Veterinary drugs are substances(including pharmaceutical feed additives)used to prevent,treat,and diagnose diseases or regulate the physiological functions of animals.Veterinary drug poisoning in humans is relatively ...Veterinary drugs are substances(including pharmaceutical feed additives)used to prevent,treat,and diagnose diseases or regulate the physiological functions of animals.Veterinary drug poisoning in humans is relatively rare both in China and the rest of the world.Here,we report a case of death from veterinary drug poisoning from avermectin-closantel.Avermectin-closantel is a broad-spectrum antiparasitic drug,which has high efficacy against a variety of trematodes and nematodes.展开更多
BACKGROUND Acute kidney injury(AKI) after coronary angiography(CAG) and primary percutaneous coronary intervention(PPCI) is frequently observed, and often interpreted as contrast induced-AKI. This study aimed to inves...BACKGROUND Acute kidney injury(AKI) after coronary angiography(CAG) and primary percutaneous coronary intervention(PPCI) is frequently observed, and often interpreted as contrast induced-AKI. This study aimed to investigate the incidence, predictors and outcomes of AKI in acute ST-segment elevation myocardial infarction(STEMI) patients undergoing emergent CAG/PPCI using the control group of STEMI patients who were not exposed to contrast agents within the first 72 h.METHODS We performed a retrospective analysis of 1670 STEMI patients. Of them, 673 patients underwent emergent CAG/PPCI, and 997 patients treated with thrombolysis or no reperfusion therapy who were not exposed to contrast material during the first 72 h. AKI was defined as an increase of serum creatinine ≥ 44.2 mmol/L or ≥ 25% from baseline within 72 h. Patents were then followed up for the occurrence of all-cause mortality for 40 months(interquartile range: 24–55 months).RESULTS After propensity score matching, 505 pairs of patients were matched. Overall, the incidence of AKI was 27.4%, and AKI rates were not significantly different in patients with and without emergent CAG/PPCI procedure(27.5% vs. 27.3%, P = 0.944). Multivariate logistic regression analysis identified that the independent predictors of AKI were female, elevated interleukin-6 level,decreased lymphocyte count, left ventricular ejection fraction < 50% and use of diuretics in patients with emergent CAG/PPCI. Patients with AKI than those without AKI experienced higher incidence of acute heart failure with Killip class Ⅲ(9.4% vs. 3.3%, P =0.005;15.2% vs. 6.8%, P = 0.003, respectively) and mortality(5.8% vs. 1.4%, P = 0.014;12.3% vs. 4.6%, P = 0.002, respectively) in patients with and without emergent CAG/PPCI. Multivariate Cox regression analysis confirmed that AKI was independently associated with long-term mortality rate at 40 months follow-up in patients with and without emergent CAG/PPCI(HR = 1.867, 95% CI:1.086–3.210, P = 0.024;HR = 1.700, 95% CI: 1.219–2.370, P = 0.002, respectively).CONCLUSIONS Approximately 27.0% of STEMI patients experience AKI, which is strongly associated with an increased shortand long-term mortality regardless of emergent CAG/PPCI procedure. The development of AKI is mainly related to female gender, inflammation reaction, heart failure and use of diuretics in STEMI patients undergoing emergent CAG/PPCI.展开更多
OBJECTIVES To investigate the prevalence of polypharmacy and potentially inappropriate medication(PIM)in elderly patients with heart failure(HF)and their impact on readmission and mortality.METHODS We conducted a stud...OBJECTIVES To investigate the prevalence of polypharmacy and potentially inappropriate medication(PIM)in elderly patients with heart failure(HF)and their impact on readmission and mortality.METHODS We conducted a study of 274 participants aged 60 years or older with HF.The prevalence of polypharmacy(defined as the use of five or more medications)was calculated,and the 2019 American Geriatrics Society Beers criteria were applied to access PIMs.Medications and PIMs were characterized at admission and discharge,and changes in prescriptions during hospitalization were compared.The impact of polypharmacy and PIM on readmission and mortality were investigated.RESULTS The median age of this study population was 68 years old.The median number of prescribed drugs was 7 at admission and 10 at discharge.At discharge,99.27%of all patients were taking five or more drugs.The incidence of composite endpoint and cardiovascular readmission increased with the number of polypharmacy within 6 months.The use of guideline-directed medical therapy reduced the incidence of composite endpoint events and cardiovascular readmission,while the use of noncardiovascular medications increased the composite endpoint events.The frequency of PIMs was 93.79%at discharge.The incidence of composite endpoint events increased with the number of PIMs.“PIMs in older adults with caution”increased cardiovascular readmission and“PIMs based on kidney function”increased cardiovascular mortality.Several comorbidities were associated with cardiovascular mortality or non-cardiovascular readmission.CONCLUSIONS Polypharmacy and PIM were highly prevalent in elderly patients with HF,and their use was associated with an increased risk of composite endpoint events,readmission and mortality.Non-cardiovascular medications,“PIMs in older adults with caution”,“PIMs based on kidney function”and several comorbidities were important factors associated with hospital readmission and mortality.Our findings highlight the importance of medication optimization in the management of HF in elderly patients.展开更多
BACKGROUND Heart failure(HF)is a global health problem characterized by impaired heart function.Cardiac remodeling and cell death contribute to the development of HF.Although treatments such as digoxin and angiotensin...BACKGROUND Heart failure(HF)is a global health problem characterized by impaired heart function.Cardiac remodeling and cell death contribute to the development of HF.Although treatments such as digoxin and angiotensin receptor blocker drugs have been used,their effectiveness in reducing mortality is uncertain.Researchers are exploring the use of adipose-derived mesenchymal stem cell(ADMSC)exosomes(Exos)as a potential therapy for HF.These vesicles,secreted by cells,may aid in tissue repair and regulation of inflammation and immune responses.However,further investigation is needed to understand the specific role of these vesicles in HF treatment.AIM To investigate the mechanism of extracellular vesicles produced by ADMSC s in the treatment of HF.METHODS Exogenous surface markers of ADMSCs were found,and ADMSCs were cultured.RESULTS The identification of surface markers showed that the surface markers CD44 and CD29 of adipose-derived stem cells(ADSCs)were well expressed,while the surface markers CD45 and CD34 of ADSCs were negative,so the cultured cells were considered ADSCs.Western blotting detected the Exo surface marker protein,which expressed CD63 protein but did not express calnexin protein,indicating that ADSC-derived Exos were successfully extracted.CONCLUSION The secretion of MSCs from adipose tissue can increase ATP levels,block cardiomyocyte apoptosis,and enhance the heart function of animals susceptible to HF.The inhibition of Bax,caspase-3 and p53 protein expression may be related to this process.展开更多
Objective: To observe the cerebral protective effect of dagliflozin, a sodium-glucose co-transport protein 2 (SGLT2) inhibitor, in aging mice and to explore its molecular mechanism. Methods: 1. 66 male C57BL/6 mice we...Objective: To observe the cerebral protective effect of dagliflozin, a sodium-glucose co-transport protein 2 (SGLT2) inhibitor, in aging mice and to explore its molecular mechanism. Methods: 1. 66 male C57BL/6 mice were divided into control group (13) and model group (53), and the model group was moulded by subcutaneous injection of D-galactose into the back of the neck, while the control group was treated with equal amount of saline for 8 weeks. The weight of each group of mice was observed and recorded every 7 days, and two groups of mice were randomly selected for frozen sections of brain tissue at the end of the modelling period to verify the aging model. 2. After the aging model was successfully established, the aging groups were divided into 5 groups: model group, dagliflozin-treated group (high and low dose), and dagliflozin + ex527-inhibited group (high and low dose). Fasting blood glucose was measured in each group every 2 weeks for 8 weeks. At the end of treatment, Morris water maze was performed at the end of the treatment. After execution of the mice, the organ indices of heart, brain, liver, kidney and spleen were measured;the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in serum were determined. Results: After the successful establishment of the aging model, it was found that during the treatment phase of dagliflozin. 1) The organ indices of mice in the aging group were significantly lower than those of other groups, and no significant hypoglycemia was observed throughout the treatment process. 2) In the water maze test, mice in the aging group had a significantly longer latency in the plateau phase compared to the control and treatment groups, while the number of times the mice crossed the original plateau and the percentage of time spent exploring the original plateau quadrant were reduced after the plateau was removed. 3) The nerve cells in the aging mice were disorganized and the nuclei of the mice were deeply stained;the dagliflozin group improved the morphological changes in the brain of aging mice. 4) In addition, compared with the control mice, the serum MDA level was significantly increased and the antioxidant enzyme SOD activity was significantly decreased in the aging group, while compared with the aging group, dagliflozin significantly decreased the MDA level and increased the SOD activity. 5) The expression of SIRT1 and PGC-1α was significantly upregulated in the low and high doses of dagliflozin compared to the aging group. Conclusion: The present study suggests that dagliflozin can delay organ aging, improve the learning and memory ability of aging mice, and exert antioxidant effects, probably through upregulating the SIRT1/PGC-1α signaling pathway.展开更多
BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizin...BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.展开更多
BACKGROUND Epidemiological studies have revealed a correlation between Alzheimer’s disease(AD)and type 2 diabetes mellitus(T2D).Insulin resistance in the brain is a common feature in patients with T2D and AD.KAT7 is ...BACKGROUND Epidemiological studies have revealed a correlation between Alzheimer’s disease(AD)and type 2 diabetes mellitus(T2D).Insulin resistance in the brain is a common feature in patients with T2D and AD.KAT7 is a histone acetyltransferase that participates in the modulation of various genes.AIM To determine the effects of KAT7 on insulin patients with AD.METHODS APPswe/PS1-dE9 double-transgenic and db/db mice were used to mimic AD and diabetes,respectively.An in vitro model of AD was established by Aβstimulation.Insulin resistance was induced by chronic stimulation with high insulin levels.The expression of microtubule-associated protein 2(MAP2)was assessed using immunofluorescence.The protein levels of MAP2,Aβ,dual-specificity tyrosine phosphorylation-regulated kinase-1A(DYRK1A),IRS-1,p-AKT,total AKT,p-GSK3β,total GSK3β,DYRK1A,and KAT7 were measured via western blotting.Accumulation of reactive oxygen species(ROS),malondialdehyde(MDA),and SOD activity was measured to determine cellular oxidative stress.Flow cytometry and CCK-8 assay were performed to evaluate neuronal cell death and proliferation,respectively.Relative RNA levels of KAT7 and DYRK1A were examined using quantitative PCR.A chromatin immunoprecipitation assay was conducted to detect H3K14ac in DYRK1A.RESULTS KAT7 expression was suppressed in the AD mice.Overexpression of KAT7 decreased Aβaccumulation and MAP2 expression in AD brains.KAT7 overexpression decreased ROS and MDA levels,elevated SOD activity in brain tissues and neurons,and simultaneously suppressed neuronal apoptosis.KAT7 upregulated levels of p-AKT and p-GSK3βto alleviate insulin resistance,along with elevated expression of DYRK1A.KAT7 depletion suppressed DYRK1A expression and impaired H3K14ac of DYRK1A.HMGN1 overexpression recovered DYRK1A levels and reversed insulin resistance caused by KAT7 depletion.CONCLUSION We determined that KAT7 overexpression recovered insulin sensitivity in AD by recruiting HMGN1 to enhance DYRK1A acetylation.Our findings suggest that KAT7 is a novel and promising therapeutic target for the resistance in AD.展开更多
BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on ...BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.展开更多
BACKGROUND Reactivation of hepatitis B virus(HBV)infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies,including cancer chemotherapy.HBV reactivation can cause significan...BACKGROUND Reactivation of hepatitis B virus(HBV)infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies,including cancer chemotherapy.HBV reactivation can cause significant morbidity and even mortality,which are preventable if at-risk individuals are identified through screening and started on antiviral prophylaxis.AIM To determine the prevalence of chronic HBV(CHB)and occult HBV infection(OBI)among oncology and hematology-oncology patients undergoing chemo-therapy.METHODS In this observational study,the prevalence of CHB and OBI was assessed among patients receiving chemotherapy.Serological markers of HBV infection[hepatitis B surface antigen(HBsAg)/anti-hepatitis B core antigen(HBc)]were evaluated for all patients.HBV DNA levels were assessed in those who tested negative for HBsAg but positive for total anti-HBc.RESULTS The prevalence of CHB in the study cohort was determined to be 2.3%[95%confidence interval(95%CI):1.0-4.2].Additionally,the prevalence of OBI among the study participants was found to be 0.8%(95%CI:0.2-2.3).CONCLUSION The findings of this study highlight the importance of screening for hepatitis B infection in oncology and hematology-oncology patients undergoing chemotherapy.Identifying individuals with CHB and OBI is crucial for implementing appropriate antiviral prophylaxis to prevent the reactivation of HBV infection,which can lead to increased morbidity and mortality.展开更多
Objective PERK/eI F2α/CHOP is a major signaling pathway mediating endoplasmic reticulum(ER) stress related with atherosclerosis.Oxidized LDL(ox-LDL) also induces endothelial apoptosis and plays a vital role in the in...Objective PERK/eI F2α/CHOP is a major signaling pathway mediating endoplasmic reticulum(ER) stress related with atherosclerosis.Oxidized LDL(ox-LDL) also induces endothelial apoptosis and plays a vital role in the initiation and progression of atherosclerosis.The present study was conducted to explore the regulatory effect of ox-LDL on PERK/e IF2α/CHOP signaling pathway in vascular endothelial cells.Methods The effects of ox-LDL on PERK and p-e IF2α protein expression of primary human umbilical vein endothelial cells(HUVECs) were investigated by Western blot analysis.PERK gene silencing and selective eI F2α phosphatase inhibitor,salubrinal were used to inhibit the process of ox-LDL induced endothelial cell apoptosis,caspase-3 activity,and CHOP mR NA level.Results Ox-LDL treatment significantly increased the expression of PERK,PERK-mediated inactivation of e IF2α phosphorylation,and the expression of CHOP,as well as the caspase-3 activity and apoptosis.The effects of ox-LDL were markedly decreased by knocking down PERK with stable transduction of lentiviral sh RNA or by selective eI F2α phosphatase inhibitor,salubrinal.Conclusion This study provides the first evidence that ox-LDL induces apoptosis in vascular endothelial cells mediated largely via the PERK/eI F2α/CHOP ER-stress pathway.It adds new insights into the molecular mechanisms underlying the pathogenesis and progression of atherosclerosis.展开更多
Sea cucumbers belong to the Class Holothuroidea of marine invertebrates.They are commercially valuable and prized as a food and folk medicine in Asia.Nutritionally,sea cucumbers have an impressive profile of valuable ...Sea cucumbers belong to the Class Holothuroidea of marine invertebrates.They are commercially valuable and prized as a food and folk medicine in Asia.Nutritionally,sea cucumbers have an impressive profile of valuable nutrients such as vitamins,minerals and amino acids.A number of unique biological and pharmacological activities/properties,including anticancer,anticoagulant/antithrombotic,antimicrobial,antioxidant,antihyperlipidemic,antihyperglycemic,anti-inflammatory,antihypertension and radioprotective,have been ascribed to various compounds isolated from sea cucumbers.The therapeutic properties and medicinal benefits of sea cucumbers can be linked to the presence of a wide array of bioactives,especially triterpene glycosides,acid mucopolysaccharide,sphingoid bases,glycolipids,fucosylated chondroitin sulfate,polysaccharides,phospholipids,cerebrosides,phosphatidylcholines,and other extracts and hydrolysates.This review highlights the valuable bioactive components as wellas the multiple therapeutic properties of sea cucumbers with a view to exploring their potential uses as functional foods and a natural source of new multifunctional drugs.展开更多
Bushen Tiansui decoction is composed of six traditional Chinese medicines:Herba Epimedii,Radix Polygoni multiflori,Plastrum testudinis,Fossilia Ossis Mastodi,Radix Polygalae,and Rhizoma Acorus tatarinowii.Because Bush...Bushen Tiansui decoction is composed of six traditional Chinese medicines:Herba Epimedii,Radix Polygoni multiflori,Plastrum testudinis,Fossilia Ossis Mastodi,Radix Polygalae,and Rhizoma Acorus tatarinowii.Because Bushen Tiansui decoction is effective against amyloid beta(Aβ) toxicity,we hypothesized that it would reduce hippocampal synaptic damage and improve cognitive function in Alzheimer's disease.To test this hypothesis,we used a previously established animal model of Alzheimer's disease,that is,microinjection of aggregated Aβ25–35 into the bilateral brain ventricles of Sprague-Dawley rats.We found that long-term(28 days) oral administration of Bushen Tiansui decoction(0.563,1.688,and 3.375 g/m L;4 m L/day) prevented synaptic loss in the hippocampus and increased the expression levels of synaptic proteins,including postsynaptic density protein 95,the N-methyl-D-aspartate receptor 2 B subunit,and Shank1.These results suggested that Bushen Tiansui decoction can protect synapses by maintaining the expression of these synaptic proteins.Bushen Tiansui decoction also ameliorated measures reflecting spatial learning and memory deficits that were observed in the Morris water maze(i.e.,increased the number of platform crossings and the amount of time spent in the target quadrant and decreased escape latency) following intraventricular injections of aggregated Aβ25–35 compared with those measures in untreated Aβ_(25–35)-injected rats.Overall,these results provided evidence that further studies on the prevention and treatment of dementia with this traditional Chinese medicine are warranted.展开更多
Tubulointerstitial fibrosis(TIF)is a common pathological feature of end-stage kidney disease.Previous studies showed that upregulation of TGFβ1 notably contributed to the chronic renal injury and irbesartan halted th...Tubulointerstitial fibrosis(TIF)is a common pathological feature of end-stage kidney disease.Previous studies showed that upregulation of TGFβ1 notably contributed to the chronic renal injury and irbesartan halted the development of TIF in rats with 5/6 renal mass reduction.This study was to investigate the effects of irbesartan on chronic TIF and the mechanism involved TGFβ1 in the rodent model of chronic renal failure involving 5/6 nephrectomy.The results showed that irbesartan significantly attenuated the rise in blood pressure and tubulointerstitial injury observed in this model.Masson staining of the renal tissue revealed that there appeared severe renal tubule atrophy and fibrosis in operation group,but the lesion was attenuated mostly in irbesartan-treated group.Immunohistochemistry showed that irbesartan treatment apparently decreased the protein expression of TGFβ1 which was up-regulated in operation groups.Western blot showed that irbesartan treatment down-regulated the expression of TGFβ1,phosphorylated smad2(p-smad2),AT1R and phosphorylated p38(p-p38)MAPK,but significantly up-regulated the protein expression of smad6 as compared with operation group.These findings suggest that irbesartan attenuates hypertension and reduces the development of TIF in rats with 5/6 renal mass reduction via changes in the expression of these proteins at least including smad6,TGF-β1,p-smad2,AT1 and p-p38 MAPK.展开更多
Parkinson's disease is a neurological disorder with distinct motor signs of resting tremor,akinesia and/or lead-pipe rigidity,together with non-motor symptoms of impaired smell,cognition and autonomic function.The...Parkinson's disease is a neurological disorder with distinct motor signs of resting tremor,akinesia and/or lead-pipe rigidity,together with non-motor symptoms of impaired smell,cognition and autonomic function.These manifest after a major degeneration of neurones mainly within the brainstem,particularly among the dopaminergic展开更多
Dear editor,Paraquat(PQ)can cause acute lung injury and irreversible pulmonary fibrosis,without specific antidotes.Respiratory failure is the main cause of death among patients with PQ poisoning.Currently,the treatmen...Dear editor,Paraquat(PQ)can cause acute lung injury and irreversible pulmonary fibrosis,without specific antidotes.Respiratory failure is the main cause of death among patients with PQ poisoning.Currently,the treatment involves the use of adsorbents,intensive hemoperfusion,antioxidants,immunosuppressive therapy,respiratory support by mechanical ventilation,and other symptomatic and supportive treatments.[1-3]The mortality of patients with severe PQ poisoning remains high.More eff ective and safer therapies remain to be explored.Few studies reported performing extracorporeal membrane oxygenation(ECMO)and subsequent lung transplantation with either successful or poor clinical outcome in extremely critical patients with PQ poisoning.[4,5]This study aims to summarize the clinical experience and refl ect on the therapeutic prospect of ECMO in respiratory failure or cardiopulmonary failure caused by fatal PQ poisoning.展开更多
BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT o...BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is uncommon.We reported the first case of intracranial malignant SFT metastasized to the chest wall.CASE SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss.His medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years old.An unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain tumor.Finally,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest wall.We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall.We notified him and his family of the disease,and offered palliative care.He passed away on the 29 th hospital day.CONCLUSION This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.展开更多
Background and Objective To investigate the effects of simvastatin on lipid lowering therapy and platelet activation in elderly patients with hypercholesterolemia. Methods Fasting serum lipids, CD63, CD41a, serum gluc...Background and Objective To investigate the effects of simvastatin on lipid lowering therapy and platelet activation in elderly patients with hypercholesterolemia. Methods Fasting serum lipids, CD63, CD41a, serum glucose, hepatic and renal function, routine urine analysis (UA) were measured in 50 healthy subjects, and in 50 elderly patients with hypercholesterolemia before and after 4 weeks treatment with simvastatin (20mg daily for 4 weeks). Results 1. After simvastatin treatment for 4 weeks, the fasting serum level of lipids in elderly patients with hypercholesterolemia was significantly lower than before treatment (P<0.01). 2. CD63 and CD41a were decreased after treatment compared with before, respectively (1.36 0.34) vs (4.26 1.06), (P<0.01) and (123.54 19.73) vs (253.78 16.75), (P<0.01). 3. Changes in serum lipid level tended to be positively correlated with the declines in CD63 and CD41a, but there was no statistical significance (P>0.05). Conclusions The results suggested that lipid lowering therapy with simvastatin inhibit platelet activity.(J Geriatr Cardiol 2007;4:215-217.)展开更多
Purpose:The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.Met...Purpose:The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.Methods:An umbrella review of systematic reviews with meta-analyses of observational studies was conducted.We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values,95%prediction intervals,heterogeneity,small-study effects,and excess significance.We graded the evidence from convincing(Class I)to weak(Class IV).Results:From 504 articles returned in a search of the literature,8 systematic reviews were included in our review,with a total of 11 outcomes.Overall,nine of the 11 of the outcomes reported nominally significant summary results(p<0.05),with 4 associations surviving the application of the more stringent p value(p<106).No outcome presented convincing evidence.Three associations showed Class II evidence(i.e.,highly suggestive):(1)higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population(n=34 studies;sample size=1,855,817;relative risk=0.72,95%confidence interval(95%CI):0.670.78),(2)cardiovascular death risk in mixed populations(n=15 studies;relative risk=0.84,95%CI:0.780.91),and(3)incidence of disability(n=7 studies;relative risk=0.76,95%CI:0.660.87).Conclusion:The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality,as well as disability.To further inform intervention strategies,future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.展开更多
Objective To determine the diagnostic yield of repeated screening for atrial fibrillation(AF)among geriatric patients.Methods A pragmatic prospective cohort study into applying opportunistic screening for AF with a ha...Objective To determine the diagnostic yield of repeated screening for atrial fibrillation(AF)among geriatric patients.Methods A pragmatic prospective cohort study into applying opportunistic screening for AF with a handheld single lead ECG device(SLD)in a geriatric cohort.Consecutive patients of 65 years old and older visiting the geriatric outpatient clinic were eligible for inclusion.A 12 lead ECG was performed,followed by measurements with the SLD during every visit to the geriatric outpatient clinic.A frailty index was based on the accumulation of deficits model.Results 478 patients were eligible.Patients were excluded if they did not give informed consent(17 patients),had a pacemaker or implantable cardioverter defibrillator(20 patients),or had incomplete medical files(two patients).After exclusion,439 patients participated in this study.The mean age was 78 years(range 65 to 100 years),54%were female.AF was known in 89 patients(20%),first detected on the baseline ECG in four patients(1%)and first detected with the SLD in 20 patients(5%)during follow up visits.Sensitivity of the SLD was 90.0%,specificity 99.0%,negative predictive value 99.7%,and positive predictive value 73.5%.Most patients(82%)with AF were frail and 53%were severely frail.Conclusion Repeated screening in geriatric patients has a five times higher diagnostic yield than usual care.It was easily combined with usual care.Because of the positive predictive value of 73.5%,it remains necessary to confirm AF with a 12 lead ECG or 24-h Holter monitoring.展开更多
文摘Veterinary drugs are substances(including pharmaceutical feed additives)used to prevent,treat,and diagnose diseases or regulate the physiological functions of animals.Veterinary drug poisoning in humans is relatively rare both in China and the rest of the world.Here,we report a case of death from veterinary drug poisoning from avermectin-closantel.Avermectin-closantel is a broad-spectrum antiparasitic drug,which has high efficacy against a variety of trematodes and nematodes.
文摘BACKGROUND Acute kidney injury(AKI) after coronary angiography(CAG) and primary percutaneous coronary intervention(PPCI) is frequently observed, and often interpreted as contrast induced-AKI. This study aimed to investigate the incidence, predictors and outcomes of AKI in acute ST-segment elevation myocardial infarction(STEMI) patients undergoing emergent CAG/PPCI using the control group of STEMI patients who were not exposed to contrast agents within the first 72 h.METHODS We performed a retrospective analysis of 1670 STEMI patients. Of them, 673 patients underwent emergent CAG/PPCI, and 997 patients treated with thrombolysis or no reperfusion therapy who were not exposed to contrast material during the first 72 h. AKI was defined as an increase of serum creatinine ≥ 44.2 mmol/L or ≥ 25% from baseline within 72 h. Patents were then followed up for the occurrence of all-cause mortality for 40 months(interquartile range: 24–55 months).RESULTS After propensity score matching, 505 pairs of patients were matched. Overall, the incidence of AKI was 27.4%, and AKI rates were not significantly different in patients with and without emergent CAG/PPCI procedure(27.5% vs. 27.3%, P = 0.944). Multivariate logistic regression analysis identified that the independent predictors of AKI were female, elevated interleukin-6 level,decreased lymphocyte count, left ventricular ejection fraction < 50% and use of diuretics in patients with emergent CAG/PPCI. Patients with AKI than those without AKI experienced higher incidence of acute heart failure with Killip class Ⅲ(9.4% vs. 3.3%, P =0.005;15.2% vs. 6.8%, P = 0.003, respectively) and mortality(5.8% vs. 1.4%, P = 0.014;12.3% vs. 4.6%, P = 0.002, respectively) in patients with and without emergent CAG/PPCI. Multivariate Cox regression analysis confirmed that AKI was independently associated with long-term mortality rate at 40 months follow-up in patients with and without emergent CAG/PPCI(HR = 1.867, 95% CI:1.086–3.210, P = 0.024;HR = 1.700, 95% CI: 1.219–2.370, P = 0.002, respectively).CONCLUSIONS Approximately 27.0% of STEMI patients experience AKI, which is strongly associated with an increased shortand long-term mortality regardless of emergent CAG/PPCI procedure. The development of AKI is mainly related to female gender, inflammation reaction, heart failure and use of diuretics in STEMI patients undergoing emergent CAG/PPCI.
基金The authors express their gratitude to all the hospital staff who assisted with data retrieval from the electronic medical record database and routine telephone follow-up.Additionally,the authors would like to extend their appreciation to Wenhui Liu for providing statistical guidance at the School of Public Health,Shandong University.The authors declare that they have no conflicts of interests to disclose.
文摘OBJECTIVES To investigate the prevalence of polypharmacy and potentially inappropriate medication(PIM)in elderly patients with heart failure(HF)and their impact on readmission and mortality.METHODS We conducted a study of 274 participants aged 60 years or older with HF.The prevalence of polypharmacy(defined as the use of five or more medications)was calculated,and the 2019 American Geriatrics Society Beers criteria were applied to access PIMs.Medications and PIMs were characterized at admission and discharge,and changes in prescriptions during hospitalization were compared.The impact of polypharmacy and PIM on readmission and mortality were investigated.RESULTS The median age of this study population was 68 years old.The median number of prescribed drugs was 7 at admission and 10 at discharge.At discharge,99.27%of all patients were taking five or more drugs.The incidence of composite endpoint and cardiovascular readmission increased with the number of polypharmacy within 6 months.The use of guideline-directed medical therapy reduced the incidence of composite endpoint events and cardiovascular readmission,while the use of noncardiovascular medications increased the composite endpoint events.The frequency of PIMs was 93.79%at discharge.The incidence of composite endpoint events increased with the number of PIMs.“PIMs in older adults with caution”increased cardiovascular readmission and“PIMs based on kidney function”increased cardiovascular mortality.Several comorbidities were associated with cardiovascular mortality or non-cardiovascular readmission.CONCLUSIONS Polypharmacy and PIM were highly prevalent in elderly patients with HF,and their use was associated with an increased risk of composite endpoint events,readmission and mortality.Non-cardiovascular medications,“PIMs in older adults with caution”,“PIMs based on kidney function”and several comorbidities were important factors associated with hospital readmission and mortality.Our findings highlight the importance of medication optimization in the management of HF in elderly patients.
文摘BACKGROUND Heart failure(HF)is a global health problem characterized by impaired heart function.Cardiac remodeling and cell death contribute to the development of HF.Although treatments such as digoxin and angiotensin receptor blocker drugs have been used,their effectiveness in reducing mortality is uncertain.Researchers are exploring the use of adipose-derived mesenchymal stem cell(ADMSC)exosomes(Exos)as a potential therapy for HF.These vesicles,secreted by cells,may aid in tissue repair and regulation of inflammation and immune responses.However,further investigation is needed to understand the specific role of these vesicles in HF treatment.AIM To investigate the mechanism of extracellular vesicles produced by ADMSC s in the treatment of HF.METHODS Exogenous surface markers of ADMSCs were found,and ADMSCs were cultured.RESULTS The identification of surface markers showed that the surface markers CD44 and CD29 of adipose-derived stem cells(ADSCs)were well expressed,while the surface markers CD45 and CD34 of ADSCs were negative,so the cultured cells were considered ADSCs.Western blotting detected the Exo surface marker protein,which expressed CD63 protein but did not express calnexin protein,indicating that ADSC-derived Exos were successfully extracted.CONCLUSION The secretion of MSCs from adipose tissue can increase ATP levels,block cardiomyocyte apoptosis,and enhance the heart function of animals susceptible to HF.The inhibition of Bax,caspase-3 and p53 protein expression may be related to this process.
文摘Objective: To observe the cerebral protective effect of dagliflozin, a sodium-glucose co-transport protein 2 (SGLT2) inhibitor, in aging mice and to explore its molecular mechanism. Methods: 1. 66 male C57BL/6 mice were divided into control group (13) and model group (53), and the model group was moulded by subcutaneous injection of D-galactose into the back of the neck, while the control group was treated with equal amount of saline for 8 weeks. The weight of each group of mice was observed and recorded every 7 days, and two groups of mice were randomly selected for frozen sections of brain tissue at the end of the modelling period to verify the aging model. 2. After the aging model was successfully established, the aging groups were divided into 5 groups: model group, dagliflozin-treated group (high and low dose), and dagliflozin + ex527-inhibited group (high and low dose). Fasting blood glucose was measured in each group every 2 weeks for 8 weeks. At the end of treatment, Morris water maze was performed at the end of the treatment. After execution of the mice, the organ indices of heart, brain, liver, kidney and spleen were measured;the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in serum were determined. Results: After the successful establishment of the aging model, it was found that during the treatment phase of dagliflozin. 1) The organ indices of mice in the aging group were significantly lower than those of other groups, and no significant hypoglycemia was observed throughout the treatment process. 2) In the water maze test, mice in the aging group had a significantly longer latency in the plateau phase compared to the control and treatment groups, while the number of times the mice crossed the original plateau and the percentage of time spent exploring the original plateau quadrant were reduced after the plateau was removed. 3) The nerve cells in the aging mice were disorganized and the nuclei of the mice were deeply stained;the dagliflozin group improved the morphological changes in the brain of aging mice. 4) In addition, compared with the control mice, the serum MDA level was significantly increased and the antioxidant enzyme SOD activity was significantly decreased in the aging group, while compared with the aging group, dagliflozin significantly decreased the MDA level and increased the SOD activity. 5) The expression of SIRT1 and PGC-1α was significantly upregulated in the low and high doses of dagliflozin compared to the aging group. Conclusion: The present study suggests that dagliflozin can delay organ aging, improve the learning and memory ability of aging mice, and exert antioxidant effects, probably through upregulating the SIRT1/PGC-1α signaling pathway.
基金the Science and Technology Program of Guiyang Baiyun District Science and Technology Bureau.No.[2017]50Science and Technology Program of Guiyang Municipal Bureau of Science and Technology,No.[2018]1-72Science and Technology Fund Project of Guizhou Provincial Health Commission,No.gzwkj2021-127.
文摘BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2020MH147National Natural Science Foundation of China,No.82002343.
文摘BACKGROUND Epidemiological studies have revealed a correlation between Alzheimer’s disease(AD)and type 2 diabetes mellitus(T2D).Insulin resistance in the brain is a common feature in patients with T2D and AD.KAT7 is a histone acetyltransferase that participates in the modulation of various genes.AIM To determine the effects of KAT7 on insulin patients with AD.METHODS APPswe/PS1-dE9 double-transgenic and db/db mice were used to mimic AD and diabetes,respectively.An in vitro model of AD was established by Aβstimulation.Insulin resistance was induced by chronic stimulation with high insulin levels.The expression of microtubule-associated protein 2(MAP2)was assessed using immunofluorescence.The protein levels of MAP2,Aβ,dual-specificity tyrosine phosphorylation-regulated kinase-1A(DYRK1A),IRS-1,p-AKT,total AKT,p-GSK3β,total GSK3β,DYRK1A,and KAT7 were measured via western blotting.Accumulation of reactive oxygen species(ROS),malondialdehyde(MDA),and SOD activity was measured to determine cellular oxidative stress.Flow cytometry and CCK-8 assay were performed to evaluate neuronal cell death and proliferation,respectively.Relative RNA levels of KAT7 and DYRK1A were examined using quantitative PCR.A chromatin immunoprecipitation assay was conducted to detect H3K14ac in DYRK1A.RESULTS KAT7 expression was suppressed in the AD mice.Overexpression of KAT7 decreased Aβaccumulation and MAP2 expression in AD brains.KAT7 overexpression decreased ROS and MDA levels,elevated SOD activity in brain tissues and neurons,and simultaneously suppressed neuronal apoptosis.KAT7 upregulated levels of p-AKT and p-GSK3βto alleviate insulin resistance,along with elevated expression of DYRK1A.KAT7 depletion suppressed DYRK1A expression and impaired H3K14ac of DYRK1A.HMGN1 overexpression recovered DYRK1A levels and reversed insulin resistance caused by KAT7 depletion.CONCLUSION We determined that KAT7 overexpression recovered insulin sensitivity in AD by recruiting HMGN1 to enhance DYRK1A acetylation.Our findings suggest that KAT7 is a novel and promising therapeutic target for the resistance in AD.
基金Supported by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties,No.SZGSP013Shenzhen Key Medical Discipline Construction Fund,No.SZXK042+2 种基金Sanming Project of Medicine in Shenzhen,No.SZSM202311025Natural Science Fund of Fujian Province,No.2023J011622Natural Science Fund of Xiamen City,No.3502Z20224ZD1259.
文摘BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.
文摘BACKGROUND Reactivation of hepatitis B virus(HBV)infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies,including cancer chemotherapy.HBV reactivation can cause significant morbidity and even mortality,which are preventable if at-risk individuals are identified through screening and started on antiviral prophylaxis.AIM To determine the prevalence of chronic HBV(CHB)and occult HBV infection(OBI)among oncology and hematology-oncology patients undergoing chemo-therapy.METHODS In this observational study,the prevalence of CHB and OBI was assessed among patients receiving chemotherapy.Serological markers of HBV infection[hepatitis B surface antigen(HBsAg)/anti-hepatitis B core antigen(HBc)]were evaluated for all patients.HBV DNA levels were assessed in those who tested negative for HBsAg but positive for total anti-HBc.RESULTS The prevalence of CHB in the study cohort was determined to be 2.3%[95%confidence interval(95%CI):1.0-4.2].Additionally,the prevalence of OBI among the study participants was found to be 0.8%(95%CI:0.2-2.3).CONCLUSION The findings of this study highlight the importance of screening for hepatitis B infection in oncology and hematology-oncology patients undergoing chemotherapy.Identifying individuals with CHB and OBI is crucial for implementing appropriate antiviral prophylaxis to prevent the reactivation of HBV infection,which can lead to increased morbidity and mortality.
基金State Key Clinical Specialty Construction Project,China
文摘Objective PERK/eI F2α/CHOP is a major signaling pathway mediating endoplasmic reticulum(ER) stress related with atherosclerosis.Oxidized LDL(ox-LDL) also induces endothelial apoptosis and plays a vital role in the initiation and progression of atherosclerosis.The present study was conducted to explore the regulatory effect of ox-LDL on PERK/e IF2α/CHOP signaling pathway in vascular endothelial cells.Methods The effects of ox-LDL on PERK and p-e IF2α protein expression of primary human umbilical vein endothelial cells(HUVECs) were investigated by Western blot analysis.PERK gene silencing and selective eI F2α phosphatase inhibitor,salubrinal were used to inhibit the process of ox-LDL induced endothelial cell apoptosis,caspase-3 activity,and CHOP mR NA level.Results Ox-LDL treatment significantly increased the expression of PERK,PERK-mediated inactivation of e IF2α phosphorylation,and the expression of CHOP,as well as the caspase-3 activity and apoptosis.The effects of ox-LDL were markedly decreased by knocking down PERK with stable transduction of lentiviral sh RNA or by selective eI F2α phosphatase inhibitor,salubrinal.Conclusion This study provides the first evidence that ox-LDL induces apoptosis in vascular endothelial cells mediated largely via the PERK/eI F2α/CHOP ER-stress pathway.It adds new insights into the molecular mechanisms underlying the pathogenesis and progression of atherosclerosis.
文摘Sea cucumbers belong to the Class Holothuroidea of marine invertebrates.They are commercially valuable and prized as a food and folk medicine in Asia.Nutritionally,sea cucumbers have an impressive profile of valuable nutrients such as vitamins,minerals and amino acids.A number of unique biological and pharmacological activities/properties,including anticancer,anticoagulant/antithrombotic,antimicrobial,antioxidant,antihyperlipidemic,antihyperglycemic,anti-inflammatory,antihypertension and radioprotective,have been ascribed to various compounds isolated from sea cucumbers.The therapeutic properties and medicinal benefits of sea cucumbers can be linked to the presence of a wide array of bioactives,especially triterpene glycosides,acid mucopolysaccharide,sphingoid bases,glycolipids,fucosylated chondroitin sulfate,polysaccharides,phospholipids,cerebrosides,phosphatidylcholines,and other extracts and hydrolysates.This review highlights the valuable bioactive components as wellas the multiple therapeutic properties of sea cucumbers with a view to exploring their potential uses as functional foods and a natural source of new multifunctional drugs.
基金supported by the National Natural Science Foundation of China,No.81373705the Natural Science Foundation of Hunan Province in China,No.13JJ3030
文摘Bushen Tiansui decoction is composed of six traditional Chinese medicines:Herba Epimedii,Radix Polygoni multiflori,Plastrum testudinis,Fossilia Ossis Mastodi,Radix Polygalae,and Rhizoma Acorus tatarinowii.Because Bushen Tiansui decoction is effective against amyloid beta(Aβ) toxicity,we hypothesized that it would reduce hippocampal synaptic damage and improve cognitive function in Alzheimer's disease.To test this hypothesis,we used a previously established animal model of Alzheimer's disease,that is,microinjection of aggregated Aβ25–35 into the bilateral brain ventricles of Sprague-Dawley rats.We found that long-term(28 days) oral administration of Bushen Tiansui decoction(0.563,1.688,and 3.375 g/m L;4 m L/day) prevented synaptic loss in the hippocampus and increased the expression levels of synaptic proteins,including postsynaptic density protein 95,the N-methyl-D-aspartate receptor 2 B subunit,and Shank1.These results suggested that Bushen Tiansui decoction can protect synapses by maintaining the expression of these synaptic proteins.Bushen Tiansui decoction also ameliorated measures reflecting spatial learning and memory deficits that were observed in the Morris water maze(i.e.,increased the number of platform crossings and the amount of time spent in the target quadrant and decreased escape latency) following intraventricular injections of aggregated Aβ25–35 compared with those measures in untreated Aβ_(25–35)-injected rats.Overall,these results provided evidence that further studies on the prevention and treatment of dementia with this traditional Chinese medicine are warranted.
基金supported by a grant from Natural Sciences Foundation of Hubei Province,China(No.2008CDB178)
文摘Tubulointerstitial fibrosis(TIF)is a common pathological feature of end-stage kidney disease.Previous studies showed that upregulation of TGFβ1 notably contributed to the chronic renal injury and irbesartan halted the development of TIF in rats with 5/6 renal mass reduction.This study was to investigate the effects of irbesartan on chronic TIF and the mechanism involved TGFβ1 in the rodent model of chronic renal failure involving 5/6 nephrectomy.The results showed that irbesartan significantly attenuated the rise in blood pressure and tubulointerstitial injury observed in this model.Masson staining of the renal tissue revealed that there appeared severe renal tubule atrophy and fibrosis in operation group,but the lesion was attenuated mostly in irbesartan-treated group.Immunohistochemistry showed that irbesartan treatment apparently decreased the protein expression of TGFβ1 which was up-regulated in operation groups.Western blot showed that irbesartan treatment down-regulated the expression of TGFβ1,phosphorylated smad2(p-smad2),AT1R and phosphorylated p38(p-p38)MAPK,but significantly up-regulated the protein expression of smad6 as compared with operation group.These findings suggest that irbesartan attenuates hypertension and reduces the development of TIF in rats with 5/6 renal mass reduction via changes in the expression of these proteins at least including smad6,TGF-β1,p-smad2,AT1 and p-p38 MAPK.
文摘Parkinson's disease is a neurological disorder with distinct motor signs of resting tremor,akinesia and/or lead-pipe rigidity,together with non-motor symptoms of impaired smell,cognition and autonomic function.These manifest after a major degeneration of neurones mainly within the brainstem,particularly among the dopaminergic
基金the Foundation of Key Discipline Construction of Zhejiang Province for Traditional Chinese Medicine(2017-XK-A36)the Medical and Health Science Foundation of Zhejiang Province(2019327552).
文摘Dear editor,Paraquat(PQ)can cause acute lung injury and irreversible pulmonary fibrosis,without specific antidotes.Respiratory failure is the main cause of death among patients with PQ poisoning.Currently,the treatment involves the use of adsorbents,intensive hemoperfusion,antioxidants,immunosuppressive therapy,respiratory support by mechanical ventilation,and other symptomatic and supportive treatments.[1-3]The mortality of patients with severe PQ poisoning remains high.More eff ective and safer therapies remain to be explored.Few studies reported performing extracorporeal membrane oxygenation(ECMO)and subsequent lung transplantation with either successful or poor clinical outcome in extremely critical patients with PQ poisoning.[4,5]This study aims to summarize the clinical experience and refl ect on the therapeutic prospect of ECMO in respiratory failure or cardiopulmonary failure caused by fatal PQ poisoning.
文摘BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is uncommon.We reported the first case of intracranial malignant SFT metastasized to the chest wall.CASE SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss.His medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years old.An unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain tumor.Finally,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest wall.We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall.We notified him and his family of the disease,and offered palliative care.He passed away on the 29 th hospital day.CONCLUSION This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.
文摘Background and Objective To investigate the effects of simvastatin on lipid lowering therapy and platelet activation in elderly patients with hypercholesterolemia. Methods Fasting serum lipids, CD63, CD41a, serum glucose, hepatic and renal function, routine urine analysis (UA) were measured in 50 healthy subjects, and in 50 elderly patients with hypercholesterolemia before and after 4 weeks treatment with simvastatin (20mg daily for 4 weeks). Results 1. After simvastatin treatment for 4 weeks, the fasting serum level of lipids in elderly patients with hypercholesterolemia was significantly lower than before treatment (P<0.01). 2. CD63 and CD41a were decreased after treatment compared with before, respectively (1.36 0.34) vs (4.26 1.06), (P<0.01) and (123.54 19.73) vs (253.78 16.75), (P<0.01). 3. Changes in serum lipid level tended to be positively correlated with the declines in CD63 and CD41a, but there was no statistical significance (P>0.05). Conclusions The results suggested that lipid lowering therapy with simvastatin inhibit platelet activity.(J Geriatr Cardiol 2007;4:215-217.)
文摘Purpose:The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.Methods:An umbrella review of systematic reviews with meta-analyses of observational studies was conducted.We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values,95%prediction intervals,heterogeneity,small-study effects,and excess significance.We graded the evidence from convincing(Class I)to weak(Class IV).Results:From 504 articles returned in a search of the literature,8 systematic reviews were included in our review,with a total of 11 outcomes.Overall,nine of the 11 of the outcomes reported nominally significant summary results(p<0.05),with 4 associations surviving the application of the more stringent p value(p<106).No outcome presented convincing evidence.Three associations showed Class II evidence(i.e.,highly suggestive):(1)higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population(n=34 studies;sample size=1,855,817;relative risk=0.72,95%confidence interval(95%CI):0.670.78),(2)cardiovascular death risk in mixed populations(n=15 studies;relative risk=0.84,95%CI:0.780.91),and(3)incidence of disability(n=7 studies;relative risk=0.76,95%CI:0.660.87).Conclusion:The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality,as well as disability.To further inform intervention strategies,future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.
文摘Objective To determine the diagnostic yield of repeated screening for atrial fibrillation(AF)among geriatric patients.Methods A pragmatic prospective cohort study into applying opportunistic screening for AF with a handheld single lead ECG device(SLD)in a geriatric cohort.Consecutive patients of 65 years old and older visiting the geriatric outpatient clinic were eligible for inclusion.A 12 lead ECG was performed,followed by measurements with the SLD during every visit to the geriatric outpatient clinic.A frailty index was based on the accumulation of deficits model.Results 478 patients were eligible.Patients were excluded if they did not give informed consent(17 patients),had a pacemaker or implantable cardioverter defibrillator(20 patients),or had incomplete medical files(two patients).After exclusion,439 patients participated in this study.The mean age was 78 years(range 65 to 100 years),54%were female.AF was known in 89 patients(20%),first detected on the baseline ECG in four patients(1%)and first detected with the SLD in 20 patients(5%)during follow up visits.Sensitivity of the SLD was 90.0%,specificity 99.0%,negative predictive value 99.7%,and positive predictive value 73.5%.Most patients(82%)with AF were frail and 53%were severely frail.Conclusion Repeated screening in geriatric patients has a five times higher diagnostic yield than usual care.It was easily combined with usual care.Because of the positive predictive value of 73.5%,it remains necessary to confirm AF with a 12 lead ECG or 24-h Holter monitoring.
