This article introduces the experience of Academician SHI Xuemin in treatment of stroke combined with obstructive sleep apnea hypopnea syndrome. It is believed that this disease is the syndrome of "stroke of lung qi exhaustion". It is rooted at the deficiency of primary qi, and lung qi declining; and characterized by phlegm stagnation, qi reversion and mind blockage. This disease is manifested as somnolence-like symptoms, snoring-like breathing and sawing-like expectorating. The therapeutic regimen focuses on "governing qihai (sea of qi ), regulating the spirit and adjusting the orifice closure". The main acupoints include Neiguan (PC6), Shuigou (GV26) and Sanyinjiao (SP6) to regain the consciousness and open the orifices. Besides, Renying (ST9) is added to regulate the respiration, Baihui (GV20) and Sishencong (EX-HN1) to harmonize the spirit, and Fengchi (GB20), Wangu (GB12) and Yifeng (TE17) to open the orifice for the treatment of symptoms. It provides a new idea for the clinical diagnosis and treatment of stroke with accompanying symptoms.
Humans ; Sleep Apnea, Obstructive/complications* ; Acupuncture Therapy ; Stroke/physiopathology* ; Male ; Acupuncture Points ; Female ; Middle Aged ; Qi ; Aged ; Lung/physiopathology* ; Snoring/physiopathology* ; Adult ; Drugs, Chinese Herbal/administration & dosage*

OBJECTIVES: To compare perioperative and mid-term results of multiple versus single arterial off-pump coronary artery bypass grafting (OPCABG) in patients with impaired left ventricular function. METHODS: This study was conducted among 86 patients with a left ventricular ejection fraction (LVEF) <50%, who underwent OPCABG at our hospital between January, 2018 and December, 2021. Of these patients, 22 underwent OPCABG with multiple arterial grafts (multiple graft group) and 64 received a single arterial graft in OPCABG (single graft group). The preoperative, intraoperative, and perioperative data were collected, and the patients were followed up for a mean of 29.28±14.84 months. The perioperative outcomes and follow-up results of the patients were compared, and the factors influencing major adverse cardiovascular events (MACE) were identified using logistic regression. Kaplan-Meier analysis was used to compare the postoperative survival rate without MACE. RESULTS: The patients in multiple graft group had a significantly younger age than those in single graft group (P<0.05), but the other baseline data were similar between the two groups (P>0.05). Perioperative mortality, 24-h postoperative drainage volume, length of ICU stay, intubation time, and the incidence of new-onset atrial fibrillation were all similar between the two groups (P>0.05), but the rate of postoperative hypotension was significantly higher in multiple graft group (34.78% vs 11.54%, P=0.009). No significant differences were found in the incidence of MACE or echocardiographic data during the follow-up. Logistic regression identified the female sex (OR: 0.191, 95% CI: 0.049-0.075) and creatinine level (OR: 1.016, 95% CI: 1.000-1.033) as factors affecting postoperative MACE occurrence. Kaplan-Meier analysis showed no significant difference in MACE-free survival rate between the two groups. CONCLUSIONS OPCABG with multiple arterial grafts does not increase severe perioperative complications or the risk of mid-term MACE in patients with impaired left ventricular function.
Humans ; Follow-Up Studies ; Postoperative Complications/epidemiology* ; Ventricular Dysfunction, Left/physiopathology* ; Coronary Artery Bypass, Off-Pump/adverse effects* ; Male ; Female ; Ventricular Function, Left ; Middle Aged ; Risk Factors ; Aged ; Perioperative Period ; Stroke Volume

Abstract: To explore the mechanism of the intestinal microecology regulation by polysaccharide prebiotics, ELISA, histopathologic analysis, immunohistochemical analysis, 16S rRNA high-throughput sequencing, and gas chromatography-mass spectrometry were applied to investigate the effects of fermented polysaccharides on changes in the intestinal microbiota and short-chain fatty acids (SCFAs) in mice with dextran sulfate sodium (DSS)-induced colitis model and their relationship with the level of intestinal inflammation and barrier protein expression. It was found that fermented Lycium barbarum polysaccharides (FLBP) significantly reduced intestinal inflammation level, improved colonic tissue structure, up-regulated the expression of tight junction proteins Claudin-1 and ZO-1, and significantly increased the content of intestinal SCFAs in mice. Gut bacteria analyses showed that FLBP enriched intestinal Dubosiella and Akkermansia in mice and decreased the abundance of Turicibacter, Faecalibaculum, and Escherichia-Shigella. Results showed that remodeled Dubosiella activated by FLBP played a dominant role in ameliorating colitis by significantly increasing SCFAs content, improving intestinal barrier and reducing intestinal inflammation. The study aimed to provide a safer and better option for the amelioration of colitis and to provide a theoretical basis for the development of functional foods with FLBP.

Objective:To explore the different characteristics of early postoperative kinesiophobia in elderly patients with total hip arthroplasty (THA) and analyze the influencing factors, so as to provide reference for formulating targeted nursing strategies.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 225 elderly THA patients admitted to the Second Affiliated Hospital of Air Force Medical University of PLA from May 2022 to June 2023 were selected as the research objects. The evaluation was conducted using the general information questionnaire, Tampa Scale for Kinesiophobia (TSK), Numeric Rating Scale, Pain Catastrophizing Scale and Groningen Orthopedic Social Support Scale.Results:A total of 225 questionnaires were distributed and 210 valid questionnaires were collected, with an effective response rate of 93.33%. The TSK score of 210 elderly THA patients was (38.76±8.52), among which 49.52% (104/210) of patients had kinesiophobia (TSK>37 points). The latent profile analysis results showed that early postoperative kinesiophobia in elderly THA patients could be divided into three potential categories, such as catastrophic cognition-high kinesiophobia group (48.57%, 102/210), uncertain cognition-moderate kinesiophobia group (20.48%, 43/210) and positive cognition-low kinesiophobia group (30.95%, 65/210). The results of Logistic regression analysis showed that age greater than or equal to 76 years old, education level of primary school or below, high comorbidity, moderate to severe pain and positive catastrophic pain were the influencing factors for patients in the catastrophic cognition-high kinesiophobia group ( P<0.05), while education level of primary school or below and low social support were the influencing factors for patients in the uncertain cognition-moderate kinesiophobia group ( P<0.05) . Conclusions:There is significant heterogeneity in early postoperative kinesiophobia among elderly patients with total hip arthroplasty, with the main influencing factors being advanced age, physical pain, social support and educational level. It is suggested that medical staff should carry out psychological counseling according to the characteristics of early kinesiophobia of different categories of patients, strengthen social support to correct wrong cognition of patients, reduce their kinesiophobia and improve early rehabilitation training behavior.

Collagen contains abundant cell binding motifs, which are conducive to adhesion, migration, and differentiation, maintain cell vitality and promote cell proliferation. However, pure collagen hydrogel has some shortcomings such as poor mechanical properties, poor thermal stability and fast degradation. Numerous studies have shown that the properties of collagen can be improved by combining it with natural polysaccharides such as alginate, chitosan, hyaluronic acid and cellulose. In this paper, the research status and biological application fields of four kinds of composite hydrogels, including collagen-alginate composite hydrogels, collagen-chitosan hydrogels, collagen-hyaluronic acid hydrogels and collagen-cellulose hydrogels, were summarized. The common preparation methods of four kinds of composite hydrogels were introduced, and the future development direction of collagen-based composite hydrogels was prospected.
Hydrogels/chemical synthesis* ; Collagen/chemistry* ; Polysaccharides/chemistry* ; Alginates/chemistry* ; Hyaluronic Acid/chemistry* ; Chitosan/chemistry* ; Biocompatible Materials/chemistry* ; Humans ; Tissue Engineering/methods* ; Cellulose/chemistry* ; Tissue Scaffolds

BACKGROUND: Limited data are available on the comparison of clinical outcomes of complete vs. incomplete percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) and multi-vessel disease (MVD). The study aimed to compare their clinical outcomes. METHODS: A total of 558 patients with CTO and MVD were divided into the optimal medical treatment (OMT) group ( n = 86), incomplete PCI group ( n = 327), and complete PCI group ( n = 145). Propensity score matching (PSM) was performed between the complete and incomplete PCI groups as sensitivity analysis. The primary outcome was defined as the occurrence of major adverse cardiovascular events (MACEs), and unstable angina was defined as the secondary outcome. RESULTS: At a median follow-up of 21 months, there were statistical differences among the OMT, incomplete PCI, and complete PCI groups in the rates of MACEs (43.0% [37/86] vs. 30.6% [100/327] vs. 20.0% [29/145], respectively, P = 0.016) and unstable angina (24.4% [21/86] vs. 19.3% [63/327] vs. 10.3% [15/145], respectively, P = 0.010). Complete PCI was associated with lower MACE compared with OMT (adjusted hazard ratio [HR] = 2.00; 95% confidence interval [CI] = 1.23-3.27; P = 0.005) or incomplete PCI (adjusted HR = 1.58; 95% CI = 1.04-2.39; P = 0.031). Sensitivity analysis of PSM showed similar results to the above on the rates of MACEs between complete PCI and incomplete PCI groups (20.5% [25/122] vs. 32.6% [62/190], respectively; adjusted HR = 0.55; 95% CI = 0.32-0.96; P = 0.035) and unstable angina (10.7% [13/122] vs. 20.5% [39/190], respectively; adjusted HR = 0.48; 95% CI = 0.24-0.99; P = 0.046). CONCLUSIONS For treatment of CTO and MVD, complete PCI reduced the long-term risk of MACEs and unstable angina, as compared with incomplete PCI and OMT. Complete PCI in both CTO and non-CTO lesions can potentially improve the prognosis of patients with CTO and MVD.
Humans ; Treatment Outcome ; Percutaneous Coronary Intervention/methods* ; Coronary Occlusion/surgery* ; Prognosis ; Angina, Unstable/surgery* ; Chronic Disease ; Risk Factors

Objective : To analyze the expression and immune infiltration levels of the BMP7 gene ( BMP7) in e- sophageal squamous cell carcinoma(ESCC) ． Methods : Initially，in 274 cases of ESCC and 242 cases of normal tissues，the level of BMP7 was verified by immunohistochemistry ，and the relationship between the expression difference and the survival cycle and clinical pathological characteristics of patients with ESCC was explored，and BMP7 overexpression plasmid transfection of ESCC cells was established，and the effect of BMP7 on the biological behavior of ESCC cells was examined by CCK-8，Clone，and Transwell. Results : BMP7 expression in normal e- sophageal tissues was higher than that of ESCC(P＜0. 001) ，the expression level of BMP7 was correlated with the degree of differentiation of patients(P = 0. 006) and TNM staging(P ＜0. 001) ，and the survival of patients with high expression of BMP7 exceeded that of patients with low BMP7 (P = 0. 041) ，and the experiments of CCK-8 and Clone showed that the proliferation effect of cells in the overexpressed BMP7 group was lower than that of the control group．Transwell experiments confirmed that the cell invasion migration capacity of the overexpressed BMP7 group was less than that of the control one．The immune infiltration results showed that BMP7 was positively correlated with macrophages(P = 0. 008) and negatively correlated with γ-δT cells(P = 0. 028) ． Conclusion BMP7 is low in ESCC and associated with poor prognosis and immune infiltration levels in patients.

Objective:To explore the effect of Wagner grade home follow-up management of diabetic foot led by specialist nurses.Methods:From January 2017 to December 2018, convenience sampling was used to select 241 patients with type 2 diabetes and Wagner grade 0 diabetic foot in the Endocrinology Department of the First Affiliated Hospital of Xinxiang Medical University. According to the enrollment time, 113 patients with Wagner grade 0 diabetic foot enrolled from January to December 2017 were set as the control group, and 128 patients with Wagner grade 0 diabetic foot enrolled from January to December 2018 were set as the observation group. The control group implemented routine home care management, and the observation group carried out the Wagner grade home follow-up management of diabetic foot led by specialist nurses. Both groups were followed up for 18 months. The blood glucose index, Scale of the Diabetes Self-care Activities (SDSCA) score and foot prognosis were compared between the two groups.Results:After the intervention, the fasting blood glucose and glycosylated hemoglobin of the observation group were lower than those of the control group, and lower than those before the intervention, and the SDSCA score was higher than that of the control group, and higher than that before the intervention, the differences were statistically significant ( P<0.05) . At the end of the sixth month, the observation group had no patients in grade 4 and grade 5, had more people in grade 0 to 1 than in the control group, and fewer people in grade 2 to 3 than in the control group, and the difference was statistically significant ( P<0.05) . At the end of the twelfth and eighteenth months, the observation group had more people in grades 0 to 1 than in the control group, and fewer in grades 2 to 3 and 4 to 5 than in the control group, and the difference was statistically significant ( P<0.05) . At the end of the eighteenth month, there were no deaths in the two groups, and 6 patients with surgery, and 1 patient with amputation in the control group, and 1 patient with surgery and without amputation in the observation group. Conclusions:The Wagner grade home follow-up management of diabetic foot led by specialist nurses can effectively improve the patient's blood glucose control level, self-management ability, and delay the progress of diabetic foot.

Objective : To explore the influence and mechanism of different types of proteins on the corrosion resistance of alloy to provide a reference for the safe application and surface modification of nickel-titanium (Ni-Ti) and stainless steel bow wires in the clinic. Methods: The effects of fibrinogen, IgG and mucin on the electrochemical corrosion resistance of Ni-Ti and stainless steel arch wires were tested by the potentiodynamic polarization method, and the repair ability of passive films on surfaces treated with the three proteins were tested by the cyclic polarization method. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used to determine the types of corrosion products, and the surface morphology after corrosion was analyzed by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Results : The addition of fibrinogen, IgG or mucin to an alloy has different effects on its corrosion resistance. Adding protein can reduce the corrosion resistance of stainless steel alloys and slow the corrosion process of Ni-Ti alloys. The addition of mucin can improve the corrosion resistance of Ni-Ti alloy and the repair ability of passive film. Compared with mucin and IgG, fibrinogen can reduce the pitting resistance of Ni-Ti and stainless steel alloys. Conclusion Different types of proteins interact differently with the arch wire, form different deposition morphologies on the surface, and participate differently in the corrosion process of the alloy.

Objective To establish a qualitative and quantitative determination of glyphosate in serum using ultraviolet spectro-photometry(UV) to provide basis for clinical diagnosing and treating glyphosate poisoning .Methods The mixture of 0 .5 mL serum and 0 .2 mL 10% methanol solution of perchloric acid was shocked and centrifuged with 10 000 r/min for 5 min .A nitrosyla-tion reaction conducted on supernatant and 50 μL serum nitrosylation liquid was detected by UV scanning .Results The results of serum theophylline absorption maxima was(243 ± l) nm and the concentration of 10 .0-60 .0 μg/mL range linear regression equa-tion was Y=0 .0173 8X+0 .036 3(r= 0 .999 8) .The recovery rate was from 85 .5% to 102 .4% and the relative standard deviation (RSD) was from 3 .50% to 4 .90% .The intra-day and inter-day RSD were 3 .79% -5 .10% and 3 .88% -4 .55% .The minimum de-tectable concentration was 5μg/mL .Conclusion This method is simple ,rapid and accurate results for detecting glyphosate poison-ing .