OBJECTIVES:This study aimed to explore the effects of bone marrow-derived Mesenchymal Stem Cell-Conditioned Medium (MSC-CM) treating diabetic foot ulcers in rats. METHODS:Models of T2DM rats were induced by a high-fat diet and intraperitoneal injection of STZ in SD rats. Models of Diabetic Foot Ulcers (DFUs) were made by operation on hind limbs in diabetic rats. Rats were divided into four groups (n = 6 for each group), i.e., Normal Control group (NC), Diabetes Control group (DM-C), MSC-CM group and Mesenchymal Stem Cells group (MSCs). MSC-CM group was treated with an injection of conditioned medium derived from preconditioned rats' bone marrow MSCs around ulcers. MSCs group were treated with an injection of rats' bone marrow MSCs. The other two groups were treated with an injection of PBS. After the treatment, wound closure, re-epithelialization (thickness of the stratum granulosums of the skin, by H&E staining), cell proliferation (Ki67, by IHC), angiogenesis (CD31, by IFC), autophagy (LC3B, by IFC and WB; autolysosome, by EM) and pyroptosis (IL-1β, NLRP3, Caspase-1, GSDMD and GSDMD-N, by WB) in ulcers were evaluated. RESULTS:After the treatment wound area rate, IL-1β by ELISA, and IL-1β, Caspase-1, GSDMD and GSDMD-N by WB of MSC-CM group were less than those of DM group. The thickness of the stratum granulosums of the skin, proliferation index of Ki67, mean optic density of CD31 and LC3B by IFC, and LC3B by WB of MSC-CM group were more than those of DM group. The present analysis demonstrated that the injection of MSC-CM into rats with DFUs enhanced the wound-healing process by accelerating wound closure, promoting cell proliferation and angiogenesis, enhancing cell autophagy, and reducing cell pyroptosis in ulcers. CONCLUSIONS:Studies conducted indicate that MSC-CM administration could be a novel cell-free therapeutic approach to treat DFUs accelerating the wound healing process and avoiding the risk of living cells therapy.
Background and rationale: Urine drainage after renal secretion and excretion requires an unobstructed urinary tract. In the event of an obstruction, and depending on the etiology of the obstruction, endoscopic drainage of the urinary tract is indicated. This study aimed to identify the indications and assess the quality of life of patients who have undergone endoscopic drainage of the upper urinary tract at the Clinique Universitaire d'Urologie - Andrologie of the CNHU-HKM in Cotonou over the past five years. Patients and method: This was a descriptive, retrospective study of patients who underwent endoscopic drainage of the upper urinary tract (JJ stent assembly) at the CNHU-HKM University Urology-Andrology Clinic from January 1, 2018, and December 31, 2022. The English-language "ureteral stent symptom questionnaire (USSQ)" developed and validated by Joshi et al, then translated and validated in French in 2010, enabled us to assess the tolerance of JJ stents in our patients. Results: A total of 173 patients were selected, with an average age of 46. Males accounted for 64.61 % of cases. JJ catheterization was indicated in 51.44 % of cases (n=89), due to ureterohydronephrosis. Etiologies were dominated by lithiasis obstacles in 73.41 % of cases. Pain and discomfort associated with the presence of the JJ stent were found in 27.75 % of cases (n=48). Sexual activity was impeded by pain in 4 patients (8.0 %). Conclusion: The use of JJ stent is common practice in urology, but they are responsible for significant morbidity. In our study, the indication is dominated by renal colic complicating lithiasis. Studies aimed at assessing the quality of life of JJ stent patients remain a challenge, as they very often lead to subjective conclusions and are generally influenced by confounding variables such as age and comorbidities. A better understanding of the areas of daily life impacted by JJ stent use will enable us to better inform our patients, as well as develop new JJ stent models to improve their tolerability.
Background: Air pollution is a serious public health concern, killing an estimated 800,000 people annually in developing and developed nations. In urban areas, traffic is one of the most significant sources of hazardous exhaust pollutants. Street vendors are often exposed to air pollutants as a result of their proximity to busy roads and intersections where vehicle emissions are high. Street vendors form an integral part of urban life globally as they provide convenience, affordable goods, and services to the general public. Aim: This study aimed to assess the prevalence and factors associated with respiratory and other health symptoms among street vendors in Gaborone, Botswana. Materials and Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire distributed to randomly selected street vendors. The questionnaire gathered information on demographic characteristics and respiratory and other health symptoms among street vendors. Data was analysed using logistic regression. Results: About 392 street vendors participated in the study, with 71% females. The mean age (M±SD) of the respondents was 46±13 years, with an age range of 25–66 years. About 46%) and 38% attained senior and junior secondary school certificates, respectively and 78%) worked for >8 hours/day. Coughing, headache and dizziness were reported by 89%, 62% and 58% of respondents respectively. Female vendors were at increased risk of wheezes (Odds Ratio (OR): 3.12, 95% Confidence Intervals (CI):1.24-7.85) and headaches (OR: 4.61, 95% CI: 2.02-10.54) when compared to males. Increasing age and working for >5 days/week were significantly associated with respiratory and other health symptoms such as sore throat, nasal congestion and wheezes. Tobacco smoking and alcohol consumption predisposed street vendors to nasal congestion (OR: 4.34, 95% CI: 1.28-14.72) and shortness of breath (OR: 3.70, 95% CI: 1.29-10.65), respectively. Physical exercise provided a protective effect against chest tightness (OR: 0.133, 95% CI: 0.03-0.06) and dizziness (OR: 0.73, 95% CI: 0.15-0.35). Conclusion: Street vendors reported a high prevalence of respiratory and related health symptoms. Factors such as increasing age, tobacco smoking and alcohol consumption have been associated with respiratory and related health symptoms among street vendors. Large scale research that quantifies TRAP pollutants and health symptoms is needed to inform policy development.
ABSTRACT Objective: To analyze the differences of peripheral blood immune cells in healthy people, and patients with myelodysplastic syndromes (MDS) patients or acute myeloid leukemia (AML), and to investigate their correlations with International Prostate Symptom Score(IPSS), blasts and other factors in MDS patients. Methods: 55 patients with MDS(MDS group), 67 patients with AML(AML group) and 25 heathy people(healthy group) were selected as research objects from Dongzhimen Hospital Affiliated with Beijing University of Chinese Medicine from January, 2012 to April, 2022 for this retrospective analysis. By comparing peripheral blood lymphocyte subsets count and peripheral blood lymphocyte subsets percentage, we studied the expression of T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+, CD3+CD4+CD25+FoxP3+), B cells (CD19+) and NK cells (CD3-CD16+CD56+). The correlations between the different indexes and IPSS and blasts were analyzed. Results: (1) Peripheral blood lymphocyte subsets count: There were differences among the three groups. Through pairwise comparison, MDS group had lower peripheral blood lymphocyte subsets count(P＜0.025), probably owing to the low peripheral blood lymphocyte count. (2)Peripheral blood lymphocyte subsets percentage: The percentages of Treg cells, B cells and T cells varied among the three groups. Compared with the healthy group, the percentages of T cells ( P＜0.025) and Treg cells ( P＞0.025) in MDS group were higher, and the percentage of B cells ( P＜0.025) was lower. Compared with MDS group, the percentage of Treg cells ( P＜0.025) in AML group was higher and the proportion of B cells was lower ( P＜0.025). (3)Correlations with IPSS and blasts: The percentage of Treg cells was positively correlated with IPSS and blasts. Conclusion: Treg cells showed an increasing trend in turn by healthy people group, MDS group and AML group. The high expression of Treg cells may have great significance in prognosis and progression of MDS. Key words: Acute myeloid leukemia; Blasts; Immune cells; Myelodysplastic syndromes.
Objective To investigate the changes and clinical significance of bile acid spectrum levels in patients with early non-alcoholic fatty liver disease(NAFLD).Methods A total of 149 patients with early NAFLD(NAFLD group)and 140healthy controls(healthy group)who underwent physical examinations at the Physical Examination Center,the Fourth Affiliated Hospital of Zhejiang Uni-versity School of Medicine from July 2021 to February 2022 were selected,and liver function test,bile acid spectrum detection and con-trolled attenuation parameter test were performed on all patients,the differences in liver function and bile acid spectrum between the two groups were compared,and the risk factors of early NAFLD and the efficacy of bile acid subgroups in diagnosing early NAFLD were ana-lyzed.Results The levels of aspartate transaminase(AST),alanine aminotransferase(ALT),and γ-glutamyl transpeptidase(r-GT)in the NAFLD group were higher than those in the healthy group(P<0.05).cholic acid(CA),glycocholic acid(GCA),tauro-cholic acid(TCA),glycodeoxycholic acid(GDCA),chenodeoxycholic acid(CDCA),glycochenodeoxycholic acid(GCDCA),tauro-chenodeoxycholic acid(TCDCA),glycineursodeoxycholic acid(GUDCA),tauroursodeoxycholic acid(TUDCA)and taurolithocholic acid(TLCA)were higher than those in the healthy group(P<0.05),and the level of lithocholic acid(LCA)was lower than the healthy group(P<0.05);Logistic regression analysis showed that AST,GCA,TCA,CDCA,GCDCA,TCDCA,GUDCA and TLCA were inde-pendent risk factors in NAFLD patients;receiver operating characteristic curve shows that AST,GCA,TCA,CDCA,GCDCA,TCDCA,GUDCA and TLCA could predict the occurrence of NAFLD to a certain extent,among which AST had the best comprehensive prediction effect(AUC =0.750),and GCA had the highest sensitivity(77.2%),and TLCA had the strongest specificity(88.6%);the levels of GCA and TCA in the severe group were significantly higher than those in the mild group(P<0.05),the concentration of serum TCA in-creased gradually increased with the aggravation of NAFLD severity,and there was a linear correlation between them(r = 0.52,P<0.05).Conclusion The bile acid spectrum components of patients with early NAFLD was changed,mainly primary bile acids and con-jugated bile acids.The level of TCA can not only predict the occurrence of NAFLD to a certain extent,but also has a positive correlation with the severity of NAFLD,which is expected to become a serological marker of NAFLD.
近年来,糖尿病肾脏病(diabetic kidney disease,DKD)在我国的发病人数迅速增加.随着病情进展,患者的心血管事件和死亡风险显著增加,在后期终末期肾病需要昂贵的肾脏替代治疗,这为患者和社会带来了巨大的心理和经济负担.可靠的诊断和预测是减少 DKD危害的基础策略.本文探讨传统和在研的 DKD 生物学标志物的研究现状,并评估其预测 DKD 进展的可能性.
Objective To evaluate the effect of negative-pressure wound therapy with irrigation(NPWTi)combined with red and blue light on diabetic foot wounds.Methods According to random number method,a total of 80 patients with type 2diabetes combined with diabetic foot admitted to Xuzhou Central Hospital from December 2021 to May 2022 were selected and divided into two groups:con-trol group and NPWTi + red and blue light group,with 40 cases in each group.All patients received basic treatment,while the control group received NPWTi treatment,NPWTi + red and blue light group was treated with red and blue light on the basis of NPWTi.The chan-ges of wound healing speed rate,serum inflammatory markers[erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),pro-calcitonin(PCT)]and growth factors[vascular endothelial growth factor(VEGF),epidermal growth factor(EGF),basic fibroblast growth factor(bFGF)]were observed before and 7days after treatment.After 12 weeks of follow-up,the wound healing rate of the two groups were observed,and the cumulative wound healing rate of the two groups was evaluated through Kaplan-Meier curve.Results Af-ter 7days of treatment,the wound healing rate of NPWTi + red and blue light group was faster than that of the control group(P<0.01).The average levels of VEGF,EGF and bFGF in NPWTi + red blue light group were higher than those in the control group(P<0.05),while the average levels of ESR,CRP and,PCT in NPWTi + red and blue light group were lower than those in the control group(P<0.05).The wound healing rate of NPWTi + red and blue light group at 12 weeks was higher than that of the control group(P<0.05).Kaplan-Meier curve analysis showed that the cumulative wound healing rate of NPWTi + red and blue light group was higher than that of the control group(P<0.05).Conclusion NPWTi combined with red and blue light is effective in treating diabetic foot wounds,and it is worthy of clinical application.
目的 探讨一分钟教学法(one minute preceptor,OMP)在放射科住院医师规范化培训教学阅片中的应用效果.方法 选取北京大学第三医院放射科参加规范化培训的住院医师,将 2020 年的 15 名学生作为对照组,2021 年的 16 名学生作为试验组.在以案例为基础的教学法(case-based learning,CBL)的前提下,试验组增加 OMP.通过"问卷星"微信平台制作调查问卷,课后采用问卷调查两组学生对当前教学阅片方式的评价,同时比较两组学生影像读片和理论考试成绩.结果 试验组读片考试平均成绩为 88.25±4.36 分,显著高于对照组(82.00±6.40 分),差异有统计学意义(P<0.05);试验组理论考试平均成绩为 85.63±11.69 分,对照组为 81.33±8.06 分,差异无统计学意义(P = 0.247).结论 OMP 结合 CBL 的模式可以提高放射科住院医师规范化培训中的教学阅片效果.
Objective To explore the expression and clinical significance of sine oculis homeobox homolog 4(SIX4)in endometrial carcinoma and its effect on the invasion and migration of Ishikawa cells.Methods Real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression level of SIX4 in endometrial carcinoma tissue(endometrial carcinoma group)and normal endometrial tissue(control group).The correlation between the expression level and the clinicopathological characteristics of endometrial carcinoma patients was analyzed.Ishikawa cells were divided into normal group(blank control group),negative control group(transfect-ed with siRNA-NC group)and inhibition group 1(transfected with siRNA-1 group),inhibition group 2(transfected with siRNA-2 group),inhibition group 3(transfected with siRNA-3 group),RT-qPCR was used to detect the expression of SIX4 in each group.Western blot was used to detect the protein expression level of SIX4,E-cadherin and N-cadherin in Ishikawa cells of each group;Tran-swell test and scratch test were used to detect the invasion and migration ability of Ishikawa cells in each group.Results Compared with the control group,the expression level of SIX4 was higher in endometrial carcinoma group(P<0.05).The high expression of SIX4 was correlated with the clinical stage of endometrial carcinoma,the depth of muscular invasion and lymph node metastasis(P<0.05),but not with age,tissue type and differentiation degree(P>0.05).After SIX4 expression was inhibited by siRNA,RT-qPCR showed that inhi-bition group 2 had the best interference effect.Western blot showed that the expression of E-cadherin in inhibition group was higher than that in normal group and negative control group,while the expression of SIX4 and N-cadherin was lower.Transwell and scratch experi-ments showed that the invasion and migration of cells in the inhibition group were significantly lower than those in the normal group and negative control group(P<0.05).Conclusion SIX4 is highly expressed in endometrial carcinoma tissues,and its high expression is related to the adverse pathological features of endometrial carcinoma.siRNA targeted inhibition of SIX4 expression can inhibit the invasion and migration ability of endometrial cancer cells through epithelial mesenchymal transition pathway.
狼疮性肾炎(lupus nephritis,LN)是系统性红斑狼疮引起的继发性肾炎,其致病机制复杂,且缺乏特异性治疗.细胞焦亡是一种伴随炎性反应的程序性细胞死亡,其在 LN中的作用愈发受到广泛关注,miR-155 作为一种高度保守的非编码小RNA,近年来被发现通过参与多种信号通路从而影响细胞焦亡及 LN的发生、发展.本文通过归纳概括细胞焦亡参与 LN 的致病过程、miR-155 对细胞焦亡通路的调控及对LN的影响等方面,总结了miR-155 通过调节细胞焦亡从而影响LN的作用机制,旨在为 LN的靶向治疗提供新的视角.
Objective To explore the correlation between peripheral blood monocyte levels and postoperative cognitive dysfunction(POCD)in elderly patients.Methods A total of 96 elderly patients undergoing elective total hip arthroplasty under general anesthesia in the Affiliated Hospital of Xuzhou Medical University from October 2021 to March 2022 were enrolled in the prospective observational stud-y,and the patients were divided into POCD group(26 cases)and Non-POCD group(70 cases)according to the mini-mental state ex-amination(MMSE)score.Peripheral blood monocyte levels and other relevant indicators were recorded.Receiver operating characteristic(ROC)curve were applied to analyze the predictive value of peripheral blood monocyte levels for POCD with total hip arthroplasty in eld-erly patients.Univariate and multivariate Logistic regression analyses were used to evaluate risk factors.Results The optimal cut-off value for preoperative monocyte levels predicting POCD in elderly patients with total hip arthroplasty was 0.55×109/L,and area under the curve value was 0.729.Univariate Logistic regression analysis showed that lower education level,higher American Society of Anesthe-siologists(ASA)grade,and preoperative and postoperative elevated monocyte levels were the risk factors for POCD;multivariate Logistic regression analysis showed that preoperative monocyte levels were independently associated with the occurrence of POCD.Conclusion Preoperative peripheral blood monocyte levels are associated with the occurrence of POCD,and preoperative elevated monocyte level is a risk factor for POCD,helping to predict the potential risk of POCD.
实验教学是病理教学的有机组成部分,要求学生具有较高的自主学习能力、动手操作能力和创新能力.本文运用CiteSpace软件对国内近 6 年来发布的病理实验教学相关文献进行归纳整理,从年度发文量、发文期刊、文章下载及被引次数、发文机构、作者合作、关键词共现、关键词聚类、关键词时间线、关键词突现等 9 个方面进行了可视化分析,整理了目前病理实验教学的研究内容及发展动态,以期为后续的研究重点和教学改革提供参考依据.
Objective To investigate the efficacy of different doses of clopidogrel combined with aspirin in the treatment of high-risk non-disabling ischaemic cerebrovascular events(HR-NICE)under the precise guidance of point-of-care testing(POCT)of cy-tochrome P-450 2C19(CYP2C19)genotype.Methods The single-center,randomised,prospective,and blinded endpoint assess-ment was used.HR-NICE patients continuously enrolled in the stroke green channel and neurology ward of Xuzhou Central Hospital from January 2021 to January 2022,and all patients scraping of the buccal mucosa will be screened for CYP2C19 loss-of-function allele car-riers by POCT.According to the random number table method,they were divided into the intensive group(clopidogrel 150mg/d)and the conventional group(clopidogrel 75mg/d)combined with aspirin(100mg/d)dual antiplatelet for 21 days.Baseline information,acute stroke Org 10172 treatment trial(TOAST)staging and 90 days modified Rankin scale(mRS)score and occurrence of adverse events and severe adverse events were collected for the two groups.The primary efficacy outcome was new stroke within 90 days and the primary safety outcome was severe or moderate bleeding within 90 days.Results A total of 1301 patients were screened,of which 727 patients carried CYP2C19 loss-of-function allele,and 476 patients were included:236 patients in the intensive group and 240 patients in the conven-tional group.The differences between the two groups were not statistically significant at baseline(P>0.05);4 cases(1.7%)inthein-tensive group and 26 cases(10.8%)in the conventional group had a new stroke at 90 days.The differences between the two groups were statistically significant(χ2 = 16.827,P<0.001);0 case(0)in the intensive group and1 case(2.5%)in the conventional group had moderate to severe haemorrhage at 90 days.The differences between the two groups was not statistically significant(P>0.05).Conclu-sion In HR-NICE patients with CYP2C19 loss-of-function allele,the enhanced clopidogrel dose was more effective than the conven-tional dose in the treatment with the antiplatelet drug aspirin combined with clopidogrel,and had a consistent safety profile with no more adverse events such as bleeding.
神经病理性疼痛是由中枢神经系统及周围神经系统的原发性损害和功能障碍诱发,常会引起痛觉过敏、异常疼痛、自发性疼痛和感觉异常,而这些变化是如何发生的仍然难以确定.最新研究表明,外周有害刺激改变了 RNA修饰、非编码 RNA、DNA甲基化、组蛋白修饰等表观遗传学修饰,这些变化可能与神经病理性疼痛的痛觉敏感有关.本文综述目前神经病理疼痛表观遗传学作用机制的研究进展,以期为该疾病的诊疗提供潜在靶点.
Objective To explore the value of shear wave elastography(SWE)in the kidneys of children with Henoch-Schonlein purpura(HSP).Methods A total of 59 cases with HSP admitted to the Second Affiliated Hospital of Wenzhou Medical University from November 2021 to August 2022 were selected and divided into simple HSP group(29 cases)and Henoch-Schonlein purpura nephritis(HSPN)group(30 cases).50 normal children during the same period were included as control group.The Young′s modulus(YM)of right renal cortex and medulla were compared among the three groups.receiver operating characteristic curve(ROC curve)was plotted to evaluate the diagnostic efficiency of SWE for simple HSP.Correlation analysis and multiple linear regression analysis were performed for the YM value of right renal cortex and medulla of all children with HSP and related indexes.Results There was statistical significance in YM values of right renal cortex and medulla among the three groups(P<0.05).The YM value of right renal cortex of the simple HSP group was higher than that in the control group and HSPN group(P<0.05).The YM value of right renal medulla of the simple HSP group were higher than that in the control group(P<0.05).The YM value of right renal cortex was better than the YM value of right renal medulla in the diagnostic efficiency of simple HSP.The YM value of right renal cortex and medulla both had a linear regression relation-ship with the right renal volume.Conclusion The YM value of right renal cortex and medulla were higher than those of healthy children,with the progression of the disease the YM values decreasing.It may become a new technology for routine screening and follow-up moni-toring of renal involvement in children with HSP.
细胞外囊泡阐述了一种全新的细胞间交流方式,成为近年来的研究热点.在卵泡发育过程中,颗粒细胞和卵母细胞间的交互作用至关重要,两者之间的交流主要是通过间隙连接进行.细胞外囊泡则主要通过其内容物对卵泡发育关键信号通路进行调节.随着对细胞外囊泡研究的不断深入,细胞外囊泡在液态活检、癌症治疗、靶向药物递送等应用上有了重大成果.本文将从卵泡发育过程中颗粒细胞和卵母细胞的交互作用和细胞外囊泡的交互作用两个方面进行综述,探讨细胞外囊泡在解决早发性卵巢功能不全的卵泡发育问题上的应用前景.
Objective To investigate the efficacy of different courses of saccharomyces boulardii powder combined with triple therapy in eradicating helicobacter pylori(Hp)in children.Methods A total of 135 children with Hp-related gastritis who received initial treatment in the Department of Pediatrics,Affiliated Hospital of Xuzhou Medical University from October 2021 to June 2022 were selected and divided into three groups according to random number table method:group A,group B and group C,with 45 cases in each group.Group A:triple therapy(omeprazole + clarithromycin + amoxicillin)for 14 days;group B and group C:on the basis of triple therapy,saccharomyces boulardii powder was added from the first day of treatment for 2 weeks and 4 weeks,respectively.The adverse reactions during treatment were recorded,the levels of serum pepsinogen Ⅰ(PGⅠ)and pepsinogen Ⅱ(PGⅡ),clinical efficacy and Hp eradica-tion rate were observed 4 weeks after the end of treatment.Results The levels of serum PGⅠ and PGⅡ in the three groups after treat-ment were significantly lower than those before treatment(P<0.05),the levels of serum PGⅠ and PGⅡ in group B and group C after treatment were lower than those in group A(P<0.05),and the levels of serum PGⅠ and PGⅡ in group B were lower than those in group C after treatment(P<0.05).The clinical effective rates of group B(93.0%)and group C(90.4%)were higher than those of group A(62.5%)(P<0.05).The clinical effective rate of group B was higher than that of group C(P>0.05).The Hp eradication rate of group B and group C was significantly higher than that of group A(P<0.05),and the Hp eradication rate of group B was higher than that of group C(P>0.05).The incidence of diarrhea and loss of appetite in group B and group C were lower than those in group A(P<0.05);the incidence of diarrhea and loss of appetite in group B was lower than that in group C(P<0.05).There was no signifi-cant difference in the incidence of abdominal pain,nausea and vomiting among the three groups(P>0.05).Conclusion Saccharomy-ces boulardii decoction combined with triple therapy for 2 or 4 weeks can effectively regulate PG level,improve the eradication rate of Hp,and reduce the incidence of adverse reactions.It is suggested that 2 weeks is the best course of treatment.
Objective To explore the clinical efficacy of sacubitril/valsartan(SV)in the treatment of maintenance hemodialysis(MHD)with heart failure with preserved ejection fraction(HFpEF).Methods A total of 90 patients with MHD combined with HFpEF admitted to the Second People′s Hospital Affiliated of Hefei to Bengbu Medical College from January to December 2021,they were divided into control group and treatment group according to the random number method,with 45 cases in each group.Patients in the control group tookangiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker(ACEI/ARB)conventional drugs orally;patients in the treatment group took ARNI orally,the initial dose was 50mg,twice a day,followed by an increase to 100mg twice a day,after 2 weeks.After 3 months of treatment,the relevant indicators of cardiac function,including left ventricular ejection fraction(LVEF),left ventricu-lar end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD),pulmonary artery pressure(PAP),N-ter-minal pro-B-type natriuretic peptide(NT-pro BNP),6-minutes walk test(6MWT),blood pressure level,serum potassium and the incidence of adverse events before and after treatment were collected and compared.Results After 3months of treatment,there were no significant differences in the clinical data,cardiac function index,cardiac function grade,6MWT,blood pressure level and serum potassi-um between the control group and the treatment group before treatment(P<0.05);after 3months of treatment,the levels of LVEF,LVEDD,LVESD,PAP,NT-pro BNP,6MWT,and blood pressure were all improved significantly compared with the baseline in both groups(P<0.05),and there was no significant difference of serum potassium before and after treatment in the two groups(P>0.05);after treatment,LVEF and 6MWT in the treatment group were higher than those in the control group,the LVEDD,LVESD,PAP,NT-pro BNP and blood pressure were lower than in the control group(P<0.05).There were significant differences in LVEF,LVEDD,LVESD,NT-pro BNP,6MWT,systolic blood pressure and diastolic blood pressure between the two groups before and after treatment(P<0.05).Conclusion The clinical efficacy of SV in MHD patients with HFpEF is certain,and can significantly improve cardiac function,increase the NYHK grade,improve blood pressure levels and exercise tolerance,reduce rehospitalization rates.
Objective To investigate the relationship between neutrophil-to-albumin ratio(NAR)and severity and prognosis of patients with spontaneous intracerebral hemorrhage(sICH).Methods A total of 330 patients with sICH who met the enrollment criteria were included.They were divided into good prognosis group(mRS≤3,n =139)and poor prognosis group(mRS>3,n =191)according to the modified Rankin scale at 30days after onset.The clinical data of the two groups were analyzed by Univariate analysis,and the risk factors affecting the poor prognosis of sICH patients wereidentified by multivariate Logistic regression analysis.Spearman correlation analy-sis was used to explore the correlations between NAR and National Institute of Health stroke scale and intracerebral hemorrhage scale.The receiver operating characteristic(ROC)curve was further used to evaluate the predictive value of NAR in the early clinical prognosis of sICH patients.Results The NAR of patients with poor prognosis was significantly higher than that of patients with good prognosis[0.16(0.13,0.18)vs 0.22(0.19,0.28),P<0.001].Multivariate Logistic regression analysis showed that NAR was an independent risk factor for poor prognosis in patients with sICH after adjusting for confounding factors(OR =1.480,95%CI:1.320-1.521,P<0.001).NAR was moderately positively correlated with NIHSS(r =0.489,P<0.001)and ICH score(r =0.450,P<0.001).The area under the ROC curve of NAR was0.818(95%CI:0.771-0.865),indicating good prediction efficiency.Conclusion Elevated NAR on admission was associated with the severity of sICH,and NAR represents an independent factor associated with poor outcome in sICH patients.
Objective To investigate the changes and clinical significance of the expression of neutrophil gelatinase-associated li-pocalin(NGAL)and autophagy during different time of renal ischemia/reperfusion(I/R)injury in rats.Methods The rat renal I/R in-jury model was established,thirty male Wistar rats were divided by random number table method into sham operation group(Sham group)and I/R group,according to the different time of reperfusion after I/R injury,the I/R group was divided into 4subgroups:2h group,6h group,24h group,48h group.Blood,urine and renal tissue samples were collected at different time points,NGAL levels of blood and u-rineweredetectedbyenzyme-linkedimmunoadsordentassay(ELISA)method.Bloodureanitrogen(BU)and serum creatinine(SCr)were detected by automatic biochemical analyzer.Hematoxylin-eosin staining was used to detect the degree of histopathological injury and score the degree of injury.TdT-mediated dUTP nick end labeling(TUNEL)method was used to detect the apoptosis of renal tubular ep-ithelial cells;the expression of autophagy related genes LC3 and Beclin-1gene was detected by real-time quantitative polymerase chain reaction(RT-qPCR)method.Results The expression levels of NGAL in blood and urine were elevated in the 2h after I/R injury,and peaked at 6h of reperfusion,and showed a downward trend at 24h.BU and Scr values began to increase after the 6h reperfusion of I/R in-jury and peaked at 24h of reperfusion.TUNEL positive cells began to increase at 6h after I/R injury,the number of the highest was at 24h reperfusion of I/R injury.Hematoxylin-eosin staining showed that there were different degrees of swelling and necrosis of renal tubular epithelial tissue in all groups after I/R injury.The expression of LC3 and Beclin-1 gene began to increased after the 6h reperfusion of I/R injury and peaked at 24h of reperfusion.Conclusion The expression level of NGAL increased at the early stage of renal I/R injury in rats,which was earlier than the changes of BU and SCr levels,and could be used as a molecular indicator for early diagnosis of renal I/R injury.During the aggravation of renal I/R injury,the expression of NGAL was increased and autophagy was activated,which indica-ted that NGAL and autophagy played a certain role in the process of renal I/R injury.
