Many people engagingin medical scienceasked me,"You’ve beenworking on the exploration of Holistic Integrated Medicine（HIM）for quite awhile.What is the progressyou have made in your research?Have you got your article published?May I beyour first reader?"
目的 探讨海南地区癫痫儿童 HLA-B*1502基因与芳香族抗癫痫药物(AEDs)治疗后发生皮肤型药物不良反应(cADRs)的相关性.方法 纳入本院2020年1月-2022年7月收治的癫痫儿童100例,均使用芳香族AEDs治疗,并根据是否发生cADRs分为cADRs组(n=32)与非cADRs组(n=68).针对患儿进行HLAB* 1502基因检测,记录HLA-B * 1502基因分型与等位基因频率.根据cADRs的严重程度,将轻微反应者纳入轻微组,将Stevens-Johnson综合征(SJS)、中毒性表皮坏死松解症(TEN)以及药物超敏综合征(DHS)者纳入重型组.比较不同严重程度患儿的HLA-B * 1502基因分型;分析HLA-B * 1502基因与cADRs的相关性.结果 cADRs组HL4-B *1502TB位点的CT型比率高于非cADRs组(68.75％、36.76％),CC型比率低于非cADRs组(28.13％、63.24％),差异有统计学意义(P＜0.05).cADRs组HLA-B * 1502TB位点的T等位基因频率为37.50％,高于非cADRs组的18.38％,差异有统计学意义(P＜0.05).轻微组与重型组HL4-B * 1502基因的基因分型及等位基因频率比较,差异无统计学意义(P＞0.05).Logistic回归分析显示,HLA-B*1502TB位点的CT基因分型及T等位基因会增加海南地区癫痫儿童AEDs治疗后cADRs的发生风险(P＜0.05).结论 海南地区癫痫儿童经芳香族AEDs治疗后,cADRs的发生与HLA-B * 1502基因密切相关.HLA-B * 1502TB位点携带CT基因分型与T等位基因的患儿的cADRs发生风险更高.
膜性肾病(MN)是一组以肾小球基底膜上皮细胞下免疫复合物沉积伴基底膜弥漫增厚为病理特征的疾病,其中70％～80％因病因不明被称为特发性膜性肾病(IMN).近年来,随着抗M型磷脂酶A2受体(PLA2R)抗体、I型血小板反应蛋白7A域(THSD7A)等自身抗体在IMN患者外周血中被发现,B淋巴细胞在IMN中的致病作用已逐渐引起重视.利妥昔单抗(RTX)是一种人/鼠嵌合型单抗,可耗竭CD20+B淋巴细胞,以减少自身抗体的产生.T淋巴细胞与B淋巴细胞在功能上相辅相成,IMN患者已被证实亦存在T淋巴细胞亚群数量和功能紊乱,故纠正T淋巴细胞亚群失衡可能是RTX发挥作用的另一重要机制.本文综述利妥昔单抗对IMN患者外周血T淋巴细胞的影响及其临床意义,以期为多靶点治疗IMN提供理论依据.
非酒精性脂肪性肝病发病率逐年上升,脂肪肝肝纤维化的早期评估和早期干预对于改善非酒精性脂肪性肝病患者的预后至关重要.非侵入性的风险预测模型在临床实践中越来越受到重视.本文基于临床指标及不同算法,系统回顾了各类肝纤维化预测模型的优势及局限性,分析阐述了各模型的特点及在临床中的使用价值.
重症监护病房获得性肌无力(ICUAW)是发生于ICU患者的危重疾病,常累及肢体肌肉及呼吸肌,导致患者脱机困难、住院时间延长及病死率增高,严重影响ICU患者预后.机械通气、脓毒血症、多脏器功能衰竭及全身炎症反应综合征(SIRS)是ICUAW常见致病原因;肠外营养、神经肌肉阻滞剂及大剂量糖皮质激素的使用、制动等也可引起ICUAW.目前,尚无ICUAW早期诊断的金标准及治疗策略.本文就ICUAW相关研究进展进行综述,以期加深临床对ICUAW的认识,并提高临床医生的诊疗能力.
生酮饮食(KD)是低碳水化合物、高脂肪的饮食模式,是长期以来用于治疗癫痫的有效手段.随着研究的不断开展,KD在其他疾病领域也有一定的尝试,例如肥胖、2型糖尿病、代谢相关脂肪性肝病、阿尔茨海默综合征及肿瘤等.然而,KD因其独特的饮食结构,会造成营养素摄入失衡,在应用期间存在一些相关的不良反应,因此也存在较大的临床争议.本研究就KD对多种疾病的利与弊进行综述.
目的 分析原发性干燥综合征(pSS)合并血液系统损害患者的临床特征,并建立预测模型.方法 收集183例pSS患者的临床表现、实验室检查结果,对合并(n=109)或不合并(n=74)血液系统损害的pSS患者进行对比分析,采用Logistic回归方法分析pSS患者合并血液系统损害的相关因素.建立pSS合并血液系统损害的多因素逻辑回归(MLR)预测模型和人工神经网络(ANN)预测模型,绘制受试者工作特征曲线并比较2种模型的基本参数和曲线下面积(AUC),以评估模型预测效能.结果 Logistic回归分析显示,肝脏受累(OR=0.191,P＜0.05,95％CI:0.070～0.524)、皮肤受累(OR=0.292,P＜0.05,95％CI:0.121～0.704)、低白蛋白血症(OR=0.840,P＜0.05,95％CI:0.743～0.948)、低钾血症(OR=0.351,P＜0.05,95％CI:0.145～0.846)、高免疫球蛋白 M(IgM)(OR=1.732,P＜0.05,95％CI:1.085～2.765)、高红细胞沉降率(ESR)(OR=1.028,P＜0.05,95％CI:1.005～1.051)和抗 SSA 抗体阳性(OR=0.21,P＜0.05,95％CI:0.052～0.828)是pSS患者合并血液系统损害的危险因素.在预测血小板和白细胞下降方面,MLR和ANN模型的预测效能比较,差异无统计学意义(P＞0.05).ANN模型对血红蛋白下降方面的预测效能优于MLR模型,差异有统计学意义(P＜0.05).结论 pSS患者发生血液系统损害的风险较高.肝脏功能异常、皮肤受累、低白蛋白血症、低钾血症、高IgM、高ESR和抗SSA抗体阳性是pSS患者血液系统受累的危险因素.ANN和MLR模型是基于本研究的原始数据开发的2个有效预测工具,可考虑应用于临床.
Objective To explore the clinical value of different patterns of complete left bundle branch block（CLBBB） evaluated by two-dimensional speckle tracing echocardiography（2D-STE） in predicting acute response of chronic congestive heart failure（CHF） patients with cardiac resynchronization therapy（CRT）. Methods A total of 36 patients with CHF and CLBBB by CRT were selected and conducted with echocardiography examination in the ON and OFF states of CRT, and the increase of left ventricular ejection fraction（LVEF）≥5% at ON state of CRT was defined as responsive, while the increase of LVEF＜5% was defined as unresponsive. According to the longitudinal time-strain curve types of left ventricular posterior interventricular septum, CLBBB was divided into type Ⅰ, type Ⅱ and type Ⅲ. Patients with type Ⅰ and type Ⅱ were set as study group 1, patients with type Ⅲ were set as study group 2,and the conventional ultrasound parameters,systolic function parameters and systolic asynchrony parameters were detected at the OFF state of CRT. Results Among the 36 patients,there were 29 cases（ 80. 56%） with response and 7 cases（ 19. 44%） without response; there were 20 patients with type Ⅰ CLBBB,4 patients with type Ⅱ,and 12 patients with type Ⅲ． There were 22 patients with effective response to acute response of CRT in the study group1,and the effective rate of response was 91. 67%（ 22/24）; in the study group 2,7 patients had effective response to acute response of CRT,and the effective rate of response was 58. 3%（ 7/12）;the effective rate of response to acute response of CRT in the study group 1 was significantly higher than that in the study group 2（ P ＜ 0. 05）. There were no significant differences in left ventricular diameter,left ventricular systolic function,left ventricular diastolic function and ventricular asynchrony parameters between the two groups（ P ＞ 0. 05）. The overall longitudinal peak strain of the interventricular septum and the overall longitudinal peak strain of the lateral wall in the study group1 were significantly lower than those in the study group 2（ P ＜ 0. 05）. The standard deviation of the peak time of left ventricular strain at 18 segments in the study group 1 was significantly greater than that in the study group 2（ P ＜ 0. 05）. Conclusion There are differences in response efficiency of acute response among different types of CLBBB; the response efficiency of acute response in type Ⅰand Ⅱ CLBBB is better than that of type Ⅲ CLBBB; the function of interventricular septum and left ventricular sidewall in type Ⅰ and Ⅱ CLBBB is better than that of type Ⅲ CLBBB; the left ventricular systolic asynchrony of type Ⅰ and Ⅱ CLBBB is more significant than that of type Ⅲ CLBBB.
目的 探讨转化生长因子-β(TGF-β)和镍纹样蛋白(Metrnl)与2型糖尿病(T2DM)大血管病变的相关性.方法 选取T2DM患者106例,按颈动脉内中层厚度(CIMT)分为单纯T2DM组50例(CIMT≤1.0 mm)、T2DM合并大血管病变组56例(CIMT＞1.0 mm),并随机选取同期体检的健康受试者52例为健康对照组.比较3组外周血清中的TGF-β、Metrnl水平,分析各代谢指标与T2DM大血管病变的相关性.结果 T2DM合并大血管病变组TGF-β、Metrnl水平低于单纯T2DM组和健康对照组,差异有统计学意义(P＜0.05);血清TGF-β与Metrnl水平呈正相关(P＜0.05);收缩压、吸烟、低密度脂蛋白胆固醇(LDL-C)、HOMA-IR是T2DM大血管病变的危险因素,Mernl、TGF-β是T2DM大血管病变的保护因素(P＜0.05);受试者工作特征(ROC)曲线分析结果显示,TGF-β和Metrnl预测的曲线下面积(AUC)分别为0.757、0.846,TGF-β联合Metrnl预测的AUC为0.901.结论 血清TGF-β和Metrnl水平降低与T2DM大血管病变的发生相关,TGF-β联合Metrnl检测对T2DM大血管病变的早期评估具有重要意义.
目的 评价连续菱形肌-肋间肌阻滞(CRIB)用于胸腔镜术后镇痛的效果.方法 将120例胸腔镜手术患者随机分为CRIB组、单次菱形肌-肋间肌阻滞组(SRIB组)和患者自控静脉镇痛组(PCIA组),每组40例.CRIB组患者在出室前实施CRIB;SRIB组患者在出室前实施SRIB;PCIA组患者在出室前连接PCIA镇痛泵.术后1、2、6、12、24 h时,采用视觉模拟评分(VAS)评估患者静止状态和活动状态下的术后疼痛程度.术后24 h时,采用40项恢复质量评分量表(QoR-40)评估患者术后恢复质量.记录术后24 h内补救镇痛例数、首次补救镇痛时间、麻醉复苏室(PACU)停留时间和术后住院时间.记录患者术后恶心呕吐(PONV)、头晕、皮肤瘙痒、气胸、呼吸困难等不良反应发生情况.结果 最终纳入118例患者,CRIB组、SRIB组各39例,PCIA组40例.SRIB组患者静止状态下、活动状态下的术后2 h的VAS评分低于CRIB组、PCIA组患者,差异有统计学意义(P＜0.05).CRIB组患者静止状态下、活动状态下的术后12、24 h的VAS评分低于SRIB组、PCIA组患者,差异有统计学意义(P＜0.05).CRIB组、SRIB组患者活动状态下各时点VAS评分低于PCIA组患者,差异有统计学意义(P＜0.05).SRIB组患者活动状态下的术后12、24 h的VAS评分低于PCIA组患者,差异有统计学意义(P＜0.05).CRIB组、SRIB组患者术后24 h QoR-40总分高于PCIA组患者,CRIB组患者术后24 h QoR-40总分高于SRIB组患者,差异有统计学意义(P＜0.05).CRIB组患者补救镇痛例数少于SRIB组和PCIA组患者,差异有统计学意义(P＜0.05).CRIB组患者首次补救镇痛时间长于SRIB组、PCIA组患者,差异有统计学意义(P＜0.05).PCIA组患者PONV、头晕、皮肤瘙痒发生率高于CRIB组、SRIB组患者,差异有统计学意义(P＜0.05).结论 CRIB是一种具有良好术后镇痛效果的镇痛方法,能够改善胸腔镜术后恢复质量.
目的 探讨应用猪后肢隐动脉及伴行静脉异位重建股骨头血供的动物实验研究方法.方法 选取10头8～10月龄的体质量90～104 kg的普通长白猪,麻醉后构建头下型股骨颈骨折模型,离体后固定于胫骨近端的内侧缘;显微镜下将股骨头内后下支持带动脉同隐动脉分支吻合、前支持带动脉同隐静脉分支吻合以重建股骨头血供;经骨面开窗、数字减影血管造影(DSA)观察术后即时股骨头内血管通血情况;术后7 d观察股骨头钻孔出血情况,记录前支持带动脉、后下支持带动脉外径及隐动脉、隐静脉分支口径.结果 前支持带动脉、后下支持带动脉与隐动脉、隐静脉口径基本匹配,可进行血管吻合.经骨面开窗及DSA检查显示异位血管吻合后股骨头内通血明显,术后7 d股骨头钻孔均可见明显的活跃性出血.实验用猪围术期均无明显的不良反应.结论 应用猪后肢隐动脉及伴行静脉异位重建股骨头血供效果良好,可提供一种快速、有效、损伤小的实验方法,间接论证通过骨内吻合方法重建股骨颈头下型骨折后股骨头血运存在理论上的可能.
目的 探讨每日目标化管理模式联合快速康复护理路径在跟腱断裂患者中的应用价值.方法 选择2019年6月—2021年6月60例行跟腱修复手术的跟腱断裂患者为研究对象,根据随机数字表法将其分为对照组及干预组,每组30例.对照组患者接受跟腱修复围术期常规护理,干预组按照快速康复计划建立护理路径并结合每日目标化管理模式进行护理.比较2组患者术后疼痛评分与口渴评分及患肢肿胀时间、术后并发症发生率、护理满意度评分及平均住院时间.结果 干预组患者术后疼痛评分及口渴评分低于对照组,患肢肿胀持续时间及平均住院时间均短于对照组,护理满意度评分高于对照组,差异有统计学意义(P＜0.05).干预组患者切口感染发生率和肌肉萎缩发生率分别为3.33％(1/30)、0,分别低于对照组的26.67％(8/30)、20.00％(6/30),差异有统计学意义(P＜0.05).结论 每日目标化管理联合快速康复护理路径在跟腱断裂围术期护理中有明显优势,可减轻患者术后疼痛及肿胀程度,促进早期离床活动,降低术后感染、肌肉萎缩等并发症发生率.对患者进行目标化管理有利于护士精准执行,能够提高患者的参与度和护理质量.
Objective To investigate the effect of stent-assisted coil intracranial embolization in patients with ruptured intracranial aneurysms.Methods A total of 110 patients with ruptured in-tracranial aneurysm were selected as the study objects.The patients were divided into control group(pure embolization with spring coil,n=55)and study group(stent-assisted embolization with spring coil,n=55)according to the stent assisted method.The operation status,length of hospital stay,nerve function,serum myelin basic protein(MBP)level,clinical efficacy and cerebrospinal fluid in-flammatory factor level were compared between the two groups.Results After surgery,the levels of nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)in the two groups were sig-nificantly higher than those before surgery,and those in the study group were significantly higher than those in the control group(P＜0.05).After operation,the levels of serum MBP and cerebrospinal flu-id interleukin-4(IL-4),tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)in two groups were significantly higher than those before operation,and those in the study group were significantly lower than those in the control group(P＜0.05).The total effective rate of the study group was 96.36％,which was significantly higher than 83.64％of the control group(P＜0.05).Conclusion Stent as-sisted coil intracranial embolization has a good effect in patients with ruptured intracranial aneurysm,which can improve the nerve function of patients,reduce the level of cerebrospinal fluid inflammation and serum MBP.
Objective To analyze the application of intelligent speech follow-up system in sec-ondary prevention of ischemic stroke(IS).Methods A total of 842 IS patients who received intra-venous thrombolysis were randomly divided into intelligent group and artificial group.In the artificial group,corresponding intelligent follow-up templates were developed for the main risk factors affecting the occurrence of IS.The intelligent follow-up system determined the follow-up time and period ac-cording to the reserved information of patients when they were discharged,automatically called out the patients'home conditions for follow-up,and converted the response contents into text mode for out-put.The artificial group was followed up by professionally trained nursing staff,and the follow-up con-tent was the same as that of the intelligent group.Call out,hypertension,diabetes,medication,exer-cise,average call time and satisfaction of follow-up in the two groups were collected.Results The tel-ephone connection rates showed no statistical significances between two groups(P＞0.05).During the follow-up calls,the correct recognition rate of follow-up contents in the intelligent group was low-er,and therateof unwillingness to cooperate and call interruption rate were higher than those in the control group(P＜0.05).There were no statistically significant differences in the percentages of au-tomatic message leaving,inconvenient answering,resident death,family members unable to answer and number error between the two groups(P＞0.05),and there was no statistical significance in the distribution of disconnected calls between the two groups(P＞0.05).In the effective follow-up calls,there was no statistical significance in the answers to questions related to hypertension and diabetes,compliance and exercise between the two groups(P＞0.05).The average call duration in the intel-ligent group was significantly shorter,and follow-up satisfaction was lower than that in the control group(P＜0.05).Conclusion Intelligent voice follow-up system can replace manual telephone follow-up to a certain extent,and help medical staff understand the compliance of home blood pres-sure,blood sugar,medication,exercise and secondary prevention in IS patients,and can save fol-low-up time and improve follow-up efficiency compared with manual follow-up,but its language rec-ognition and improvement of cooperation rate still need to be optimized.
Objective To explore the predictive efficacy of three machine learning algorithms for carotid plaque stability in patients with cerebral infarction.Methods The clinical data of 500 pa-tients with cerebral infarction were retrospectively analyzed.Univariate analysis and multivariate anal-ysis were used to determine the predictive factors entering the model.The prediction model of carotid plaque stability in patients with cerebral infarction was constructed based on nomogram,decision tree and random forest respectively.The enrolled patients were randomly divided into training set and test set according to the ratio of 7∶3.Sensitivity,specificity,accuracy,recall,accuracy and area under the curve(AUC)were used to compare the application efficiency of the model.Results The AUC of the nomogram model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.910(95％CI,0.950 to 0.983),the sensitivity was 0.910,the specificity was 0.917,the accuracy was 0.886,the recall rate was 0.910,and the accuracy rate was 0.914.The AUC of the decision tree model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.932(95％CI,0.903 to 0.961),the sensitivity was 0.903,the specificity was 0.922,the accuracy was 0.891,the recall rate was 0.903,and the accuracy rate was 0.914.The AUC of the random forest model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.984(95％CI,0.970 to 0.998),the sensitivity was 0.972,the specificity was 0.995,the accuracy was 0.993,the recall rate was 0.972,and the ac-curacy was 0.986.Conclusion The model based on the random forest algorithm has a better pre-diction effect and stability in evaluating the stability of carotid plaque in patients with cerebral infarc-tion,and its prediction efficiency is better than that of the Nomogram and decision tree.
Objective To observe the effect of group biofeedback in patients with residual schiz-ophrenia(RS).Methods A total of 127 patients with RS were selected as study objects,and ran-domly divided into control group(n=63)and observation group(n=64).The control group re-ceived routine nursing,and the observation group received group biofeedback based on the control group.The Positive and Negative Symptom Scale(PANSS),Personal and Social Performance Scale(PSP)and Self-awareness Inventory(SAI)Questionnaire(treatment compliance)scores were com-pared between the two groups.Results After 12 weeks of intervention,the score of the positive symptoms,the score of negative symptoms and the total score of PANSS in the observation group were significantly lower than those in the control group(P＜0.05).The number of patients with PSP scores greater than 70 to 100 and greater than 30 to 70 in the observation group was significantly more than those in the control group,and the number of patients with PSP score of 0 to 30 was significantly less than that in the control group(P＜0.05).The SAI score of the observation group after interven-tion was significantly higher than that before intervention and control group,and the number of com-pleted biofeedback therapy in the observation group was significantly more than that in the control group(P＜0.05).Conclusion Group biofeedback can promote symptom relief and improve treat-ment compliance in patients with RS.
Objective To investigate the effects of Danshen polyphenolate combined with edara-vone on cognitive function,cerebral artery pulse index(PIMCA)and serum trypanoprotein-like pro-tein-1(VILIP-1)levels in patients with acute cerebral infarction(ACI).Methods A total of 88 pa-tients with ACI were selected as study objects.The patients were divided into single drug group(n=44)and combination group(n=44)according to random number table method.The single drug group was treated with edaravone,and the combination group was treated with edaravone combined with salvianolic acid for injection.The efficacy,cognitive function,PIMCA and serum VILIP-1 levels of the two groups were observed and compared.Results The overall effective rate of treatment in the combi-nation group was higher than that of the single drug group(81.82％versus 54.55％,P＜0.05).Af-ter treatment,the scores of Montreal Cognitive Assessment Scale(MoCA),Reactivity Exploration Scale(RSS)and Simple Mental State Assessment Scale(MMSE)in two groups were higher than be-fore treatment,and the combination group was higher than the single drug group(P＜0.05).After treatment,the levels of PIMCA and serum VILIP-1 in two groups were lower than before treatment,and the combination group was lower than the single drug group(P＜0.05).Conclusion Compared with edaravone alone,salvia miltiorrhiza polyphenolate injection combined with edaravone has a better therapeutic effect in ACI patients,which can effectively improve the patients'cognition,reduce PIMCA and serum VILIP-1 levels.
Objective To analyze the effects of painting and medication intervention on psycho-logical state,compliance and quality of life in patients with generalized anxiety disorder(GAD).Methods A total of 70 patients with GAD from May 2020 to September 2022 were included as study subjects,among whom 35 patients receiving single drug intervention were included in single group,and 35 patients receiving painting combined drug intervention were included in combined group.The psychological state scores and intervention compliance of the subjects in the two groups were ana-lyzed,the life quality scores and serum factor expression levels of the subjects in the two groups were compared before and after intervention,and the changes in sleep quality of the two groups were ob-served before and after intervention.Results After intervention,the scores of Hamilton Anxiety Rat-ing Scale(HAMA),Hamilton Depression Rating Scale(HAMD)in the two groups were decreased compared with those before intervention,but their scores in the combined group were lower,and the differences were statistically significant(P＜0.05).The total compliance rate of the combined group was higher than that of the single group(P＜0.05).After intervention,the 36-item Shot-form Health Status Survey(SF-36)scores of the two groups were improved compared with that before intervention,and the SF-36 score of the combined group was higher,the difference was statistically significant(P＜0.05).After intervention,the expression levels of brain derived neurotrophic factor(BDNF)and malondialdehyde(MDA)in the combined group were lower than those in the single group,and the expression level of superoxide dismutase(SOD)was higher than those in the single group(P＜0.05).After intervention,the sleep quality of the two groups was improved compared with that be-fore intervention,but the improvement degree of the combined group was higher(P＜0.05).Conclusion Painting combined with drug intervention can effectively improve the adverse psycho-logical state of GAD patients,improve their intervention compliance,and further improve their qual-ity of life and sleep quality.
Objective To establish an individualized prediction model for medication compli-ance in epilepsy adult patients and verify its predictive effect.Methods A total of 192 epilepsy pa-tients were selected as study objects,the Morisky Medication Adherence Scale(MMAS)was applied to assess patients'medication compliance,and patients were divided into compliance group(MMAS score of 6 to 8 points)and control group(MMAS score＜6 points)based on their compliance status.The general information,disease information,medication information,and social support of patients were analyzed.Multiple Logistic regression analysis was applied to analyze the influencing factors of pa-tients'medication compliance,the rms program package in R software was applied to establish a column chart model for predicting medication adherence,and the area(AUC)under the receiver operating characteristic(ROC)curve and the calibration curve were used to test its discrimination and accuracy.Results Among the 192 patients,119(61.98％)had good medication adherence and 73(38.02％)had poor medication adherence.The main influencing factors of medication compliance in epilepsy patients included educational background,antiepileptic drug medication type,side effects of drugs,frequency of medication knowledge education,and social support(P＜0.05);a column chart model for medication compliance in epilepsy patients was constructed based on five predictive indicators,the results showed that the AUC was 0.830(95％CI,0.772 to 0.888),and the calibration curve and ideal curve trends were similar,the goodness of fit Hosmer-Lemeshow test showed that thechi-square value was 9.970 and P value was 0.267,indicating that the model had high discrimination and accu-racy.Conclusion The nomogram established based on educational background,administration of antiepileptic drug type,side effects of drugs,frequency of medication knowledge education,and social support has a good predictive value in medication compliance in epilepsy patients.
Objective To explore the effects and possible mechanism of Mongolian medicine Eridun ·Wurile(EW)on neuronal apoptosis in rats with acute spinal cord injury(SCI).Methods The male SD rats were randomly divided into sham-operated group(sham group),SCI group,EW low-dose group,EW medium-dose group,EW high-dose group and EW high dose+AG490 group,with 15 rats in each group,and the SCI model of rats was established by Allen's method.EW low-dose group,EW medium-dose group and EW high-dose group were given EW suspension at a dosage of 0.32,0.63 and 1.26 g/kg for gavage after surgery,respectively;the EW high-dose+AG490 group was given Janus kinase 2(JAK2)inhibitor AG490(5 mg/kg)by gavage before surgery and EW(1.26 g/kg)by ga-vage after surgery;and the sham and SCI groups were given equal volume of distilled water,twice a day for 2 weeks.The hind limb motor function of each group was assessed by BBB grading score at 1 day,3,7 and 14 days postoperatively;the rats were executed 12 h after the last administration and the spinal cord water content was examined;the histopathological changes were observed by Hematoxy-lin-Eosin(HE)staining in the spinal cord of each group;the apoptosis of spinal neurons was detec-ted by in situ notch end labeling(TUNEL).The expression of Cleaved caspase-3,B-lymphoblas-toma-2(Bcl-2),Bcl-2 associated X protein(Bax),phosphorylated(p)-JAK2,and p-signal transduction and transcriptional activator 3(STAT3)proteins in spinal cord were detected by West-ern blot.Results Compared with the sham group,the BBB scores of rats in the SCI group were significantly lower,spinal cord edema and pathological structural damage were severe,the number of apoptotic cells and the expression of Cleaved caspase-3,Bax,p-JAK2 and p-STAT3 proteins in the spinal cord were significantly increased,while the expression of Bcl-2 was decreased(P＜0.05 or P＜0.01);compared with the SCI group,the BBB scores of EW low-dose group,EW medium-dose group and EW high-dose group gradually increased,the pathological injury degree of spinal cord tissue was relieved,and the number of apoptotic cells in spinal cord tissue was reduced,Cleaved caspase-3,Bax,p-JAK2,and p-STAT3 protein expressions were gradually down-regulated,while Bcl-2 protein expression was gradually up-regulated(P＜0.05 or P＜0.01);compared with EW high-dose group,the expression of P-JAK2,p-STAT3,Bax,Cleaved caspase-3 proteins down-regulated in the spinal cord tissue of EW high dose+AG490 group,and Bcl-2 protein were up-regu-lated,and the differences were statistically significant(P＜0.01).Conclusion EW plays a neu-roprotective role via inhibiting JAK2/STAT3 signaling pathway and reducing apoptosis in acute spi-nal cord injury rats.
