Objective:To investigate the levels of chemokine 2 (CCL2), chemokine (C-X-C motif) ligand 1 (CXCL1), chemokine (C-X3-C motif) ligand 1 (CX3CL1), and chemokine (C-X-C motif) ligand 10 (CXCL10) in the cerebrospinal fluid of patients with acute and chronic herpes zoster (HZ), and their correlation with the severity of neuropathic pain.Methods:A total of 60 patients with acute herpes zoster and postherpetic neuralgia (PHN) treated at the First Affiliated Hospital of Zhengzhou University from November 2022 to November 2023 were selected for a case-control study. These patients were divided into a HZ group ( n = 25) and a PHN group ( n = 35). The pressure pain threshold in the affected area was measured on the day of admission for all patients. The Visual Analogue Scale scores were evaluated in both groups. After lumbar puncture, 2 mL of cerebrospinal fluid was collected, and the levels of related chemokines in the cerebrospinal fluid were detected using the enzyme-linked immunosorbent assay. Results:In the HZ group, the levels of chemokines CXCL1 and CXCL10 were (24.84 ± 6.97) ng/L and (107.46 ± 28.29) μg/L, respectively, while in the PHN group, they were (20.51 ± 3.16) ng/L and (132.98 ± 30.92) μg/L. The differences in the levels of chemokines CXCL1 and CXCL10 between the two groups were statistically significant ( t = 2.91, -3.26, both P < 0.05). There were no statistically significant differences in the levels of chemokines CCL2 and CX3CL1 between the two groups ( t = 1.62, -0.23, both P > 0.05). The levels of CCL2, CXCL1, CX3CL1, and CXCL10 in both groups were negatively correlated with the pressure pain threshold (HZ group: r = -0.84, -0.78, -0.93, -0.86; PHN group: r = -0.71, -0.78, -0.94, -0.76, all P < 0.01). Conclusion:Higher levels of chemokines in the cerebrospinal fluid of patients with acute and chronic HZ are associated with more pronounced neuropathic pain. The neuro-immune inflammation involving chemokines may be correlated with the severity of neuropathic pain in acute and chronic HZ.

Objective:To evaluate the efficacy of individualized mini-fluid challenge test in determining the fluid responsiveness in the patients undergoing surgery in prone position.Methods:A total of 47 patients of either sex, aged > 18 yr, with boy mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective spinal surgery in prone position, were included. The volume-controlled mode was used for mechanical ventilation, and the tidal volume was set at 8 ml/kg. The hemodynamic parameters were monitored by FloTrac/Vigileo system. The patient was changed to prone position at 5 min after endotracheal intubation (T 1), hydroxyethyl starch 130/0.4 sodium chloride injection 2 ml/kg was intravenously given at 5 min of prone position (T 2), and fluid 3 ml/kg was continuously infused at 1 min after 2 ml/kg fluid infusion (T 3), and both infusion rates were 0.5 ml·kg -1·min -1. A mini-fluid challenge test was performed during T 2-T 3 period, the standard volume therapy (total infusion of liquid 5 ml/kg) was carried out from T 2 to 1 min after infusion of liquid 3 ml/kg (T 4). The rate of change in SV at T 3 time point (ΔSVT 3) was calculated relative to T 2 time point, and the rate of change in SV at T 4 time point (ΔSVT 4) was calculated relative to T 2 time point. Positive fluid responsiveness test was defined as an increase in ΔSVT 4≥10%, and patients were divided into volume response group (Rs group) and non-volume response group (NRs group). ΔSVT 3, ΔSVT 4 and stroke volume variation and pulse pressure variation at T 3 and T 4 time points were selected, the receiver operating characteristic curve predicting fluid responsiveness was generated, and the area under the receiver operating characteristic curve (AUC) was calculated. Results:Forty-one patients were finally enrolled, including 18 cases in Rs group and 23 cases in NRs group. The AUC of ΔSVT 3 determining fluid responsiveness was 0.976, with the sensitivity 0.944 and specificity 0.957. The AUC of ΔSVT 4 determining fluid responsiveness was 0.971, with sensitivity 0.889 and specificity 0.95. The AUC of stroke volume variation at T 3 and T 4 in predicting fluid responsiveness was 0.632 and 0.609, respectively. The AUC of pulse pressure variation at T 3 and T 4 predicting fluid responsiveness was 0.470 and 0.380, respectively. Conclusions:Individualized mini-fluid challenge test (2 mg/kg colloidal solution) can accurately determine the fluid responsiveness in the patients undergoing surgery in prone position.

Objective:To evaluate the accuracy of mini-fluid challenge test in predicting fluid responsiveness in elderly patients undergoing surgery in prone position.Methods:Forty-eight elderly patients, aged ≥ 65 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective spinal surgery, were enrolled.Patients were mechanically ventilated using a volume-controlled mode with a tidal volume of 6 ml/kg of ideal body weight during operation.A radial arterial catheter was inserted and connected to FloTrac/Vigileo system to monitor hemodynamic parameters.At 5 min after prone position, volume expansion was started when the hemodynamics was stable: lactated Ringer′s solution 1 ml/kg was intravenously infused over 1 min, 1 min later lactated Ringer′s solution 1 ml/kg was intravenously infused over 1 min, 1 min later lactated Ringer′s solution 1 ml/kg was intravenously infused over 1 min, and 1 min later operation was started.After tracheal intubation and before prone position (T 1), 5 min of prone position (T 2), 1 min after 1st infusion of 1 ml/kg liquid (T 3), and 1 min after 2nd infusion of 1 ml/kg liquid (T 4) and 1 min after infusion of 3 ml/kg fluid (T 5), heart rate, mean arterial pressure, cardiac output, cardiac index, stroke volume, stroke volume index (SVI), stroke volume variability (SVV), pulse pressure variability (PPV), and changes in SVI induced by rapid infusion of 1, 2 and 5 ml/kg crystalloid (ΔSVI 1 ml/kg, ΔSVI 2 ml/kg, ΔSVI 5 ml/kg) were calculated.Positive fluid challenges were defined as an increase in SVI of 10% or more from baseline, and the patients were divided into responder group (R) and non-responder group (NR). Receiver operating characteristic curves predicting fluid responsiveness were generated for ΔSVI 1 ml/kg, ΔSVI 2 ml/kg, SVV and PPV, and areas under the receiver operating characteristic curves (AUC) were calculated. Results:Thirty patients were enrolled in group R and 18 cases in group NR.The AUC of ΔSVI 1 ml/kg in predicting fluid volume responsiveness was 0.87 with a diagnostic threshold of 7%, a sensitivity of 80%, and a specificity of 83%.The AUC of ΔSVI 2 ml/kg in predicting fluid responsiveness was 0.928 with a diagnostic threshold of 8%, a sensitivity of 78%, and a specificity of 89%.The AUC of SVV and PPV in predicting fluid responsiveness was 0.65 and 0.53, respectively. Conclusion:Mini-fluid challenge test guided by ΔSVI can predict fluid responsiveness in elderly patients undergoing surgery in prone position, and rapid infusion of 2 ml/kg crystalloid provides better accuracy than 1 ml/kg.

OBJECTIVE: To investigate the association of the time of initial diagnosis with the severity of chronic obstructive pulmonary disease (COPD). METHODS: A total of 803 patients who were diagnosed to have COPD for the first time in our hospital between May 2015 to February 2018 were enrolled in this study.The diagnoses of COPD and asthma COPD overlap (ACO) were made according GOLD guidelines and european consensus definition.Lung function of the patients was graded according to the GOLD guidelines. RESULTS: The patients with COPD had a mean age of 61.8±9.9 years,including 726 male and 77 female patients.The course of the patients (defined as the time from symptom onset to the establishment of a diagnosis) was 3(0.5,8) years.Among these patients,85.2% had a moderate disease severity (FEV1%<80%),and 48.3% had severe or very severe conditions (FEV1%<50%);47.0% of them were positive for bronchial dilation test.In the overall patients,295(36.7%) were also diagnosed to have ACO,and the mean disease course of ACO[3(1,9) years]was similar to that of COPD[3(0.5,8) years](>0.05).A significant correlation was found between the disease course and the lung function of the patients.Multiple linear regression analysis showed that an older age and a longer disease course were associated with poorer lung functions and a greater disease severity. CONCLUSIONS The delay of the initial diagnosis is significantly related to the severity of COPD.
Age Factors ; Aged ; Asthma ; diagnosis ; Delayed Diagnosis ; adverse effects ; Disease Progression ; Female ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; diagnosis ; physiopathology ; Severity of Illness Index ; Time Factors

Objective To investigate the application value of magnetic-controlled capsule endoscopy (MCE) for gastric diseases in physical examination of asymptomatic population.Methods Data of 211 asymptomatic individuals who received MCE examinations from July 2015 to December 2016 in Changhai Hospital were collected and rctrospectively analyzed.The tolerance and safety of MCE were studied by analyzing the detection rate for the focal lesions and the rate of endoscopy transfer.Results Among 211 patients,the detection rate of the gastric focal lesions was 9.5％ (20/211).The detection rate in male was higher than that in female (P＜0.05).All patients completed MCE examination successfully and no adverse event was reported.Conclusion MCE,a non-invasive endoscopic modality,is safe and better tolerated than conventional endoscopy,and can be used as a promising approach to screening the gastric diseases in asymptomatic population due to high detection rate of these diseases.

Objective To study the effects and mechanism of p-hydroxyacetophenone (PHA ) on bile secretion ,choles-terol metabolism and blood lipids .Methods Cystic duct cannula was cannulated and bile were collected in SD rats .PHA was administrated in the high cholesterol rats .The activity of HMG-CoA reductase was determined by spectrophotometry in reac-tion system .Samples of liver were obtained in experiment hypercholesterolemia rats and Real-time PCR test was conducted for AQP8 ,CYP7A1 ,OATP and NTCP .Results Secretion of bile were increased ,cholesterol in bile were reduced and secretion of total bile acid were increased in rats by PHA .The level of serum cholesterol in hyperglycemia rat model was reduced signifi-cantly and inhibitory ability had been limited in the activity of HMG-CoA reeducates by PHA ,but the gene transcription inclu-ding AQP8 ,CYP7A1 ,OATP ,and NTCP were promoted ,which are related to function of excretion of biliary acid and trans-formation of cholesterol .Conclusion These results suggest that PHA ,as a lead compound ,might be of significance for fur-ther development for a bile secretory and lipid lowering agent .

Objective:To explore the relationship between thyroid function and cardiovascular diseases .Methods:A total of 980 patients undergoing thyroid function examination during hospitalization were selected . According to their thyroid function ,they were divided into normal thyroid function group (normal group ,n= 930) , hyperthy-roidism group (n=18) ,and hypothyroidism group (n=32) .Clinical data were analyzed ,blood lipids and coagula-tion function indexes were examined and compared among three groups . Results:Compared with normal group ,the incidence rate of atrial fibrillation significantly rose ,incidence rate of hypertension ,cardiac insufficiency signifi-cantly reduced;levels of TC、TG、 LDL-C、 HDL-C significantly reduced ,activated partial thromboplastin time significantly extended in hyperthyroidism group , P<0.01 all;incidence rate of coronary heart disease significantly rose ,levels of TG、HDL-C significantly rose ,levels of TC 、LDL-C significantly reduced in hypothyroidism group , P<0.01 all;Compared with hyperthyroidism group ,the incidence rate of hypertension ,coronary heart disease sig-nificantly rose ,atrial fibrillation significantly reduced ,P<0.05 or <0.01 ;levels of TG、LDL-C、HDL-C signifi-cantly rose ,TC level significantly reduced in hypothyroidism group , P<0. 01 all .Conclusion:Thyroid function is closely related to cardiovascular diseases .so it′s suggested that thyroid function detection should be regarded as a routine examination in patients with cardiovascular diseases and a follow-up index for those with thyroid dysfunc-tion .

Objective To investigate the effect of albumin on expression of NLRP3 inflammasome and its downstream cytokines IL-1β and IL-18 in tubular epithelial cells.Methods Thirty mesangioproliferative glomerulonephritis (MsPGN) patients with different levels of proteinuria were selected, and their renal biopsy samples were stained by PAS and Masson to observe tubular epithelial cells injury and inflammatory cells infiltration.NLRP3, caspase-1, IL-1β and IL-18, as well as different inflammatory cells, were detected by immunohistostaining.In vitro, Western blotting and real-time PCR were employed to detect NLRP3, caspase-1, IL-1β and IL-18 protein and mRNA in HK-2 cells stimulated by bovine serum albumin (BSA) (20 g/L).Results In MsPGN patients with high levels of proteinuria, there were obvious renal tubular epithelial cell injury and inflammatory cells infiltration (all P ＜ 0.05), and the expressions of NLRP3, caspase-1, IL-1β and IL-18 were up-regulated compared to patients with low levels of proteinuria (all P ＜ 0.05).Furthermore, IL-1β and IL-18expressions were positively correlated with the degree of proteinuria (r=0.836, P ＜ 0.05;r=0.901, P ＜0.05).NLRP3, caspase-1, IL-1β and IL-18 protein and mRNA were significantly increased in HK-2cells stimulated by BSA compared to the control group (all P ＜ 0.05).Conclusions Albumin is able to induce NLRP3 inflammasome activation in tubular epithelial cells, which may be the mechanism of tubulointerstitial injury and inflammation caused by proteinuria.

ObjectiveTo compare the clinical efficacies between bloodletting cupping plus acupuncture and acupuncture alone in treating hypertension.MethodSixty patients with primary hypertension were randomized into a treatment group and acontrol group, 30 cases in each group. The treatment group was intervened by bloodletting cupping plus acupuncture, while the controlgroup was by acupuncture. The clinical symptoms, blood pressure, and hemorheological parameters were observed before and after intervention.ResultThe clinical symptoms were improved in both groups after intervention, and the total effective rate was 76.7%in the treatment group versus 63.3% in the control group; the blood pressure dropped in both groups, and the differences were statistically significant between the two groups (P<0.05); the treatment group was superior to the control group in improving the whole blood viscosity and erythrocyte sedimentation rate(P<0.01).ConclusionBloodletting cupping is effective in treating primary hypertension; regarding the short-term therapeutic efficacy, bloodletting cupping plus acupuncture can produce a more significant effect than acupuncture alone in improving the blood pressure, whole blood viscosity, and erythrocyte sedimentation rate in primary hypertension patients.

Objective To observe features of twist of the left ventricle (LV) in patients of essential hypertension (EH) with LV normal geometry (LVN) by three-dimensional speckle tracking imaging (3D-STI).Methods Thirty EH patients with LVN and 32 healthy control subjects were included.From the dynamic images of LV apical two-and four-chamber-views and three-dimensional full volume dataset acquired,the following parameters were obtained:peak of LV basal,middle and apical segment rotation (Prot-B,Prot-M and Prot-A),peak of LV global segment twist (LV-tw) and rotation (LV-rot),the global radial and longitudinal displacement (Dr,Dl) and the global 3D displacement (D3d).The difference of these parameters was compared between EH and control groups,and the correlation between LV-tw and the displacements in EH group was studied.Results Compared with the normal control group,Prot-B,Prot-M,Prot-A,LV-tw,LV-rot,Dr,Dl and D3d of EH group were significantly increased (P ＜ 0.01 or 0.05),and LV-tw showed significant correlation with Dr,Dl and D3d (P ＜0.01 or 0.05).Conclusions The evaluation of LV twist with 3DSTI in EH patients can reflect the changes of LV systolic function in early stage,3D-STI may provide a new modality for quantitative evaluation of early abnormality of LV function in clinical practice.