5.35,0.45,2.88,3.82,6.95,P＜ 0.05).There were statistically significant differences in levels of ALT,TBil,DBil and CRP between pre-operation and 8 days postoperatively (t =6.71,4.14,5.96,6.33,P＜0.05) and in levels of ALT,AST,ALP,GGT and CRP between 1 and 8 days postoperatively (t =6.23,5.55,3.14,3.56,4.99,P＜0.05).There were no statistically significant difference in levels of AST,ALP and GGT (t =0.13,0.98,1.11,P＞0.05) and in levels of TBil and DBil (t =0.08,0.23,P＞0.05).Levels of ALT,AST,ALP,GGT,TBil,DBil and CRP in the combined EN+PN group were respectively (41±38) U/L,(43±25) U/L,(100±89) U/L,(106±46) U/L,(17.9±9.8) μmol/L,(6.2±3.6) μmol/L,(3.7±2.3)mg/L before operation and (462±409)U/L,(494±162)U/L,(73±53)U/L,(75±57)U/L,(28.1±18.8)μmol/L,(9.1±6.1) μmol/L,(40.7±26.2) mg/L at 1 day postoperatively and (90±47) U/L,(42± 16) U/L,(95±40) U/L,(110±66) U/L,(22.5± 14.5) μmol/L,(8.2±8.1) μmol/L,(26.9±24.6) mg/L at 8 days postoperatively,with statistically significant differences in above indexes among pre-operation,1 and 8 days postoperatively (F=5.96,3.73,6.94,3.88,7.97,4.14,5.25,P＜0.05) and between before operation and 1 day postoperatively (t=5.72,4.96,3.95,0.88,2.83,4.13,6.11,P＜0.05).There were statistically significant differences in levels of ALT and CRP between pre-operation and 8 days postoperatively (t =4.22,6.77,P＜0.05) and in levels of ALT,AST,ALP and GGT between 1 and 8 days postoperatively (t=7.01,5.21,4.38,6.15,P＜0.05).There were no statistically significant difference in levels of AST,ALP,GGT,TBil and DBil (t =0.29,1.65,1.92,0.33,P＞0.05) and in levels of TBil,DBil and CRP (t =0.09,0.37,0.58,P＞0.05).There was no statistically significant difference in changing trends of ALT,AST,ALP,GGT,TBil,DBil and CRP of 2 groups (F=7.18,2.23,3.94,5.88,4.72,2.17,6.53,P＞0.05) and in above indexes among pre-operation,1 and at 8 days postoperatively (t=0.27,0.42,0.91,0.12,0.96,0.24,0.59,0.32,0.49,1.27,0.88,0.07,1.07,1.45,0.23,1.11,0.88,0.32,0.35,0.93,0.21,P＞0.05).(3) Comparison of postoperative conditions between groups:times of initial defecation were respectively (3.2± 1.0) days and (4.2± 1.2) days in the EN group and combined EN +PN group,showing a statistically significant difference (t =3.21,P＜ 0.05).Conclusion EEN and combined EN+PN are safe and feasible in HCC patients after precise hepatectomy,and also can improve liver function recovery,but EEN has advantages of promoting protein synthesis and gastrointestinal function recovery.

Objective To analyzed the therapeutic effect of piperacillin sodium and sulbactum sodium(PIP/SBT)for injection in children bronchopneumonia.Methods 162 bronchopneumonia children who were admitted to pediatrics department during January 2014 to January 2016 were enrolled for this study and randomly divided into the observation group and the control group.The observation group received piperacillin sodium and sulbactum sodium therapy, while the control group received azithromycin.The symptom scores of coughing, wheezing, wheezing sound and the difficulty of expectoration in the 3rd day and 7th day were compared.The therapeutic effect of the two groups were evaluated.Results The observation group and the control group could both improve the symptom scores of coughing, wheezing, wheezing sound and the difficulty of expectoration in the 3rd day and 7th day, while the scores of observation group were significantly lower than the control ones.And the effective rate of observation group(97.5%)was significantly higher than the control one(90.1%).Conclusion Piperacillin sodium and sulbactum sodium(PIP/SBT)for injection had significantly clinical effect applying in children bronchopneumonia treatment, which was worthy of further popularization and application.

Objective To investigate the clinical efficacy of intraoperative methylprednisolone used in combination with perioperative enteral nutrition support in improving liver synthetic function after hepatectomy and postoperative recovery.Methods In this prospective controlled trial,79 patients treated with hepatectomy at Departement of Hepatobiliary Pancreatic Surgery in Drum Tower Hospital between June 2013 and May 2014 were included and divided into control group (n =39) and steroid group (n =40) according to the order of surgery.The control group underwent hepatectomy only,while the steroid group received intraoperative methylprednisolone (500 mg) at the start of liver excision.Both of the two groups were given the same perioperative enteral nutrition support.Liver function,prealbumin (PA),and C-reactive protein (CRP) levels were measured before and on days 1,3,and 5 after the operation.Human blood albumin infusion volume,postoperative gas passing,postoperative hospital stay,and incidence of complications were recorded.Results The serum level of PA on day 3 after hepatectomy was significantly higher in the steroid group than in the control group [(101.26 ±61.17) mg/L vs.(81.84 ±43.58) mg/L,t =-1.607,P =0.049].The serum level of cholinesterase on day 1 after hepatectomy was significantly higher in the steroid group than in the control group [(5.60±1.54) kU/Lvs.(4.68±1.01) kU/L,t=-3.136,P=0.004].On day1 and day 3 after hepatectomy,the serum levels of CRP were significantly lower in the steroid group than in the control group [(41.79 ±20.86) mg/L vs.(62.08 ±38.33) mg/L,t =2.933,P=0.027;(64.14 ±32.38) mg/L vs.(102.64 ± 49.05) mg/L,t =4.127,P =0.006].The postoperative hospital stay was significantly shorter in the steroid group than in the control group [(12.62 ±5.74) d vs.(15.41 ± 10.00)d,t =1.514,P =0.002].Conclusion Intraoperative use of methylprednisolone combined with perioperative enteral nutrition support may inhibit postoperative inflammatory response,promote early recovery of liver synthetic function,and help to promote rehabilitation after hepatectomy.

Objective To explore the effect ofhypoxic preconditioning (HPC) on the expression of sphingosine kinase-1 (SphK-1) and blood-brain barrier (BBB) permeability in rats after traumatic brain injury (TBI).Methods Two hundred and four SD rats were randomly assigned into TBI group (n=96),HPC group (giving HPC and TBI,n=96) and blank control group (n=12).The rats in the TBI group were subjected to TBI with freefall impact method,while the rats of HPC group were treated with the same methods after HPC (50.47 kpa,3 d,3 h/d).And then,they were sacrificed at each time point (1,4,8 and 12 h,and 1,3,7 and 14 d after injury).RT-PCR and Western blotting were employed to detect the mRNA and protein expression changes of SphK-1 in brain contusion area at each time points after injury.Immumohistochemical staining (IgG method) was used to detect the BBB permeability changes of the rats.Results IgG scores and Sphk-1 mRNA and protein expressions in rats of TBI group and HPC group began to increase at 1 h after injury and reached the highest level 1 d after injury; they were still higher than the normal levels,with significant differences (P＜0.05); SphK-1 mRNA and protein expressions in all the three groups had the same increased trend at all the time points excepted on the 14th d of injury,with significant differences (P＜0.05).IgG scores showed that the BBB permeability in the TBI group at each time point was significantly higher than that in the HPC group (P＜0.05).Conclusion Hypoxic preconditioning can increase SphK-1 expressions after TBI to promote sphingosine 1-phosphate sphingosine transformation so as to protect of the integrity of BBB.

Objective To evaluate the effects of aspirin-triggered lipoxin A4 (ATL) on lipopolysaccharide (LPS)-induced acute lung injury in mice.Methods Thirty male SPF BALB/C mice,aged 10-12 weeks,weighing 25-30 g,were randomly assigned into 3 groups (n =10 each):normal saline group (group NS),LPS group and ATL groups.ATL 0.1 ml was injected via the tail vein 1 h after intra-tracheal instillation of 3 mg/kg LPS in LPS group.In ATL group,ATL 0.2 mg/kg was injected via the tail vein 1 h after intra-tracheal instillation of 3 mg/kg LPS.At 24 h after instillation,the mice were sacrificed.Bronchoalveolar lavage fluid was collected for determination of the total cell count,proportion of the polymorphonuclear leukocytes,proportion of the mononuclear leukocytes,and concentrations of the total protein,TNF-αt,IL-6,monocyte chemoattractant protein-1 (MCP-1) and IL-10.Lungs were removed for determination of myeloperoxidase (MPO) activity,phosphorylation of p38 mitogenactivated protein kinase (p38 MAPK),c-Jun N-terminal kinase (JNK),and extracellular signal-regulated kinase 1/2 (ERK1/2) in lung tissues and for microscopic examination.The pathological changes of lungs were scored.Results Compared with NS group,the lung injury scores,total cell counts,proportion of polymorphonuclear leukocytes,and concentrations of TNF-α,IL-6 and MCP-1 were significantly increased,and the proportion of mononuclear leukocytes was decreased in LPS and ATL groups,and IL-10 concentrations were decreased,and the concentrations of the total protein,MPO activity,and phosphorylation of p38 MAPK,JNK and ERK1/2 were significantly increased in group LPS (P ＜ 0.05),and no significant change in the concentrations of the total protein,MPO activity,phosphorylation of p38 MAPK,JNK and ERK1/2 was found in group ATL (P ＞ 0.05).Compared with LPS group,the lung injury scores,total cell counts,proportion of polymorphonuclear leukocytes and the concentrations of the total protein,TNF-α,IL-6 and MCP-1 were significandy decreased,the proportion of mononuclear leukocytes and IL-10 concentration were increased,and MPO activity and phosphorylation of p38 MAPK and JNK were decreased (P ＜ 0.05),and no significant change in the phosphorylation of ERK1/2 was found in group ATL (P ＞ 0.05).Conclusion ATL can ameliorate LPS-induced acute lung injury by inhibiting activations of p38MAPK and JNK signal pathways in mice.

[Objective]To investigate the effects of YIGUTANG contaning serum on osteoblasts proliferation which was from the skull of newborn SD rat in vitro.[Methods] The osteoblast from newborn SD rats’skull adopted, take the method of collagenase-pancreatic enzyme digestion,then respectively culture these osteoblasts with different concentration of the YIGUTANG drug containing serum fluid together.[Results]YIGUTANG drug containing serum could stimulate the proliferation of osteoblast, and the high,the middle and the low concentrations groups contrasted with the control group, all could promote the proliferation of cell .The drug containing serum groups had insignificant difference from the blank control group(P