Objective:This study aims to evaluate the nasal structural and electrophysiological features of patients with postoperative olfactory dysfunction following aesthetic rhinoplasty.Methods:We retrospectively analyzed the clinical features of 30 outpatients (females, aged 33±6 years) from Beijing Anzhen Hospital and China-Japan Friendship Hospital between 2014 and 2023, who complained of olfactory dysfunction following aesthetic rhinoplasty. The control group was 30 healthy females aged 32±9 years. Psychophysical olfactory test (Sniffin′ Sticks, SS), olfactory and trigeminal event-related potentials (oERPs and tERPs), and acoustic rhinometry were used for evaluating the olfactory function and nasal structure in patients and healthy controls. SPSS 17.0 software was used to compare the difference in olfactory function and nasal structure between the two groups and to analyze the factors related postoperative olfactory dysfunction.Results:There was a significant difference in the scores on psychophysical olfactory test between the patients and controls (10.78±3.90 vs. 33.66±2.42, t=-23.35, P<0.001). ERPs could be evoked in all patients and controls. Patients showed higher amplitudes of N 1 waves in both oERPs and tERPs than controls ( P<0.05 for all), but no differences in the latencies of N 1 and P 2 waves or in the amplitudes of P 2 waves were observed between the two groups ( P>0.05 for all). There was no difference in nasal structure between the two groups ( P>0.05). However, after nasal decongestant, mucosal congestion in the cross-sectional area (CSA) from the nostril to 6 cm level was found more significantly in patients than controls (nasal congestion index 40.00% vs. 1.00%, t=2.09, P=0.047). Better olfactory function was associated with increasing nasal volumes, increasing nasal threshold and anterior nasal turbinate plane CSA( P<0.05 for all). Conclusion:The important factor related to olfactory dysfunction following aesthetic rhinoplasty may be attributed to local mucosal congestion, rather than nasal structural alteration or neurophysiologic deficits in the olfactory pathway.

Objective:This study aims to evaluate the nasal structural and electrophysiological features of patients with postoperative olfactory dysfunction following aesthetic rhinoplasty.Methods:We retrospectively analyzed the clinical features of 30 outpatients (females, aged 33±6 years) from Beijing Anzhen Hospital and China-Japan Friendship Hospital between 2014 and 2023, who complained of olfactory dysfunction following aesthetic rhinoplasty. The control group was 30 healthy females aged 32±9 years. Psychophysical olfactory test (Sniffin′ Sticks, SS), olfactory and trigeminal event-related potentials (oERPs and tERPs), and acoustic rhinometry were used for evaluating the olfactory function and nasal structure in patients and healthy controls. SPSS 17.0 software was used to compare the difference in olfactory function and nasal structure between the two groups and to analyze the factors related postoperative olfactory dysfunction.Results:There was a significant difference in the scores on psychophysical olfactory test between the patients and controls (10.78±3.90 vs. 33.66±2.42, t=-23.35, P<0.001). ERPs could be evoked in all patients and controls. Patients showed higher amplitudes of N 1 waves in both oERPs and tERPs than controls ( P<0.05 for all), but no differences in the latencies of N 1 and P 2 waves or in the amplitudes of P 2 waves were observed between the two groups ( P>0.05 for all). There was no difference in nasal structure between the two groups ( P>0.05). However, after nasal decongestant, mucosal congestion in the cross-sectional area (CSA) from the nostril to 6 cm level was found more significantly in patients than controls (nasal congestion index 40.00% vs. 1.00%, t=2.09, P=0.047). Better olfactory function was associated with increasing nasal volumes, increasing nasal threshold and anterior nasal turbinate plane CSA( P<0.05 for all). Conclusion:The important factor related to olfactory dysfunction following aesthetic rhinoplasty may be attributed to local mucosal congestion, rather than nasal structural alteration or neurophysiologic deficits in the olfactory pathway.

ObjectiveTo study the chemical constituents of the seeds of Sophora tonkinensis. MethodThe chemical constituents were isolated and purified by chromatography with MCI resin， silica gel， Sephadex LH-20， and semi-preparative high performance liquid chromatography. Their structures were identified by physicochemical properties， spectral data as well as relevant references. Meanwhile， the antibacterial activities against Helicobacter pylori of these compounds were screened by agar dilution method. ResultA total of 22 compounds were isolated from the methanol extract of the seeds of S. tonkinensis， and characterized as 4′，7-dihydroxy-6-methoxy isoflavone （1）， daidzein （2）， wighteone （3）， dalparvone （4）， 5，7-dihydroxy-4′-methoxyisoflavone （5）， prunetin （6）， formononetin （7）， genistein （8）， 5-methoxydaidzein （9）， ononin （10）， 7，4′-dihydroxyflavone （11）， liquiritigenin （12）， bayin （13）， 2，4-dihydroxybenzoate （14）， methyparaben （15）， 4-hydroxyacetophenone （16）， p-anisaldehyde （17）， methyl indole-3-carboxylate （18）， 4-［β-D-apiofuranoyl-（1→6）-O-β-D-glucopyranosyloxy］ phenylacetonitrile （19）， （-）-methyl dihydrophaseate （20）， methyl canavaliol ester （21）， vomifoliol 3′-O-β-D-apiofuranosyl-（1→6）-β-D-glucopyranoside （22）. ConclusionCompounds 1， 5， 6， 9 and 16 are isolated from S. tonkinensis for the first time， compounds 4， 14， 17-22 are isolated from the genus of Sophora for the first time. In addition， compounds 10 and 13 display moderate antibacterial activities against H. pylori.

The present study analyzed the correlations between curcumin(Cur), nuclear factor E2 related factor 2(NRF2)-dimethylarginine dimethylaminohydrolase(DDAH)-asymmetric dimethylarginine(ADMA)-nitric oxide(NO) pathway, and endothelial-mesenchymal transition(EndMT) based on SD rats with cardiac fibrosis, and explored the effect and mechanism of Cur in resisting cardiac fibrosis to provide an in-depth theoretical basis for its clinical application in the treatment of heart failure. The cardiac fibrosis model was induced by subcutaneous injection of isoprenaline(Iso) in rats. Thirty-two rats were randomly divided into a control group, a model group, a low-dose Cur group(100 mg·kg~(-1)·d~(-1)), and a high-dose Cur group(200 mg·kg~(-1)·d~(-1)), with eight in each group. After 21 days of treatment, cardiac function was detected by echocardiography, degree of cardiac fibrosis by Masson staining, expression of CD31 and α-SMA by pathological staining, expression of VE-cadherin, vimentin, NRF2, and DDAH by Western blot, and ADMA level by HPLC. Compared with the model group, the Cur groups showed alleviated cardiac fibrosis, accompanied by increased CD31 and VE-cadherin expression and decreased α-SMA and vimentin expression, indicating relieved EndMT. Additionally, DDAH and NRF2 levels were elevated and ADMA and NO expression declined. Cur improves cardiac fibrosis by inhibiting EndMT presumedly through the NRF2-DDAH-ADMA-NO pathway.
Amidohydrolases/metabolism* ; Animals ; Curcumin ; Fibrosis ; NF-E2-Related Factor 2/genetics* ; Nitric Oxide/metabolism* ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease. OBJECTIVE: This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m MAIN OUTCOME MEASURES: The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment. RESULTS: A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group. CONCLUSION: SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone. TRIAL REGISTRATION NUMBER NCT02063100 on ClinicalTrials.gov.

BACKGROUND: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. In this study, we aimed to identify the risk factors for severe COVID-19 to improve treatment guidelines. METHODS: A multicenter, cross-sectional study was conducted on 313 patients hospitalized with COVID-19. Patients were classified into two groups based on disease severity (nonsevere and severe) according to initial clinical presentation. Laboratory test results and epidemiological and clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression models were used to detect potential risk factors associated with severe COVID-19. RESULTS: A total of 289 patients (197 nonsevere and 92 severe cases) with a median age of 45.0 (33.0, 61.0) years were included in this study, and 53.3% (154/289) were male. Fever (192/286, 67.1%) and cough (170/289, 58.8%) were commonly observed, followed by sore throat (49/289, 17.0%). Multivariate logistic regression analysis suggested that patients who were aged ≥ 65 years (OR: 2.725, 95% confidence interval [CI]: 1.317-5.636; P = 0.007), were male (OR: 1.878, 95% CI: 1.002-3.520, P = 0.049), had comorbid diabetes (OR: 3.314, 95% CI: 1.126-9.758, P = 0.030), cough (OR: 3.427, 95% CI: 1.752-6.706, P < 0.001), and/or diarrhea (OR: 2.629, 95% CI: 1.109-6.231, P = 0.028) on admission had a higher risk of severe disease. Moreover, stratification analysis indicated that male patients with diabetes were more likely to have severe COVID-19 (71.4% vs. 28.6%, χ2 = 8.183, P = 0.004). CONCLUSIONS The clinical characteristics of those with severe and nonsevere COVID-19 were significantly different. The elderly, male patients with COVID-19, diabetes, and presenting with cough and/or diarrhea on admission may require close monitoring to prevent deterioration.
Adult ; COVID-19/pathology* ; China/epidemiology* ; Comorbidity ; Cough ; Cross-Sectional Studies ; Diarrhea ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

Objective: To explore the efficacy and feasibility of transanal hand-sewn reinforcement of low stapled anastomosis in preventing anastomotic leak after transanal total mesorectal excision (taTME). Methods: A descriptive cohort study was conducted. Clinical data of 51 patients with rectal cancer who underwent taTME with transanal hand-sewn reinforcement of low stapled anastomosis at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2020 were retrospectively collected. Inclusion criteria: (1) age >18 years old; (2) rectal cancer confirmed by preoperative pathology; (3) distance from tumor to anal verge ≤ 8 cm according to pelvic MR; (4) the lesion was evaluated to be resectable before operation; (5) with or without neoadjuvant chemotherapy and radiotherapy; (6) taTME, end-to-end stapled anastomosis, and reinforcement in the anastomosis with absorbable thread intermittently were performed, and the distance between anastomosis and anal verge was ≤ 5 cm. Exclusion criteria: (1) previous history of colorectal cancer surgery; (2) emergency surgery due to intestinal obstruction, bleeding or perforation; (3) patients with local recurrence or distant metastasis; (4) the period of postoperative follow-up less than 3 months. The procedure of transanal hand-sewn reinforcement was as follows: firstly, no sign of bleeding was confirmed after checking the anastomosis. Then, the anastomosis was reinforced by suturing the muscle layer of rectum intermittently in a figure-of-eight manner using 3-0 single Vicryl. The entry site of the next suture was close next to the exit site of the last one. Any weak point of the anastomosis could also be reinforced according to the specimen from the circular stapler. The primary outcome were the incidence of anastomotic leak, methods of the secondary operation, anastomotic infection, anastomotic stricture, and conditions of Intraoperative and postoperative. Results: All the 51 enrolled patients completed surgery successfully without any conversion to open surgery. The median operative time was 169 (109-337) minutes, and the median intraoperative blood loss was 50 (10-600) ml. The median postoperative hospital stay was 8 (5-16) days. The mssorectum was complete and distal resection margin was negative in all patients. Postive circumferential resection margin was observed in 1 patients (2.0%). Twelve (23.5%) patients underwent prophylactic ileostomy. One patient developed anastomosis stricture which was cured by digital dilatation of the anastomosis. ISREC grade C anastomotic leak was observed in 3 (5.9%) male patients, of whom 2 cases did not received prophylactic ileostomy during the operation, and were cured by a second operation with the ileostomy and anastomotic repair. The other one healed by transanal repair of the anastomosis and anti-infection therapy. One (2.0%) patient suffered from perianal infection and healed by sitz bath and anti-infection therapy. No death was reported within 30 days after operation. Conclusion: Transanal hand-sewn reinforcement in low rectal stapled anastomosis in preventing anastomotic leak after taTME is safe and feasible.
Adolescent ; Anal Canal/surgery* ; Anastomosis, Surgical ; Anastomotic Leak/prevention & control* ; Cohort Studies ; Humans ; Laparoscopy ; Male ; Postoperative Complications/prevention & control* ; Rectal Neoplasms/surgery* ; Rectum/surgery* ; Retrospective Studies ; Treatment Outcome

AIM: To investigate whether neural stem cell-derived exosomes promote the viability and inhibit the apoptosis of neurons under cobalt chloride(CoCl2)-induced hypoxia in vitro.METHODS:The exosomes were isolated based on ultracentrifugation.The exosomal markers,ALG-2-interacting protein X(Alix)and tumor susceptibility gene 101 (TSG101)were identified by Western blot.The shape of exosomes was observed under transmission electron microscope (TEM).The size distributions of exosomes were analyzed by nanoparticle analysis(qNano).The neurons were exposed in CoCl2at different doses(200~600 μmol/L)for 24 h.The exosomes were co-cultured with the neurons pre-treated with CoCl2.The viability and apoptosis of the neurons were measured by CCK-8 assay and TUNEL method.RESULTS: The exosomes released from the neural stem cells expressed exosomal markers Alix and TSG 101.They also displayed a cup-shaped appearance observed under TEM and their sizes were(95.0 ±23.5)nm(n=370).The neuronal viability was sig-nificantly inhibited by CoCl 2in a dose-dependent manner(P<0.05).After treatment with exosomes,the viability of the neuron pre-treated with CoCl2was increased and the apoptotic rate was decreased(P<0.05).CONCLUSION: Neural stem cell-derived exosomes promote the viability and inhibit the apoptosis of rat neurons uneder hypoxia.

BACKGROUND:To invent a novel cardiopulmonary resuscitation (CPR) time point recorder to synchronously and automatically record the time and to identify its effectiveness in humans. METHODS:A CPR time point recorder was invented after the doctors were familiar with the traditional Utstein recovery registration mode and mastered the registration time points required. The progress of CPR was simulated. The standard and correct times were recorded, and the doctors performing the recovery collected the data about the times using our CPR time point recorder or the memory registration mode. RESULTS:The deviation times were 21.4±24.7 seconds for the memory group and 3.57±4.58 seconds for CPR time point recorder group. The deviation of times increased significantly depending on the increase of the operation items in the memory group. A similar phenomenon was found in the timer group but with a smaller difference (P<0.01). CONCLUSION: A CPR time point recorder could reduce the deviation of operate-time, especially after a long-time operation, and for procedures with more operating items, compared with the memory mode. It was a more advantageous and accurate method for the Utstein registration.