Aqueous humor provides the necessary nutrition for the lens and transports the metabolites in the eye.It was a liquid that can directly reflect the microenvironment in the eye'and it can be easily obtained during ...Aqueous humor provides the necessary nutrition for the lens and transports the metabolites in the eye.It was a liquid that can directly reflect the microenvironment in the eye'and it can be easily obtained during the operation.This review intended to analyze the components of aqueous humor in patients with different types of cataracts'so as to reflect the pathogenesis and development of the disease'evaluate the incidence of postoperative complications and provide reference value for the surgical design of sequential cataract surgery.The aqueous humor components of different types of cataracts showed different degrees of inflammation'oxidative stress and extracellular matrix remodeling.The biomarker of early neuropathy in diabetic cataract was neural cell adhesion molecule-1(NCAM1).Transforming growth factor-β(TGF-β)was the evaluation factor of disease development in patients with pseudoexfoliation syndrome.The relationships between postoperative complications of different types of cataracts and aqueous humor components were as follows:Macular edema after diabetic cataract surgery was associated with tumor necrosis factor-alpha;capsular contraction after high myopic cataract surgery was related to monocyte chemoattractant protein-1(MCP-1)and TGF-β2;Klotho and glutathione S-transferase P 1(GSTP1)were associated with high intraocular pressure after primary open-angle glaucoma complicated by cataract surgery;capsular contraction after retinitis pigmentosa complicated by cataract surgery was associated with matrix metalloproteinases;pro-inflammatory cytokines and fibroblast growth factor 4 in the aqueous humor of congenital cataracts were associated with posterior capsular opacification after surgery.Granulocyte colony stimulating factor 3 and MCP-1 were the main cytokines mediating the pain of the second eye in the binocular sequential cataract surgery short interval(1 wk)'while MCP-1 mediated pain in the long interval(6 wk).The second eye after binocular sequential cataract surgery had a higher level of proinflammatory factors.The components of aqueous humor in patients with different types of cataracts were related to the pathogenesis and postoperative complications of the disease.Monitoring the components of the aqueous humor could help better understand the intraocular microenvironment of different types of cataracts and provide a reference for predicting the development of the disease and implementing relevant targeted therapy.展开更多
Objective To investigate the relationship between hypothermia duration and postoperative complications in patients undergoing gynecological surgery.Methods Patients who underwent elective gynecological surgery at our ...Objective To investigate the relationship between hypothermia duration and postoperative complications in patients undergoing gynecological surgery.Methods Patients who underwent elective gynecological surgery at our hospital were consecutively enrolled between October 2020 and January 2022.Core temperature was continuously monitored intraoperatively,and early postoperative complications were collected.By adjusting the logistic regression model for potential confounding factors,the association of postoperative complications with the duration of hypothermia,the lowest body temperature below 36°C,and the hypothermia upon admission to postanesthesia care unit(PACU)or intensive care unit(ICU)were analyzed.Additionally,the potential inflection point in the relationship between the duration of hypothermia and the risk of postoperative complications was explored by using cumulative probability scatter plots and moving average sequences.Results The study included 370 patients,with 193(52.2%)experiencing hypothermia and 177(47.8%)not.Among them,92(24.9%)developed complications.The duration of hypothermia(adjusted odds ratio[OR]for each one-minute increase:1.003;95%confidence interval[CI]:1.000-1.006,P=0.047)and hypothermia upon admission to PACU or ICU(adjusted OR:1.980;95%CI:1.135-3.454,P=0.016)were associated with early postoperative complications.Notably,the cumulative incidence of postoperative complications tended to rise as the duration of hypothermia increased,with a potential inflection point observed at 120 minutes.Conclusions In gynecological surgery,the duration of hypothermia as well as hypothermia upon admission to PACU or ICU are associated with postoperative complications.Minimizing the duration of hypothermia may be clinically beneficial.展开更多
Objectives Increased lipoprotein （a） serum concentration seems to be a cardiovascular risk factor; this has not been confirmed in extracoronary atherosclerosis complications. We therefore wished to gain a deeper ins...Objectives Increased lipoprotein （a） serum concentration seems to be a cardiovascular risk factor; this has not been confirmed in extracoronary atherosclerosis complications. We therefore wished to gain a deeper insight into relationship between the plasma concentrations of lipoprotein （a） and the micro- and macro-vascular complications of type 2 diabetes mellitus and to identify possible differences in this association. Methods This is a descriptive observational cross-sectional study. Two-hundred and seventeen elderly patients with type 2 diabetes mellitus were included from the internal medicine outclinic. Anthropometric data, analytical data （insulin reserve, basal and postprandial peptide C, glycosylated hemoglobin, renal parameters, lipid profile and clinical data as hypertension, obesity, micro and macrovascular complications were collected. Results Patients were grouped according to the type 2 diabetes mellitus time of evolution. The mean plasma concentration of lipoprotein （a） was 22.2± 17.3 mg/dL （22.1± 15.9 mg/dL for males, and 22.1 ± 18.4 mg/dL for females）. Patients with hypertension, coronary heart disease, cerebrovascular accident, microalbuminuria and proteinuria presented a statistically significant increased level of lipoprotein （a）. Similarly, the patients with hyperlipoprotein （a） （≥30 mg/dL） presented significantly increased levels of urea and total cholesterol. In the multivariate regression model, the level of lipoprotein （a） is positively correlated with coronary heart disease and diabetic nephropathy （P 〈 0.01 and P 〈 0.005, respectively）. Conclusions The elevation of plasma levels of lipoprotein （a） are associ- ated with the development of coronary heart disease and diabe tic nephropathy. Therefore, we consider that the determination of lipoprotein （a） may be a prognostic marker of vascular complications in patients with type 2 diabetes mellitus.展开更多
Background Very elderly patients （age 〉 85 years） are a rapidly increasing segment of the population. As a group, they experience high rates of in-hospital mortality and bleeding complications following percutaneou...Background Very elderly patients （age 〉 85 years） are a rapidly increasing segment of the population. As a group, they experience high rates of in-hospital mortality and bleeding complications following percutaneous coronary intervention （PCI）. However, the relationship between bleeding and mortality in the very elderly is unknown. Methods Retrospective review was performed on 17,378 consecutive PCI procedures from 2000 to 2015 at Dartmouth-Hitchcock Medical Center. Incidence of bleeding during the index PCI admission （bleeding requiring transfusion, access site hematoma 〉 5 cm, pseudoaneurysm, and retroperitoneal bleed） and in-hospital mortality were reported for four age groups （〈 65 years, 65-74 years, 75-84 years, and ≥ 85 years）. The mortality of patients who suffered bleeding complications and those who did not was calculated and multivariate analysis was performed for in-hospital mortality. Lastly, known predictors of bleeding were compared between patients age 〈 85 years and age ≥85 years. Results Of 17,378 patients studied, 1019 （5.9%） experienced bleeding and 369 （2.1%） died in-hospital following PCI. Incidence of bleeding and in-hospital mortality increased monotonically with increasing age （mortality： 0.94%, 2.27%, 4.24% and 4.58%; bleeding： 3.96%, 6.62%, 10.68% and 13.99% for ages 〈 65, 65-4, 75-84 and ≥ 85 years, respectively）. On multivariate analysis, bleeding was associated with increased mortality for all age groups except patients age ≥85 years [odds ratio （95% CI）： age 〈 65 years, 3.65 （1.99-6.74）; age 65-74 years, 2.83 （1.62-4.94）; age 75-84 years, 3.86 （2.56-5.82）, age ≥ 85 years 1.39 （0.49-3.95）]. Conclusions Bleeding and mortality following PCI increase with increasing age. For the very elderly, despite high rates of bleeding, bleeding is no longer predictive of in-hospital mortality following PCI.展开更多
Heart rate variability （HRV） refers to the variations between consecutive heartbeats, which depend on the continuous modulation of the sympathetic and parasympathetic branches of the autonomic nervous system. HRV ha...Heart rate variability （HRV） refers to the variations between consecutive heartbeats, which depend on the continuous modulation of the sympathetic and parasympathetic branches of the autonomic nervous system. HRV has been shown to be effective as a predictor of risk after myocardial infarction and an early warning sign of diabetic neuropathy, and in the cardiology setting is now recognized to be a useful tool for risk-stratification after hospital admission and after discharge. Recent evidences suggest that HRV analysis might predict complications even in patients undergoing cardiac surgery, and the present review summarizes the importance of HRV analysis in adult cardiac surgery and the perspectives for HRV use in current clinical practice. Although future larger studies are warranted before HRV can be included into daily clinical practice in adult cardiac surgery, HRV is a novel tool which might detect autonomic instability in the early postoperative phase and during hospital stay, thus predicting or prompt-diagnosing many of the post-operative complications.展开更多
Background: The occurrence of infectious complications characterizes the more severe forms of acute pancreatitis(AP) and is associated with high mortality. We investigated the effects of infection at different sites i...Background: The occurrence of infectious complications characterizes the more severe forms of acute pancreatitis(AP) and is associated with high mortality. We investigated the effects of infection at different sites in patients with AP, including those with necrotizing pancreatitis(NP).Methods: We conducted a retrospective analysis of 285 patients who met the inclusion criteria for AP and were admitted to Tianjin Nankai Hospital between January 2016 and September 2019. According to the source of the culture positivity during hospitalization, patients were divided into four groups: sterile group(n=148), pancreatic infection group(n=65), extrapancreatic infection group(n=22) and combined infection group(n=50). The source of infection, microbiology, biochemical parameters and prognostic indicators were analyzed.Results: In terms of baseline characteristics, the four groups were similar in age, sex, aetiology, previous pancreatitis and diabetes. Compared with the severity of the disease in the other groups, the APACHE II scores(9.91±4.65, 9.46±5.05, respectively) and organ failure rate(40.9% and 50%, respectively)were higher in the extrapancreatic infection group and the combined infection group(P<0.05). The frequency of surgical intervention and hospitalization time in patients with NP complicated with extrapancreatic infection was greatly increased(P<0.05). Regarding the primary outcome, patients in the combined infection group had longer hospital stays(68.28±51.80 vs. 55.58±36.24, P<0.05) and higher mortality(24.0% vs. 9.2%, P<0.05) than patients in the pancreatic infection group. In addition, patients in the extrapancreatic infection group also showed high intensive care utilization(59.1%) and mortality rates(18.2%). Among the 137 AP patients with infection complications, 89 patients exhibited multidrug-resistant(MDR) microorganisms, and the mortality rate of patients with MDR bacterial infection was higher than that of patients with non-MDR bacterial infection(24.7% vs. 3.6%, P=0.001).Conclusions: Clinicians should be aware that extrapancreatic infection(EPI) significantly aggravates the main outcome in pancreatic infection patients. Infection with MDR bacteria is also associated with AP mortality.展开更多
Warfarin is a commonly used anticoagulant with a narrow therapeutic range and risk of hemorrhagic complications. After CYP2C9 and VKORC1, CYP4F2 was confirmed as the third principle genetic determinant of warfarin dos...Warfarin is a commonly used anticoagulant with a narrow therapeutic range and risk of hemorrhagic complications. After CYP2C9 and VKORC1, CYP4F2 was confirmed as the third principle genetic determinant of warfarin dose variability.展开更多
BACKGROUND Acute coronary syndrome(ACS)is linked to a range of in-hospital complications,and age is recognized as risk factor for adverse events.Discrepancies between physiological and chronological age are explained ...BACKGROUND Acute coronary syndrome(ACS)is linked to a range of in-hospital complications,and age is recognized as risk factor for adverse events.Discrepancies between physiological and chronological age are explained by frailty.However,the relationship between frailty and in-hospital complications is not clear.METHODS Assessment of frailty in patients was carried out using the FRAIL scale.In-hospital complications assessed included,bleeding,infection,arrhythmia,acute kidney injury(AKI),delirium,stroke/transient ischemic attack(TIA),liver injury,hypoglycemia,length of stay in the cardiac care unit(CCU).RESULTS Of the 174 patients,frailty was identified in 39.1%and pre-frailty in 29.9%.Frailty was associated with a higher incidence of all types of bleeding(frail vs.robust:45.5%vs.16.7%,P<0.001)and infection(54.4%vs.11.1%,P<0.001),including pneumonia/lower respiratory tract infections(LRTI)and urinary tract infections(UTI).Incidence of antibiotic therapy(52.9%vs.13.0%,P<0.001),atrial fibrillation(AF)(47.1%vs.9.3%,P<0.001),AKI(57.3%vs.20.4%,P<0.001),delirium(52.9%vs.3.7%,P<0.001),liver injury,were higher in frail patients(17.6%vs.0,P=0.001),whilst their length of stay in the CCU was longer(4 days(2-6.5)vs.2 days(2-3),P<0.001).Infections,pneumonia/LRTI,antibiotic therapy during hospitalization,the incidence of AF and liver injury were more often in patients with pre-frailty compared to the robust group.After adjustment for potential confounders,frailty remained independently associated with an increased risk of infection(OR:3.3[1.6-7.0]),including pneumonia/LRTI(OR:2.5[1.1-5.8])and UTI(OR:4.8[1.8-12.5]).Frail individuals had an increased requirement for antibiotic therapy(OR:3.9[1.9-8.1]),and greater risk of AF(OR:3.5[1.3-9.3]),AKI(OR:2.6[1.2-5.3])delirium(OR:11.7[4.8-28.7]),as well as having to stay longer in the CCU(>3 days)(OR:3.7[1.9-7.3]).CONCLUSIONS Frailty was associated with an increased risk of numerous in-hospital complications in elderly patients who had been hospitalized with ACS.展开更多
BACKGROUND:Ascariasis is one of the most common human parasitic infections worldwide. In some rare cases,ascariasis may cause serious consequences even sudden death. This study was undertaken to review the life-threat...BACKGROUND:Ascariasis is one of the most common human parasitic infections worldwide. In some rare cases,ascariasis may cause serious consequences even sudden death. This study was undertaken to review the life-threatening complications of ascariasis in trauma patients reported in the literature.DATA SOURCES:Relevant articles about ascariasis and trauma were searched from Pubmed,Google scholar,Scirus,and Wanfang databases.RESULTS:Twenty-four patients with ascariasis were collected from 21 articles searched. Most of these patients were from tropical and subtropical countries. Of the 24 patients,12 were children. Their major complications occurred in the airway passage and digestive tract. There were 3 fatal cases in these patients. Twelve of the 24 patients described in 10 articles were reported in the last 10 years.CONCLUSIONS:Early diagnosis and prompt intervention are essential to minimize the high morbidity and mortality of these serious complications in trauma patients. Physicians should be aware of the possibility of Ascaris infection in a trauma patient from endemic area of ascariasis. History of Ascaris infection and routine examination of feces for Ascaris eggs may be helpful to make a correct diagnosis.展开更多
Type 2 diabetes mellitus(T2 DM)is one of metabolic diseases with the major inducer of obesity.Due to the change in lifestyle and dietary structure,more and more people are being suffered from T2 DM.Therefore,the preve...Type 2 diabetes mellitus(T2 DM)is one of metabolic diseases with the major inducer of obesity.Due to the change in lifestyle and dietary structure,more and more people are being suffered from T2 DM.Therefore,the prevention and treatment of T2 DM and its complications has become an urgent problem to be solved.As a secreted peptide,adropin is identifi ed as a useful regulator associated with insulin sensitivity and energy homeostasis.It has the potential for regulating metabolic diseases including obesity and T2 DM.It should be noted that the secretion of adropin can be induced by diets,aerobic exercise and other interventions.In this article,the underlying mechanisms of adropin for regulating obesity,T2 DM and its complications including diabetic nephropathy,diabetic retinopathy,diabetic encephalopathy,diabetic vascular disease and diabetic cardiovascular disease were summarized.Meanwhile,the strategies for promoting the secretion of adropin were also discussed,which will provide a target for the prevention and targeted treatment,or a candidate of novel and effective functional food or drug for metabolic diseases in the future.展开更多
Objective Total knee arthroplasty is one of the most common orthopedic surgeries.Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons.In this study,we evaluated the risk...Objective Total knee arthroplasty is one of the most common orthopedic surgeries.Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons.In this study,we evaluated the risk factors for severe complications after primary total knee arthroplasty.Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital.Postoperative complication≥gradeⅢwas defined as severe complication according to Clavien-Dindo classification system.Binary logistic regression was used to identify the predictive risk factors for severe complications.Results The complication rate after primary total knee arthroplasty was 6.8%and severe complication rate was 2.5%.Male(OR=2.178,95%CI:1.324-3.585,P=0.002),individuals above 75 years old(OR=1.936,95%CI:1.155-3.244,P=0.012),arrhythmia(OR=2.913,95%CI:1.350-6.285,P=0.006)and cerebrovascular disease(OR=2.804,95%CI:1.432-5.489,P=0.003)were predictive risk factors for severe complications after primary total knee arthroplasty.Conclusion Advanced age,male,arrhythmia,and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty.Special attention should be paid to patients with risk factors.展开更多
Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examin...Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative complications.We further tested the role of this mediation effect using mean arterial pressure,a hemodynamic indicator.Methods This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine arthrodesis.We used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative complications.We conducted mediation analysis using the mediation package in R(version 3.1.2),based on 5,000 bootstrapped samples,adjusting for covariates.Results Among the 300 patients in the study,40%(120/300)developed postoperative complications within 30 days.GDFT was associated with fewer 30-day postoperative complications after adjustment for confounders(odds ratio:0.460,95%CI:0.278,0.761;P=0.003).The total effect of GDFT on postoperative complications was-0.18(95%CI:-0.28,-0.07;P<0.01).The average causal mediation effect was-0.08(95%CI:-0.15,-0.04;P<0.01).The average direct effect was-0.09(95%CI:-0.20,0.03;P=0.17).The proportion mediated was 49.9%(95%CI:18.3%,140.0%).Conclusions The intraoperative blood pressure lability mediates the relationship between GDFT and the incidence of postoperative complications.Future research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications.展开更多
Objective: To observe the central nervous system (CNS) complications among 1083 consecutive renal transplant (RT) recipients. Methods: Systemic analyses of the incidence, time of onset and clinical outcome of CNS comp...Objective: To observe the central nervous system (CNS) complications among 1083 consecutive renal transplant (RT) recipients. Methods: Systemic analyses of the incidence, time of onset and clinical outcome of CNS complications were conducted in 1083 patients receiving cadaveric RT in Nanfang Hospital during Jan 1992 to Dec 1999. Results: Various CNS complications occurred in a total of 68 RT recipients (6. 28%, 68/1083) with a mortality of (1.29%, 14/1083). Of all the 1 083 recipients enrolled in this study,diffuse encephalopathy occurred in 31 cases (2.86%), cerebrovascular accidents in 17 (1.56%), seizure in 11 (1.02%) and CNS infection in 9 (0. 83%). Immusuppressive agents was the major cause for diffuse encephalopathy (93.5 %, 29/31), and cerebrovascular accidents were associated with a mortality rate of 70. 5%(12/17) and CNS infection with a mortality rate of 22. 22% (2/9). Most of the complications took place within the first month after RT, especially the first 2 weeks, but the majority of CNS infection occurred 1 year after RT. Conclusion: About 6% of renal transplant recipients develop CNS complications that result in a mortality of 1. 29%, which require early diagnosis and vigorous treatment. Diffuse encephalopathy and cerebrovascular accidents are the two most common CNS complications, and immunosuppressive agents play a important role in the occurrence of encephalopathy. Most of the CNS complications occurred early after RT, but CNS infections may occur rather late, and cerebrovascular accidents and CNS infection are the two major causes of death.展开更多
Objective To assess the prevalence of the bleeding complications in pacemaker implanted patients receiving different antiplatelet regimens, and the influence of each regimen on hospital stays after device implantation...Objective To assess the prevalence of the bleeding complications in pacemaker implanted patients receiving different antiplatelet regimens, and the influence of each regimen on hospital stays after device implantation. Methods We prospectively enrolled 364 patients receiving the cardiac rhythm device implantations in Fuwai Hospital from July 2012 to December 2013. Bleeding complications including pocket hematoma, hemothorax, cardiac tamponade and blood transfusion requirement were measured as endpoints. Post operation hospital stay was also included in the endpoints. Results Bleeding complications were detected in 15 patients （14 with hematoma, one with hemothorax） out of all 364 patients （4.12%）. Dual antiplatelet therapy （DAT） significantly increased hematoma （19.3%） compared with aspi- fin treatment （ASA） （3.2%, P = 0.001） and no antiplatelet therapy （1.9%, P 〈 0.001）. There was no significant difference in incidence of pocket hematoma between the ASA group and the control group （P = 0.45）. The post procedure hospital stay was longer in DAT group （5.45 ± 2.01 days） compared to those in the ASA group （3.65 ± 1.37 days, P 〈 0.05） or control group （3.99 ± 2.27 days, P 〈 0.05）. Pocket hema- toma was considered an independent predictor of hospital stay prolongation （OR： 5.26; 95% CI： 1.56-16.64; P = 0.007）. Conclusions Among the Chinese patients undergoing device implantation in this study, the use of dual antiplatelet agents significantly increased the risk of pocket hematoma complications and led to a longer hospital stay. Use of aspirin alone did not increase the risk.展开更多
Objective. To investigate retrospectively the complications and associated factors of gynecological laparoscopies. Methods. 1 769 laparoscopic surgeries were carried out from January 1994 to October 1999 at our depart...Objective. To investigate retrospectively the complications and associated factors of gynecological laparoscopies. Methods. 1 769 laparoscopic surgeries were carried out from January 1994 to October 1999 at our department. The procedures included 1421 surgeries of ovary and tube, 52 myomectomies and 296 cases of laproscopic-assisted vaginal hysterectomy (LAVH). A total of 312 patients had a history of prior laparotomy (176%). Results. Complications occured in 34 cases, the overall complication rate was 192%. Unintended laparotomies occured in 6 cases(034%). 12 complications were associated with insertion of Veress needle or trocar and creation of pneumoperitoneum, including 5 severe emphysema and 7 vascular injuries, this figure represents 353% of all complications of this series. Five intraoperative complications (147%) occured during the laparoscopic surgery (3 severe bleedings, one bladder injury and one skin burn of leg caused by damaged electrode plate), laparotomy was required in four of these cases. Seventeen complications occured during postoperative stage: 2 intraperitoneal hemorrhages needing laparotomy, 2 bowel injuries, 4 nerve paresis and 9 febrile morbidities. Conlusions. Operative gynecologic laparoscopy is associated with acceptable morbidity rate, but can not be overlooked. Complication rate seems to be higher in advanced procedures such as LAVH.展开更多
Objective: To analyze the inductive agents, post-surgical managements and precautions of the serious complications caused by transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinom...Objective: To analyze the inductive agents, post-surgical managements and precautions of the serious complications caused by transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma. Methods: Clinical data of 2 375 cases of TACE for 832 patients with middle-stage or advanced hepatocellular carcinoma from January 1994 to December 2002 were analyzed. Results: There were 7 cases of serious complications, one of which was liver carcinoma rupture and another was acute renal failure. Totally there were 4 cases of paraplegia and one case of conduit knotted. Conclusion: Deadly complications may happen after TACE and it needs close surveillance and management in time.展开更多
Method Fifteen hundred and fifty two patients with heart disease were examined with monoplane, biplane and omniplane TEE probe(including male 727, female 825;9～76 years old) During the s...Method Fifteen hundred and fifty two patients with heart disease were examined with monoplane, biplane and omniplane TEE probe(including male 727, female 825;9～76 years old) During the same period, 113 307 precordial echocardiographic examinations were performed in our laboratory The ratio between TEE and transthoracic Echo examines was 1:73 Result All different kinds of complication were occurred during TEE examination, including vomiting, minor mucus bleeding, laryngospasm, mandibular dislocation, angina pectoris, arrhythmia, even ventricular fibrillation and death The article suggested that there were five steps must be improved during TEE examination including instrument and patients preparation, local anesthesia, manipulation technique and TEE probes pattern Conclusion Although TEE is a semiinvasive technique and can cause some kinds of complication, it is a safe technique if the five steps are improved展开更多
Glycation of proteins and DNA forms advanced glycation end products(AGEs)causing cell and tissue dysfunction and subsequent various chronic diseases,in particular,metabolic and age-related diseases.Targeted AGE inhibi...Glycation of proteins and DNA forms advanced glycation end products(AGEs)causing cell and tissue dysfunction and subsequent various chronic diseases,in particular,metabolic and age-related diseases.Targeted AGE inhibition includes scavengers of reactive carbonyl species(RCS)such as methylglyoxal(MG),glyoxalase-1 enhancers,Nrf2/ARE pathway activators,AGE/RAGE formation inhibitors and other antiglycatng agents.Citrus flavonoids have demonstrated antioxidant and anti-inflammatory effects and are also found to be effective antiglycating agents.Herein,we reviewed the up to date progress of the antiglycation effects of citrus flavonoids and associated mechanisms.Major citrus flavonoids,hesperedin and its aglycone,hesperetin,inhibited glycation by scavenging MG forming mono-or di-flavonoid adducts with MG,enhanced the activity of glyoxase-1,activated Akt/Nrf2 signal pathway while inhibiting AGE/RAGE/NF-κB pathway,reduced the formation of Nε-(carboxylmethyl)lysine(CML)and pentosidine,inhibited aldol reductase activity and decreased the levels of fructosamine.The antiglycating activity and mechanisms of other flavonoids was also summarized in this review.In conclusion,citrus flavonoids possess effective antiglycating activity via different mechanisms,yet there are many challenging questions remaining to be studied in the near future such as in vivo testing and human study of citrus flavonoids for efficacy,effectiveness and adverse effects of citrus flavonoids as a functional food in managing high levels of AGEs and controlling AGE-induced chronic diseases,diabetic complications in particular.展开更多
文摘Aqueous humor provides the necessary nutrition for the lens and transports the metabolites in the eye.It was a liquid that can directly reflect the microenvironment in the eye'and it can be easily obtained during the operation.This review intended to analyze the components of aqueous humor in patients with different types of cataracts'so as to reflect the pathogenesis and development of the disease'evaluate the incidence of postoperative complications and provide reference value for the surgical design of sequential cataract surgery.The aqueous humor components of different types of cataracts showed different degrees of inflammation'oxidative stress and extracellular matrix remodeling.The biomarker of early neuropathy in diabetic cataract was neural cell adhesion molecule-1(NCAM1).Transforming growth factor-β(TGF-β)was the evaluation factor of disease development in patients with pseudoexfoliation syndrome.The relationships between postoperative complications of different types of cataracts and aqueous humor components were as follows:Macular edema after diabetic cataract surgery was associated with tumor necrosis factor-alpha;capsular contraction after high myopic cataract surgery was related to monocyte chemoattractant protein-1(MCP-1)and TGF-β2;Klotho and glutathione S-transferase P 1(GSTP1)were associated with high intraocular pressure after primary open-angle glaucoma complicated by cataract surgery;capsular contraction after retinitis pigmentosa complicated by cataract surgery was associated with matrix metalloproteinases;pro-inflammatory cytokines and fibroblast growth factor 4 in the aqueous humor of congenital cataracts were associated with posterior capsular opacification after surgery.Granulocyte colony stimulating factor 3 and MCP-1 were the main cytokines mediating the pain of the second eye in the binocular sequential cataract surgery short interval(1 wk)'while MCP-1 mediated pain in the long interval(6 wk).The second eye after binocular sequential cataract surgery had a higher level of proinflammatory factors.The components of aqueous humor in patients with different types of cataracts were related to the pathogenesis and postoperative complications of the disease.Monitoring the components of the aqueous humor could help better understand the intraocular microenvironment of different types of cataracts and provide a reference for predicting the development of the disease and implementing relevant targeted therapy.
基金Capital's Funds for Health Improvement and Research(2018-2-4013).
文摘Objective To investigate the relationship between hypothermia duration and postoperative complications in patients undergoing gynecological surgery.Methods Patients who underwent elective gynecological surgery at our hospital were consecutively enrolled between October 2020 and January 2022.Core temperature was continuously monitored intraoperatively,and early postoperative complications were collected.By adjusting the logistic regression model for potential confounding factors,the association of postoperative complications with the duration of hypothermia,the lowest body temperature below 36°C,and the hypothermia upon admission to postanesthesia care unit(PACU)or intensive care unit(ICU)were analyzed.Additionally,the potential inflection point in the relationship between the duration of hypothermia and the risk of postoperative complications was explored by using cumulative probability scatter plots and moving average sequences.Results The study included 370 patients,with 193(52.2%)experiencing hypothermia and 177(47.8%)not.Among them,92(24.9%)developed complications.The duration of hypothermia(adjusted odds ratio[OR]for each one-minute increase:1.003;95%confidence interval[CI]:1.000-1.006,P=0.047)and hypothermia upon admission to PACU or ICU(adjusted OR:1.980;95%CI:1.135-3.454,P=0.016)were associated with early postoperative complications.Notably,the cumulative incidence of postoperative complications tended to rise as the duration of hypothermia increased,with a potential inflection point observed at 120 minutes.Conclusions In gynecological surgery,the duration of hypothermia as well as hypothermia upon admission to PACU or ICU are associated with postoperative complications.Minimizing the duration of hypothermia may be clinically beneficial.
文摘Objectives Increased lipoprotein （a） serum concentration seems to be a cardiovascular risk factor; this has not been confirmed in extracoronary atherosclerosis complications. We therefore wished to gain a deeper insight into relationship between the plasma concentrations of lipoprotein （a） and the micro- and macro-vascular complications of type 2 diabetes mellitus and to identify possible differences in this association. Methods This is a descriptive observational cross-sectional study. Two-hundred and seventeen elderly patients with type 2 diabetes mellitus were included from the internal medicine outclinic. Anthropometric data, analytical data （insulin reserve, basal and postprandial peptide C, glycosylated hemoglobin, renal parameters, lipid profile and clinical data as hypertension, obesity, micro and macrovascular complications were collected. Results Patients were grouped according to the type 2 diabetes mellitus time of evolution. The mean plasma concentration of lipoprotein （a） was 22.2± 17.3 mg/dL （22.1± 15.9 mg/dL for males, and 22.1 ± 18.4 mg/dL for females）. Patients with hypertension, coronary heart disease, cerebrovascular accident, microalbuminuria and proteinuria presented a statistically significant increased level of lipoprotein （a）. Similarly, the patients with hyperlipoprotein （a） （≥30 mg/dL） presented significantly increased levels of urea and total cholesterol. In the multivariate regression model, the level of lipoprotein （a） is positively correlated with coronary heart disease and diabetic nephropathy （P 〈 0.01 and P 〈 0.005, respectively）. Conclusions The elevation of plasma levels of lipoprotein （a） are associ- ated with the development of coronary heart disease and diabe tic nephropathy. Therefore, we consider that the determination of lipoprotein （a） may be a prognostic marker of vascular complications in patients with type 2 diabetes mellitus.
文摘Background Very elderly patients （age 〉 85 years） are a rapidly increasing segment of the population. As a group, they experience high rates of in-hospital mortality and bleeding complications following percutaneous coronary intervention （PCI）. However, the relationship between bleeding and mortality in the very elderly is unknown. Methods Retrospective review was performed on 17,378 consecutive PCI procedures from 2000 to 2015 at Dartmouth-Hitchcock Medical Center. Incidence of bleeding during the index PCI admission （bleeding requiring transfusion, access site hematoma 〉 5 cm, pseudoaneurysm, and retroperitoneal bleed） and in-hospital mortality were reported for four age groups （〈 65 years, 65-74 years, 75-84 years, and ≥ 85 years）. The mortality of patients who suffered bleeding complications and those who did not was calculated and multivariate analysis was performed for in-hospital mortality. Lastly, known predictors of bleeding were compared between patients age 〈 85 years and age ≥85 years. Results Of 17,378 patients studied, 1019 （5.9%） experienced bleeding and 369 （2.1%） died in-hospital following PCI. Incidence of bleeding and in-hospital mortality increased monotonically with increasing age （mortality： 0.94%, 2.27%, 4.24% and 4.58%; bleeding： 3.96%, 6.62%, 10.68% and 13.99% for ages 〈 65, 65-4, 75-84 and ≥ 85 years, respectively）. On multivariate analysis, bleeding was associated with increased mortality for all age groups except patients age ≥85 years [odds ratio （95% CI）： age 〈 65 years, 3.65 （1.99-6.74）; age 65-74 years, 2.83 （1.62-4.94）; age 75-84 years, 3.86 （2.56-5.82）, age ≥ 85 years 1.39 （0.49-3.95）]. Conclusions Bleeding and mortality following PCI increase with increasing age. For the very elderly, despite high rates of bleeding, bleeding is no longer predictive of in-hospital mortality following PCI.
文摘Heart rate variability （HRV） refers to the variations between consecutive heartbeats, which depend on the continuous modulation of the sympathetic and parasympathetic branches of the autonomic nervous system. HRV has been shown to be effective as a predictor of risk after myocardial infarction and an early warning sign of diabetic neuropathy, and in the cardiology setting is now recognized to be a useful tool for risk-stratification after hospital admission and after discharge. Recent evidences suggest that HRV analysis might predict complications even in patients undergoing cardiac surgery, and the present review summarizes the importance of HRV analysis in adult cardiac surgery and the perspectives for HRV use in current clinical practice. Although future larger studies are warranted before HRV can be included into daily clinical practice in adult cardiac surgery, HRV is a novel tool which might detect autonomic instability in the early postoperative phase and during hospital stay, thus predicting or prompt-diagnosing many of the post-operative complications.
文摘Background: The occurrence of infectious complications characterizes the more severe forms of acute pancreatitis(AP) and is associated with high mortality. We investigated the effects of infection at different sites in patients with AP, including those with necrotizing pancreatitis(NP).Methods: We conducted a retrospective analysis of 285 patients who met the inclusion criteria for AP and were admitted to Tianjin Nankai Hospital between January 2016 and September 2019. According to the source of the culture positivity during hospitalization, patients were divided into four groups: sterile group(n=148), pancreatic infection group(n=65), extrapancreatic infection group(n=22) and combined infection group(n=50). The source of infection, microbiology, biochemical parameters and prognostic indicators were analyzed.Results: In terms of baseline characteristics, the four groups were similar in age, sex, aetiology, previous pancreatitis and diabetes. Compared with the severity of the disease in the other groups, the APACHE II scores(9.91±4.65, 9.46±5.05, respectively) and organ failure rate(40.9% and 50%, respectively)were higher in the extrapancreatic infection group and the combined infection group(P<0.05). The frequency of surgical intervention and hospitalization time in patients with NP complicated with extrapancreatic infection was greatly increased(P<0.05). Regarding the primary outcome, patients in the combined infection group had longer hospital stays(68.28±51.80 vs. 55.58±36.24, P<0.05) and higher mortality(24.0% vs. 9.2%, P<0.05) than patients in the pancreatic infection group. In addition, patients in the extrapancreatic infection group also showed high intensive care utilization(59.1%) and mortality rates(18.2%). Among the 137 AP patients with infection complications, 89 patients exhibited multidrug-resistant(MDR) microorganisms, and the mortality rate of patients with MDR bacterial infection was higher than that of patients with non-MDR bacterial infection(24.7% vs. 3.6%, P=0.001).Conclusions: Clinicians should be aware that extrapancreatic infection(EPI) significantly aggravates the main outcome in pancreatic infection patients. Infection with MDR bacteria is also associated with AP mortality.
基金Acknowledgements This work was supported by grants from the National Natural Science Foundation of China （No. 30971259）, and the Scientific and Technological Innovation Fund for Young Investigation, Chinese PLA General Hospital （No. 09KMM23）.
文摘Warfarin is a commonly used anticoagulant with a narrow therapeutic range and risk of hemorrhagic complications. After CYP2C9 and VKORC1, CYP4F2 was confirmed as the third principle genetic determinant of warfarin dose variability.
基金This research was supported by the National Natural Science Foundation of China(No.31025019)Innovation Team Development of the Ministry of Education of China(Grant No.IRT0967).
文摘BACKGROUND Acute coronary syndrome(ACS)is linked to a range of in-hospital complications,and age is recognized as risk factor for adverse events.Discrepancies between physiological and chronological age are explained by frailty.However,the relationship between frailty and in-hospital complications is not clear.METHODS Assessment of frailty in patients was carried out using the FRAIL scale.In-hospital complications assessed included,bleeding,infection,arrhythmia,acute kidney injury(AKI),delirium,stroke/transient ischemic attack(TIA),liver injury,hypoglycemia,length of stay in the cardiac care unit(CCU).RESULTS Of the 174 patients,frailty was identified in 39.1%and pre-frailty in 29.9%.Frailty was associated with a higher incidence of all types of bleeding(frail vs.robust:45.5%vs.16.7%,P<0.001)and infection(54.4%vs.11.1%,P<0.001),including pneumonia/lower respiratory tract infections(LRTI)and urinary tract infections(UTI).Incidence of antibiotic therapy(52.9%vs.13.0%,P<0.001),atrial fibrillation(AF)(47.1%vs.9.3%,P<0.001),AKI(57.3%vs.20.4%,P<0.001),delirium(52.9%vs.3.7%,P<0.001),liver injury,were higher in frail patients(17.6%vs.0,P=0.001),whilst their length of stay in the CCU was longer(4 days(2-6.5)vs.2 days(2-3),P<0.001).Infections,pneumonia/LRTI,antibiotic therapy during hospitalization,the incidence of AF and liver injury were more often in patients with pre-frailty compared to the robust group.After adjustment for potential confounders,frailty remained independently associated with an increased risk of infection(OR:3.3[1.6-7.0]),including pneumonia/LRTI(OR:2.5[1.1-5.8])and UTI(OR:4.8[1.8-12.5]).Frail individuals had an increased requirement for antibiotic therapy(OR:3.9[1.9-8.1]),and greater risk of AF(OR:3.5[1.3-9.3]),AKI(OR:2.6[1.2-5.3])delirium(OR:11.7[4.8-28.7]),as well as having to stay longer in the CCU(>3 days)(OR:3.7[1.9-7.3]).CONCLUSIONS Frailty was associated with an increased risk of numerous in-hospital complications in elderly patients who had been hospitalized with ACS.
文摘BACKGROUND:Ascariasis is one of the most common human parasitic infections worldwide. In some rare cases,ascariasis may cause serious consequences even sudden death. This study was undertaken to review the life-threatening complications of ascariasis in trauma patients reported in the literature.DATA SOURCES:Relevant articles about ascariasis and trauma were searched from Pubmed,Google scholar,Scirus,and Wanfang databases.RESULTS:Twenty-four patients with ascariasis were collected from 21 articles searched. Most of these patients were from tropical and subtropical countries. Of the 24 patients,12 were children. Their major complications occurred in the airway passage and digestive tract. There were 3 fatal cases in these patients. Twelve of the 24 patients described in 10 articles were reported in the last 10 years.CONCLUSIONS:Early diagnosis and prompt intervention are essential to minimize the high morbidity and mortality of these serious complications in trauma patients. Physicians should be aware of the possibility of Ascaris infection in a trauma patient from endemic area of ascariasis. History of Ascaris infection and routine examination of feces for Ascaris eggs may be helpful to make a correct diagnosis.
基金financially supported by the National Natural Science Foundation of China(No.31771318)Hubei Superior Discipline Groups of Physical Education and Health Promotion+1 种基金the 14thFive-Year-Plan Advantageous and Characteristic Disciplines(Groups)of Colleges and Universities in Hubei Province for Exercise and Brain ScienceChutian Scholar Program and Innovative Start-Up Foundation from Wuhan Sports University to Ning Chen。
文摘Type 2 diabetes mellitus(T2 DM)is one of metabolic diseases with the major inducer of obesity.Due to the change in lifestyle and dietary structure,more and more people are being suffered from T2 DM.Therefore,the prevention and treatment of T2 DM and its complications has become an urgent problem to be solved.As a secreted peptide,adropin is identifi ed as a useful regulator associated with insulin sensitivity and energy homeostasis.It has the potential for regulating metabolic diseases including obesity and T2 DM.It should be noted that the secretion of adropin can be induced by diets,aerobic exercise and other interventions.In this article,the underlying mechanisms of adropin for regulating obesity,T2 DM and its complications including diabetic nephropathy,diabetic retinopathy,diabetic encephalopathy,diabetic vascular disease and diabetic cardiovascular disease were summarized.Meanwhile,the strategies for promoting the secretion of adropin were also discussed,which will provide a target for the prevention and targeted treatment,or a candidate of novel and effective functional food or drug for metabolic diseases in the future.
文摘Objective Total knee arthroplasty is one of the most common orthopedic surgeries.Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons.In this study,we evaluated the risk factors for severe complications after primary total knee arthroplasty.Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital.Postoperative complication≥gradeⅢwas defined as severe complication according to Clavien-Dindo classification system.Binary logistic regression was used to identify the predictive risk factors for severe complications.Results The complication rate after primary total knee arthroplasty was 6.8%and severe complication rate was 2.5%.Male(OR=2.178,95%CI:1.324-3.585,P=0.002),individuals above 75 years old(OR=1.936,95%CI:1.155-3.244,P=0.012),arrhythmia(OR=2.913,95%CI:1.350-6.285,P=0.006)and cerebrovascular disease(OR=2.804,95%CI:1.432-5.489,P=0.003)were predictive risk factors for severe complications after primary total knee arthroplasty.Conclusion Advanced age,male,arrhythmia,and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty.Special attention should be paid to patients with risk factors.
基金supported by the National High Level Hospital Clinical Research Funding(2022-PUMCHB-119).
文摘Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative complications.We further tested the role of this mediation effect using mean arterial pressure,a hemodynamic indicator.Methods This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine arthrodesis.We used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative complications.We conducted mediation analysis using the mediation package in R(version 3.1.2),based on 5,000 bootstrapped samples,adjusting for covariates.Results Among the 300 patients in the study,40%(120/300)developed postoperative complications within 30 days.GDFT was associated with fewer 30-day postoperative complications after adjustment for confounders(odds ratio:0.460,95%CI:0.278,0.761;P=0.003).The total effect of GDFT on postoperative complications was-0.18(95%CI:-0.28,-0.07;P<0.01).The average causal mediation effect was-0.08(95%CI:-0.15,-0.04;P<0.01).The average direct effect was-0.09(95%CI:-0.20,0.03;P=0.17).The proportion mediated was 49.9%(95%CI:18.3%,140.0%).Conclusions The intraoperative blood pressure lability mediates the relationship between GDFT and the incidence of postoperative complications.Future research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications.
文摘Objective: To observe the central nervous system (CNS) complications among 1083 consecutive renal transplant (RT) recipients. Methods: Systemic analyses of the incidence, time of onset and clinical outcome of CNS complications were conducted in 1083 patients receiving cadaveric RT in Nanfang Hospital during Jan 1992 to Dec 1999. Results: Various CNS complications occurred in a total of 68 RT recipients (6. 28%, 68/1083) with a mortality of (1.29%, 14/1083). Of all the 1 083 recipients enrolled in this study,diffuse encephalopathy occurred in 31 cases (2.86%), cerebrovascular accidents in 17 (1.56%), seizure in 11 (1.02%) and CNS infection in 9 (0. 83%). Immusuppressive agents was the major cause for diffuse encephalopathy (93.5 %, 29/31), and cerebrovascular accidents were associated with a mortality rate of 70. 5%(12/17) and CNS infection with a mortality rate of 22. 22% (2/9). Most of the complications took place within the first month after RT, especially the first 2 weeks, but the majority of CNS infection occurred 1 year after RT. Conclusion: About 6% of renal transplant recipients develop CNS complications that result in a mortality of 1. 29%, which require early diagnosis and vigorous treatment. Diffuse encephalopathy and cerebrovascular accidents are the two most common CNS complications, and immunosuppressive agents play a important role in the occurrence of encephalopathy. Most of the CNS complications occurred early after RT, but CNS infections may occur rather late, and cerebrovascular accidents and CNS infection are the two major causes of death.
文摘Objective To assess the prevalence of the bleeding complications in pacemaker implanted patients receiving different antiplatelet regimens, and the influence of each regimen on hospital stays after device implantation. Methods We prospectively enrolled 364 patients receiving the cardiac rhythm device implantations in Fuwai Hospital from July 2012 to December 2013. Bleeding complications including pocket hematoma, hemothorax, cardiac tamponade and blood transfusion requirement were measured as endpoints. Post operation hospital stay was also included in the endpoints. Results Bleeding complications were detected in 15 patients （14 with hematoma, one with hemothorax） out of all 364 patients （4.12%）. Dual antiplatelet therapy （DAT） significantly increased hematoma （19.3%） compared with aspi- fin treatment （ASA） （3.2%, P = 0.001） and no antiplatelet therapy （1.9%, P 〈 0.001）. There was no significant difference in incidence of pocket hematoma between the ASA group and the control group （P = 0.45）. The post procedure hospital stay was longer in DAT group （5.45 ± 2.01 days） compared to those in the ASA group （3.65 ± 1.37 days, P 〈 0.05） or control group （3.99 ± 2.27 days, P 〈 0.05）. Pocket hema- toma was considered an independent predictor of hospital stay prolongation （OR： 5.26; 95% CI： 1.56-16.64; P = 0.007）. Conclusions Among the Chinese patients undergoing device implantation in this study, the use of dual antiplatelet agents significantly increased the risk of pocket hematoma complications and led to a longer hospital stay. Use of aspirin alone did not increase the risk.
文摘Objective. To investigate retrospectively the complications and associated factors of gynecological laparoscopies. Methods. 1 769 laparoscopic surgeries were carried out from January 1994 to October 1999 at our department. The procedures included 1421 surgeries of ovary and tube, 52 myomectomies and 296 cases of laproscopic-assisted vaginal hysterectomy (LAVH). A total of 312 patients had a history of prior laparotomy (176%). Results. Complications occured in 34 cases, the overall complication rate was 192%. Unintended laparotomies occured in 6 cases(034%). 12 complications were associated with insertion of Veress needle or trocar and creation of pneumoperitoneum, including 5 severe emphysema and 7 vascular injuries, this figure represents 353% of all complications of this series. Five intraoperative complications (147%) occured during the laparoscopic surgery (3 severe bleedings, one bladder injury and one skin burn of leg caused by damaged electrode plate), laparotomy was required in four of these cases. Seventeen complications occured during postoperative stage: 2 intraperitoneal hemorrhages needing laparotomy, 2 bowel injuries, 4 nerve paresis and 9 febrile morbidities. Conlusions. Operative gynecologic laparoscopy is associated with acceptable morbidity rate, but can not be overlooked. Complication rate seems to be higher in advanced procedures such as LAVH.
文摘Objective: To analyze the inductive agents, post-surgical managements and precautions of the serious complications caused by transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma. Methods: Clinical data of 2 375 cases of TACE for 832 patients with middle-stage or advanced hepatocellular carcinoma from January 1994 to December 2002 were analyzed. Results: There were 7 cases of serious complications, one of which was liver carcinoma rupture and another was acute renal failure. Totally there were 4 cases of paraplegia and one case of conduit knotted. Conclusion: Deadly complications may happen after TACE and it needs close surveillance and management in time.
文摘Method Fifteen hundred and fifty two patients with heart disease were examined with monoplane, biplane and omniplane TEE probe(including male 727, female 825;9～76 years old) During the same period, 113 307 precordial echocardiographic examinations were performed in our laboratory The ratio between TEE and transthoracic Echo examines was 1:73 Result All different kinds of complication were occurred during TEE examination, including vomiting, minor mucus bleeding, laryngospasm, mandibular dislocation, angina pectoris, arrhythmia, even ventricular fibrillation and death The article suggested that there were five steps must be improved during TEE examination including instrument and patients preparation, local anesthesia, manipulation technique and TEE probes pattern Conclusion Although TEE is a semiinvasive technique and can cause some kinds of complication, it is a safe technique if the five steps are improved
基金support from the High Level Scientific Research Cultivation Project of Huanggang Normal University(202108504)from the National Natural Science Foundation of China(31571832)。
文摘Glycation of proteins and DNA forms advanced glycation end products(AGEs)causing cell and tissue dysfunction and subsequent various chronic diseases,in particular,metabolic and age-related diseases.Targeted AGE inhibition includes scavengers of reactive carbonyl species(RCS)such as methylglyoxal(MG),glyoxalase-1 enhancers,Nrf2/ARE pathway activators,AGE/RAGE formation inhibitors and other antiglycatng agents.Citrus flavonoids have demonstrated antioxidant and anti-inflammatory effects and are also found to be effective antiglycating agents.Herein,we reviewed the up to date progress of the antiglycation effects of citrus flavonoids and associated mechanisms.Major citrus flavonoids,hesperedin and its aglycone,hesperetin,inhibited glycation by scavenging MG forming mono-or di-flavonoid adducts with MG,enhanced the activity of glyoxase-1,activated Akt/Nrf2 signal pathway while inhibiting AGE/RAGE/NF-κB pathway,reduced the formation of Nε-(carboxylmethyl)lysine(CML)and pentosidine,inhibited aldol reductase activity and decreased the levels of fructosamine.The antiglycating activity and mechanisms of other flavonoids was also summarized in this review.In conclusion,citrus flavonoids possess effective antiglycating activity via different mechanisms,yet there are many challenging questions remaining to be studied in the near future such as in vivo testing and human study of citrus flavonoids for efficacy,effectiveness and adverse effects of citrus flavonoids as a functional food in managing high levels of AGEs and controlling AGE-induced chronic diseases,diabetic complications in particular.
