Objective: To investigate the protective effect of Lycium barbarum extracts (LBE, Ningxia, China) on the retinal structure and function in the mice administrated with optic nerve crush (ONC). Methods: The changes of flash electroretinogram (fERG) and retinal structure in the normal group, ONC-2 d group and ONC-7 d group were compared. Then, the effects of intraperitoneal injection of various dosages of LBE on the survival of retinal ganglion cells (RGCs) in the ONC-7 d group were compared. After that, the LBE dosage with the best protective effect was selected for the next experiment. Finally, we further studied the effects of 1.0 mg/kg LBE on the retinal ERG and structure preservation ONC-7 d group. In all the mentioned experiments, the full-field flash ERG was used to detect the changes in the a-wave and b-wave amplitude and latency under dark and light conditions in the living animals. The collected retinas were processed as the retinal flat whole-mounts and used for the immunofluorescent labeling of the RGCs, or as the frozen sections to be utilized for the fluorescent staining of the retinal bipolar cells, cones, synaptophysin (SYN), anti-postsynaptic density protein 95 (PSD95) and the reactive oxygen species (ROS). ImageJ software was used to count the numbers of the surviving RGCs, bipolar cells and cones, to calculate the percentage of the fluorescence-positive area (PP) of the bipolar cell protrusions in the inner plexiform layer (IPL), to measure the fluorescence intensity (FI) of the SYN in the IPL and outer plexiform layer (OPL), to measure the FI and PP of the PSD95 in the OPL, and to detect the red FI after the DHE detection. Results: Compared with the N and ONC-2 d groups, the numbers of the survival RGCs, bipolar cells and cones, the PP of the bipolar cell protrusion in the INL, and the FI of the SYN in the IPL and OPL decreased (P<0.05) in the ONC-7 d group. The FI of the PSD95 did not change (P>0.05); but the PP decreased in the OPL (P<0.050). The results of ERG examination showed that the amplitudes of a- and b-waves decreased under dark adaptation (P<0.01) and the reduction in the amplitude of b wave during light adaptation was significant 7 days after surgery (P<0.05). DHE staining showed that the ROS was increased 7 days after the operation (P<0.01). Compared with the control group, treatment with LBE could increase the survival of the RGCs (P<0.01) with the largest survival average density of RGCs in the 1.0 mg/kg LBE group (P<0.01). In addition, compared with the control group, 1.0 mg/kg LBE could increase the PP occupied by the bipolar cell protrusions in the IPL (P<0.05), the number of surviving cone cells (P<0.01), the FI of SYN in the IPL (P<0.01) and OPL (P<0.05), and the FI and the PP of PSD95 in the OPL (P<0.05). The improved function of the retina was shown by the increasing amplitudes under dark adaptation (P<0.05) and light adaptation (P<0.01). LBE reduced the FI of ROS (P<0.05). Conclusion: LBE has a protective effect on the retina after ONC injury in mice, and its protective effect may be related to its inhibition of oxidative stress in the retina.
Bone homeostasis is a dynamic homeostasis process maintained by osteocytes, osteoblasts and osteoclasts, which is essential for the growth and development of bone. Protein phosphorylation and dephosphorylation can affect bone formation and development. Protein phosphatase 2A (PP2A), as an important member of the protein phosphatase family of cellular dephosphorylation, contains many subunits, has a complex structure and a wide range of functions. It can dephosphorylate proteins and participate in cellular biological processes like regulation of enzymes, transcription factors and signaling. It also plays a key role in the differentiation process of osteogenesis and osteoclasts. This review summarizes the regulatory role of PP2A in bone homeostasis and the research progress of its various inhibitors in the treatment of bone-related diseases, hoping to provide new ideas and theoretical basis for the drug treatment of bone-related diseases in clinical practice.
Objective: To evaluate the effects of simplified finger exercise on improvement of comfort degree and decrease related complications during transradial coronary procedures. Methods: This study randomized 302 patients who underwent a transradial coronary procedure in Huangshi central hospital during 2022 to one of the following 2 groups, (i) simplified finger exercise in addition to routine pre-procedure care (test group, 151 patients), (ii) routine pre-procedure care (control group, 151 patients). The achievement ratio of radial puncture, incidence of radial artery spasm and dissection (RAS, RAD), change of limb circumference, and painfulness of the limb were observed and analyzed between two groups. Results: Compared to the control group, test group had a higher achievement ratio of radial puncture, lower incidence of RAS and RAD, slighter tumidness of limb and patient felt less pain in test group. Conclusion: Simplified finger exercise has a positive effect on improvement of a patient's comfort degree and decrease related complications during transradial coronary procedures.
Objective: To investigate the efficacy and safety of different stimulus dosage of modified electroconvulsive therapy (MECT) in the treatment of depressive episode. Methods: Sixty-five patients with depressive episode according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) were randomly divided into treatment group (32 patients) and control group (33 patients). The patients in the treatment group received low stimulus dosage of MECT while the patients in the control group were treated with routine stimulus dosage of MECT. The treatment session was 6 times in both groups. The stimulus electrodes were placed on bifrontal. Hamilton depression scale-17 item (HAMD-17) and MATRICS consensus cognitive battery (MCCB) were used to evaluate the clinical symptoms and cognitive function at baseline, after 3 times of MECT, and after 6 times of MECT. Heart rate, systolic blood pressure, and diastolic blood pressure were recorded before and after stimulus in the first session of MECT treatment. Adverse reactions related to MECT were also recorded. Results: Fifty-six (29 patients in treatment group and 27 patients in control group) completed MECT treatment. The improvement rate of treatment group and control group was 68.97% and 70.37%, the remission rate was 51.72% and 62.96%, respectively. There was significant decrease of HAMD-17 score after MECT compared with baseline in both groups while there was no significant difference between groups. Compared with baseline, the heart rate, systolic pressure, and diastolic pressure increased significantly after stimulus in the first MECT session, while there was no significant difference between groups. There was no significant difference of MCCB score after MECT treatment compared with baseline and between groups. One patient experienced delirium in the treatment group, while in the control group, three patients experienced MECT related side effects involving headache, nausea and vomiting, muscle pain, and delirium. Conclusion: The efficacy of low stimulus dosage MECT treatment was equivalent to the conventional stimulus dosage in treating depressive episodes while with fewer adverse reactions.
Objective: Preliminary construction of a comprehensive scoring system based on qualitative indicators of 99mTc-SC lymphoscintigraphy to explore the predictive value of 99mTc-SC lymphoscintigraphy in assessing the efficacy of comprehensive decongestive therapy for secondary lower limb lymphedema following gynecological cancer surgery. Methods: A retrospective analysis was conducted on the data of 48 gynecological cancer patients at the First Affiliated Hospital of Sun Yat-sen University from January 2018 to March 2023 who developed secondary lymphedema following surgical procedures and received comprehensive decongestive therapy. Subsequently, the patients were stratified into effective (n=28) and ineffective treatment (n=20) groups based on predefined research criteria, with both clinical information and 99mTc-SC lymphography data collected. The qualitative indicators of lymphography primarily encompassed: ① visibility of main lymphatic vessels' uptake pattern; ② identification of obstruction site in the pelvis or knee joint; ③ classification of subcutaneous soft tissue drainage type in lower limbs; ④ assessment of collateral lymphatic circulation presence. Results: There was a statistical difference in the delayed phase of lower limb lymphatic drainage and comprehensive score between the two groups (P<0.05). The predictive performance of the comprehensive score is significantly superior to that of the single qualitative indicator of lymphoscintigraphy. The sensitivity, specificity, and accuracy of prognostic assessment based on the comprehensive scoring system derived from nuclear lymphatic imaging were 96.4%, 85.0%, and 91.7%, respectively. Conclusion: Preoperative lymphoscintigraphy may be valuable for predicting the response to treatment of gynecologic cancer-related lymphedema following comprehensive decongestive therapy. The late-stage soft tissue bypass classification and comprehensive score serves as the primary independent predictor, and a scoring system that integrates multiple qualitative features can significantly enhance the sensitivity and accuracy of prognosis prediction.
Radiation retinopathy (RR) is primarily treated with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF), which is costly and requires repeated administration. Currently, there is no unified standard for the treatment of RR. This paper reports a case where anti-VEGF therapy was ineffective in Guangdong Provincial People's Hospital in 2018, but 577 nm subthreshold micropulse laser (SML) treatment successfully resolved the severe macular edema caused by radiotherapy for nasopharyngeal carcinoma, with stable therapeutic effects maintained over a 5-year follow-up period without recurrence. There have been no domestic reports on the use of SML treatment for RR macular edema. By reviewing the existing literature, SML is considered to be a cost-effective and non-invasive, allowing for repeatable procedures, it can provide a new strategy for the treatment of RR.
Objective: To explore the distribution pattern and related influencing factors of dampness syndrome in patients with precancerous lesions of gastric cancer (PLGC) through epidemiological investigation. Methods: Epidemiological data of PLGC patients who visited Guangdong Provincial Hospital of Chinese Medicine from June 2023 to November 2023 were collected. After grouping them into different dampness syndrome types, analysed the effects of social demographics data, lifestyle, and disease conditions on PLGC patients with different dampness syndrome types. Finally, the influencing factors with statistical difference were analysed by unordered multiclassified Logistic regression analysis. Results: A total of 197 PLGC patients were collected in this study, including 35 patients with non-dampness syndrome, 30 patients with dampness-heat syndrome, 87 patients with spleen-dampness syndrome, 17 patients with wind-dampness syndrome, and 28 patients with at least 2 different types of dampness syndrome. Correlation analysis of non-dampness syndrome group, dampness-heat syndrome group, spleen-dampness syndrome group, and wind-dampness syndrome group revealed that there were statistical differences among the four groups in depression, dietary habits, food intake, smoking history, and staying up late. Logistic regression analysis of the above factors revealed that depression and having smoking history were independent influencing factors of dampness-heat syndrome, and staying up late was an independent influencing factor of spleen-dampness syndrome. Conclusion: Dampness syndrome was widely present in PLGC patients, and depression and a history of smoking may independently affect dampness-heat syndrome in PLGC, while staying up late may independently affect spleen-dampness syndrome in PLGC.
Objective: To investigate the changes in systemic immune inflammatory index (SII), D-dimer level and SOFA score in patients with sepsis and their prognostic value assessment. Methods: Retrospectivly analyzed 114 patients with sepsis hospitalized in the Second Affiliated Hospital of Xinjiang Medical University during the period from July 2021 to July 2023. 43 patients who underwent health checkups during the same period were selected as the control group. Laboratory tests such as coagulation series and blood specimens were performed after admission to the hospital to derive SOFA score. All sepsis patients were followed up for 28 d. Based on the clinical outcomes during hospitalization, the patients were divided into 37 cases in the survival group and 77 cases in the death group. The differences between SII, D-dimer level and SOFA score in the three groups were compared. Univariate and multivariate Logistic regression were used to analyze the baseline data of sepsis patients, to derive the independent factors influencing the death of sepsis patients, and to draw forest plots; Spearman correlation analysis of SII index, D-dimer level and SOFA score with prognosis of patients with sepsis; survival curves were plotted by ROC curves assessing SII, D-dimer level, SOFA scores and the combination of all three. Finally, calibration curves and clinical decision curves were plotted based on the R after the model was re-sampled 500 times using the Bootstrap method. Results: Patients in the sepsis death group had significantly higher SII, D-dimer, and SOFA score than those in the survival and control groups, and the differences were statistically significant. The case fatality rate of patients with sepsis was 68%. Analysis of one-way Logistic regression showed that SII, D-dimer level, and SOFA score were correlates of death in sepsis patients. Multifactorial Logistic regression analysis showed that high SII, high D-dimer level, and high SOFA score were independent risk factors for death in patients with sepsis. SII, D-dimer level, and SOFA score were positively correlated with death in patients with sepsis. The results of the ROC curve analysis showed that the area under the curve of SII, D-dimer level, SOFA score, and the combined test to predict death in patients with sepsis, were 0.822, 0.888, 0.874, 0.967 respectively. The diagnostic sensitivity was 73.700% and specificity was 75.000% at the optimal cut-off value of 2 063.5 for SII. The diagnostic sensitivity was 85.500% and specificity 80.600% at the optimal cut-off value of 3.8 mg/mL for D-dimer level. The diagnostic sensitivity was 75.500% and specificity was 86.100% at the cut-off value of 9.500 points for SOFA score. The sensitivity of the combined test was 93.400% and the specificity was 91.700%. Conclusion: Elevated levels of SII, D-dimer and SOFA score are independent risk factors for death in sepsis patients, the constructed prediction model has high goodness of fit and clinical applicability, and the combination of the three tests has higher predictive value for sepsis patients.
Essential oil is the main pharmacodynamic substance of Artemisia argyi. Thus, the quality control of Artemisia argyi essential oil is crucial for its stable therapeutic effect. At present, the extraction methods of Artemisia argyi essential oil include steam distillation, supercritical CO2 extraction, organic solvent extraction, ultrasonic-assisted extraction, etc. This review summarized quality control and extraction technology of Artemisia argyi essential oil in recent years, in order to provide scientific basis for the comprehensive development and application of Artemisia argyi.
Objective: To establish a new quantitative method for simultaneously determining eight bioactive ingredients (Eucalyptol, α-Thujone, Camphor, Borneol, 4-Terpineol, α-Terpineol, Carveol and β-caryophyllene ) in essential oil of Artemisia argyi by quantitative analysis of multi-components by single marker (QAMS) method,and use the external standard method to verify the feasibility and accuracy of QAMS. Methods: Using Borneol as the internal standard, the relative correction factors of other seven components were determinated by GC-MS. And using the QAMS method to analysis the eight components in nine batches Artemisia argyi essential oil samples. Results: The QAMS method established in this study has good precision, repeatability and stability. The eight components showed good linear relationships within their own ranges (r2≥0.998 5), whose average recoveries of standard addition were 80%~120%. And there was no significant difference in the results obtained by QAMS method and the external standard method respectively. The content determination results showed that the contents of the eight components were different in nine batches samples of Artemisia argyi essential oil, especially eucalyptus and α-thujone. Conclusion: The established QAMS method had high accuracy and applicability, and it can be used for quantitative analysis and quality evaluation of Artemisia argyi essential oil.
Objective: To characterize the blood-borne occupational exposures among healthcare workers in a tertiary general hospital in Shenzhen from 2019 to 2023 and determine the influencing factors, aiming to provide insights for continuously improving the management of occupational exposures and strengthening the protective measures. Methods: An observational descriptive study was performed by a retrospective retrieval of five-year data of exposures to blood among healthcare workers in a tertiary general hospital in Shenzhen. The demographic distribution, exposure routes and exposure sources were descriptively statistically analyzed. Results: From 2019 to 2023, a total of 359 cases of blood-borne occupational exposures were reported. The annual incidence rate fluctuated, of which the highest was 3.59% in 2019 and the lowest was 1.53% in 2022. The exposure mainly occurred in the second half of the year. The majority of the affected individuals were female and nurses, with 79.39% of them having less than 5 years of work experience. 84.68% of occupational exposures were caused by sharp instrument injuries, mainly occurring during needle withdrawal and disposal (22.70%) and surgery (21.05%). The main exposure sites included ward (42.34%) and operation rooms (20.61%). Most of exposure sources were tested negative for blood-borne pathogens except for 131 cases. The top three pathogens were hepatitis B virus, Treponema pallidum and hepatitis C virus. Follow-up monitoring suggested that 77.78% of the exposed individuals completed the recommended preventive medication and no post-exposure infection occurred after exposure. Conclusion: The blood-borne occupational exposure reported in this hospital during 2019 and 2023 was mainly needle stick injuries in junior nurses, and the main pathogen exposed was hepatitis B virus. No post-exposure infection occurred. Nurses are high-risk group of occupational exposure, and the prevention of needle-stick injury calls for our great concern. Meanwhile, vaccination against pathogens from occupational exposure especially hepatitis B, should be paid great attention as an effective protective measure.
Objective: Based on Donabedian “structure-process-outcome” (SPO) three-dimensional quality evaluation model, this study adopts Delphi method and analytic hierarchy process construct the quality evaluation index system of nosocomial infection management in general hospitals. Methods: Through literature review and group discussion, the indexes of nosocomial infection management quality evaluation were initially drawn up, and 20 experts were selected by Delphi method for two rounds of correspondence consultation to determine the index system of nosocomial infection management quality evaluation, and the weights of each index were calculated by analytic hierarchy process. Results: The positive coefficient of the two rounds of expert correspondence was 100%. The expert authority coefficients were 0.869 and 0.877, Kendall's W were 0.156 and 0.219, respectively, and finally formed a 3-dimensional, 21-item nosocomial infection management quality evaluation index system. Conclusion: After two rounds of expert consultation, the indexes were modified and sorted out, and the results of the selected quality evaluation indexes of nosocomial infection management were reliable and the weights of each index were reasonable, which could provide an objective and quantifiable basis for nosocomial infection management.
Objective: To evaluate the feasibility and the superiority of AI-assisted compressed sensing (ACS) in knee joint MRI. Methods: Thirty-six participants who underwent both the conventional scanning and ACS scanning of knee joint MRI in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology during the period of 2021 to 2022 were included in this study. The acquisition time of each scanning sequence, selected the bone marrow, muscle, anterior cruciate ligament and posterior cruciate ligament as regions of interest on coronal PD images, and calculated the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of these region of interst (ROI) were recorded. We evaluated the subjective image quality, and compared the objective image quality. The Wilcoxon signed-rank test was used to compare the objective image quality, and the kappa coefficient was used to statistically analyze the subjective scores. Results: Compared with conventional group, the total acquisition time of knee joint MRI in ACS group was shortened from 461 s to 245 s. There was no significant difference in SNR and CNR of bone marrow, anterior cruciate ligament and posterior cruciate ligament between the two groups (P>0.05). And there was no significant difference in the subjective scores of the two groups (P>0.05). In addition, the subjective measurement result of the two radiologists was in good agreement (Kappaacs=0.79,Kappacontrol=0.72). Conclusion: AI-assisted compressed sensing can significantly shorten the acquisition time without influencing the image quality, which has great potential in knee joint MRI. This technology can provide new ideas for rapid magnetic resonance imaging.
Objective: To explore the relationship between T2-Flair high signaling volume in different regions and insomnia in order to reveal the possible neuropathological basis of insomnia. Methods: The imaging datas of 121 patients with insomnia and 124 healthy volunteers in the Second Affiliated Hospital of Nanchang University from November 2021 to May 2024 were retrospectively collected. The insomnia group was divided into short-term insomnia group (n=55) and chronic insomnia group (n=66). All participants underwent brain scans utilizing a 3.0 T MRI scanner. The T2-Flair sequences were utilized to assess white matter integrity and high signal volume. United Imaging Artificial Intelligence were used to determine the T2-Flair high-signal volumes of the lateral ventricular rim, parietal lateral ventricle, deep white matter and near-cortical white matter, as well as their proportions to the overall volume of the relevant sites. The covariance between the insomnia group and the healthy control group was analyzed for the volume and percentage of high signal in various lateral paraventricular area regions as well as for the number of perivascular interstitial spaces. Covariance analysis was also performed to analyze the volume of white matter high signal and its percentage in different regions of the paraventricular white matter and the number of perivascular spaces in patients with different subtypes of insomnia. Results: The T2-Flair high signal volume of the lateral ventricular rim and its proportion to the volume of the lateral ventricular rim were statistically different between the insomnia patients and the healthy volunteers (F=5.01,10.05; P<0.05). However, the T2-Flair high signal volumes of the paraventricular, deep white matter, and proximal cortical white matter and their proportions to the total volume of the corresponding site were not statistically different between groups (P>0.05). There was no statistically significant difference in the volume and percentage of white matter high signal in each brain region in the chronic insomnia group compared to the short-term insomnia group (P>0.05). Conclusion: T2-Flair high signal volume in the cerebral white matter of the lateral ventricular rim was associated with insomnia, but not with the course of insomnia, suggesting that the neuropathologic basis of insomnia may be related to changes in cerebrospinal fluid dynamics or peripheral arterial hemodynamics at the lateral ventricular margin.
Objective: To explore the curative effect of electrostatically spun astragalus polysaccharide composite nanofibre dressings on lower limb venous ulcers patients. Methods: From April 2023 to December 2023, 92 patients with lower limb venous ulcers admitted to a tertiary hospital in Sichuan Province were selected and divided into experimental group and control group according to the random number table method in a ratio of 1∶1, with 46 cases in each group. The control group used conventional dressing changes, and the experimental group added electrostatically spun astragaloside composite nano-fibre dressing on the basis of the conventional dressing changes, and the intervention lasted for 4 weeks. The healing rate, number of dressing changes and quality of life scores of patients in both groups before and after 4 weeks of intervention were recorded, and the healing time was assessed after 3 months of follow-up. Results: After 4 weeks of intervention, the healing time, number of dressing changes and quality of life scores of patients in the experimental group were lower than those of the control group, and the difference was statistically significant (P<0.05). The time effect of healing rate, the interaction effect between groups and time, and the between-group effect were statistically significant (P<0.05). The healing rate of patients in the test group was higher than that of the control group after the 1st week of intervention, after the 2nd week, after the 3rd week, and after the 4th week (P<0.05). Conclusion: Electrostatically spun astragalus polysaccharide composite nanofibre dressing can improve the healing rate of patients with lower limb venous ulcers, reduce the number of dressing changes, shorten the healing time, and improve the quality of life of patients.
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