Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM a...Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.展开更多
Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (≥ 65 years old) patie...Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (≥ 65 years old) patients with hypertension who prefer TCM treatment (n=112) or WM (n=126) were questioned about hypertension. Their answers were compared. Results Only 32.6% of participants correctly identified hypertension as a main risk factor of coronary heart disease and stroke, 22.3% of patients answered that the main purpose of hypertension control was preventing cardiovascular disease. Other major reasons for these patients to seek medical treatment for their hypertension included: persuasion by physicians or their family members (21.6%), alleviating symptoms such as headache and dizziness (16.8%), lowering blood pressure without knowing specific reason (12.4%). The predictors for poor knowledge of hypertension were similar irrespective of preference for WM or TCM treatment, and included those with lower levels of education and older age. Television and newspaper (46.8%) were the most frequent sources of hypertension information for both groups. Among those who preferred TCM treatment, "TCM has fewer side effects than WM" and"TCM cures disease while WM only alleviates symptoms" were common beliefs held. Conclusion This study shows that knowledge of hypertension is similar among Chinese urban patients with preferences for either WM or TCM treatment and that misunderstandings about hypertension are common among the elderly patients. In order to control hypertension effectively, public health education is necessary. This should target those with a lower level of education and older age.展开更多
Lycii Radicis Cortex(LRC)is a medicinal and food homologous plant with various pharmacological activities,including anti-tumor effects.This study explores the anti-tumor effect of LRC on non-small cell lung cancer(NSC...Lycii Radicis Cortex(LRC)is a medicinal and food homologous plant with various pharmacological activities,including anti-tumor effects.This study explores the anti-tumor effect of LRC on non-small cell lung cancer(NSCLC)and its molecular mechanism using mice bearing Lewis lung carcinoma cells.LRC significantly suppressed the growth of NSCLC.Besides,RNA sequencing of mice tumors and hematoxylin&eosin and immunofluorescence staining revealed that LRC promoted the infiltration of T lymphocytes,specifically GZMB~+CD8~+T lymphocytes,in tumor tissues.The Gene Set Enrichment Analysis of spleen RNA indicated that LRC up-regulated PD-1-downstream pathways,suggesting that LRC exerted its effects through the PDL1/PD-1 pathway.Further experiments revealed that LRC interacted with PD-L1,blocking PD-L1/PD-1 binding and thus restoring the T cell killing activity on tumor cells.Together,these results support using LRC as healthy food to improve anti-tumor immunity in patients with NSCLC.展开更多
Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare s...Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare services. This study aims to explore the relationship between work-family confict （WFC） and burn-out among Chinese doctors and the mediating role of coping styles in this relationship.Methods A cross-sectional survey was conducted in China, with a questionnaire packet which consisted of the Chinese Maslach Burnout Inventory （CMBI）, WFC Scale and the Simplifed Coping Style Questionnaire （SCSQ）. A total of 2530 doctors participated in the survey. Correlation analysis was performed to explore the relationship between CMBI, WFC and SCSQ scores. A linear regression model was set to determine the mediating role of coping styles on the relationship between WFC and burn-out.Results Doctors who had higher scores on work interfering with family confict, reported more emotional exhaustion （r=0.514, P〈0.001） and had a sense of accomplishment （r= 0.149, P〈0.001）. Simultaneously, family interfering with work （FIW） was positively associated with all dimensions of burn-out （r=0.213, 0.504, 0.088, respectively, P〈0.001）. Coping styles had partial, complete and even mediating effects on the relationship between WFC and burn-out among Chinese doctors.Conclusions WFC was correlated with burn-out, and coping style was a mediator in this relationship among Chinese doctors. Coping style was a positive resource against burn-out.展开更多
Background:Nonalcoholic fatty liver disease(NAFLD)is associated with disordered lipid and iron metabolism.Our previous study has substantiated the pivotal role of Caveolin-1(Cav-1)in protecting hepatocytes and mediati...Background:Nonalcoholic fatty liver disease(NAFLD)is associated with disordered lipid and iron metabolism.Our previous study has substantiated the pivotal role of Caveolin-1(Cav-1)in protecting hepatocytes and mediating iron metabolism in the liver.This study aimed to explore the specific mechanisms underlying the regulation of iron metabolism by Cav-1 in NAFLD.Methods:Hepatocyte-specific Cav-1 overexpression mice and knockout mice were used in this study.Cav-1-knockdown of RAW264.7 cells and mouse primary hepatocytes were performed to verify the changes in vitro.Moreover,a high-fat diet and palmitic acid plus oleic acid treatment were utilized to construct a NAFLD model in vivo and in vitro,respectively,while a high-iron diet was used to construct an in vivo iron overload model.Besides,iron concentration,the expression of Cav-1 and iron metabolism-related proteins in liver tissue or serum were detected using iron assay kit,Prussian blue staining,Western blotting,immunofluorescence staining,immunohistochemical staining and ELISA.The related indicators of lipid metabolism and oxidative stress were evaluated by the corresponding reagent kit and staining.Results:Significant disorder of lipid and iron metabolism occurred in NAFLD.The expression of Cav-1 was decreased in NAFLD hepatocytes(P<0.05),accompanied by iron metabolism disorder.Cav-1 enhanced the iron storage capacity of hepatocytes by activating the ferritin light chain/ferritin heavy chain pathway in NAFLD,subsequently alleviating the oxidative stress induced by excess ferrous ions in the liver.Further,CD68^(+) CD163^(+) macrophages expressing Cav-1 were found to accelerate iron accumulation in the liver,which was contrary to the effect of Cav-1 in hepatocytes.Positive correlations were also observed between the serum Cav-1 concentration and the serum iron-related protein levels in NAFLD patients and healthy volunteers(P<0.05).Conclusions:These findings confirm that Cav-1 is an essential target protein that regulates iron and lipid metabolic homeostasis.It is a pivotal molecule for predicting and protecting against the development of NAFLD.展开更多
OBJECTIVES Misdiagnosis of acute aortic syndrome(AAS)significantly increases mortality.Tenascin-C(TN-C)is an extracellular matrix glycoprotein related to cardiovascular injury.The elevation of TN-C in AAS and whether ...OBJECTIVES Misdiagnosis of acute aortic syndrome(AAS)significantly increases mortality.Tenascin-C(TN-C)is an extracellular matrix glycoprotein related to cardiovascular injury.The elevation of TN-C in AAS and whether it can discriminate suddenonset of acute chest pain in Chinese remains unclear.METHODS We measured the plasma concentration of TN-C by ELISA in a cohort of 376 patients with chest or back pain.Measures to discriminate AAS from acute coronary syndrome(ACS)were compared and calculated.RESULTS From October 2016 to September 2021,376 undiagnosed patients with chest or back pain were enrolled.166 of them were finally diagnosed as AAS,100 were ACS and 110 without cardiovascular diseases(NCV).TN-C was significantly elevated in AAS at 18.18 ng/mL(IQR:13.10–27.68)compared with 7.51 ng/mL(IQR:5.67–11.38)in ACS(P<0.001)and 3.68 ng/mL(IQR:2.50–5.29)in NCV(P<0.001).There was no significant difference in TN-C level among the subtypes of AAS.Of the 166 AAS patients,the peaked level of TN-C was at acute stage(P=0.012),then a slight of decrease was observed at subacute stage.The area under receiver operating characteristic curve for AAS patients versus NCV was 0.979(95%CI:0.964-0.994)for TN-C.At a cutoff level of 11.474 ng/mL,TN-C has a sensitivity of 76.0%,specificity of 85.5%,accuracy of 82.0%,positive predictive value(PPV)of 76.0%,negative predictive value(NPV)of 85.5%.Diagnostic performance of TN-C was superior to D-dimer and hs-cTnT.CONCLUSIONS The concentration of serum TN-C in AAS patients was significantly higher than that in ACS patients and NCV.TN-C could be a new biomarker to distinguish AAS patients in the early stage after symptoms onset from other pain diseases.展开更多
Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Met...Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Methods Patients were placed in a DI group and control group.The DI group was given DI and the control group was given physiologic saline.The administration lasted 4 to 6 days in both groups after PCI.Cardiac magnetic resonance(CMR)was carried out during the perioperative period(7±2 days).The primary endpoint of the study was myocardial infarct size(IS)imaged on delayed-enhancement CMR.The secondary endpoint was major adverse cardiac events observed 6 months after PCI.Results In total,160 high-risk NR patients were enrolled,and 110 patients completed the CMR examination.According to postoperative CMR,the Myocardial Salvage Index and left ventricular ejection fraction were higher in the DI group(0.57±0.13 vs.0.48±0.17,P<0.01;49.3%±6.9%vs.46.2%±7.7%,P=0.03,respectively),whereas the IS was lower(19.7%±5.6%vs.22.2%±6.5%,P=0.04),compared with that in the control group.These differences were observed to be significant.After 6 months,the prevalence of major adverse cardiac events in the DI group decreased compared with that in the control group,but the differences were not observed to be significant(P>0.05).Conclusion The application of DI can reduce the myocardial infarct size in STEMI patients at a high risk of NR during primary PCI.展开更多
Objective To prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi af...Objective To prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy. Methods A total of 138 patients with proximal ureteral calculi underwent ureteroscopic Ho:YAG laser lithotripsy by a single endocrinologist. Stone size varied from 10 to 15 mm. After operation, the patients were randomly divided into three groups: the control group(group A), tamsulosin group(group B), and Removing Stasis and Reducing Heat Formula group(group C). The treatment lasted for 4 weeks or until stone clearance. The primary and secondary outcomes of the three groups at follow-up were assessed. Results Of the 131 patients available for follow-up, 44 cases were in the group A, 45 in the group B, and 42 in the group C, respectively. The stone free rate at 2 weeks in the groups B and C were significantly higher than that in the group A(95.56%, 97.62% vs. 79.55%; all P<0.05). The ureteral colic rate and mean time of fragment expulsion were significantly reduced in the groups B(4.44% and 7.86±4.99 days) and C(2.43% and 6.76±4.37 days) compared with the group A(22.73% and 11.54±9.89 days, all P<0.05). On the day of double-J ureteric stent removal, the group C differed significantly from the group A in the total International Prostate Symptom Score, irritative subscore, obstructive subscore, and quality of life score(all P<0.05). Conclusion Removing Stasis and Reducing Heat Formula in the medical expulsive therapy might be an effective modality for patients with calculus in the proximal uretera after ureteroscopic Ho:YAG laser lithotripsy.展开更多
THE technical achievements during the past decade have changed the modalities for the removal of ureteral calculi.The introduction of small-caliber semirigid ureteroscopes,as well as the development of holmium:yttrium...THE technical achievements during the past decade have changed the modalities for the removal of ureteral calculi.The introduction of small-caliber semirigid ureteroscopes,as well as the development of holmium:yttrium-aluminum-garnet(Ho:YAG)laser and NTrap stone occlusion device,has improved the stone-free rate of ureteroscopy and reduced the incidence of complications.Recently,medical expulsive therapy has shown encouraging results in展开更多
Objective In cerebral aneurysm clipping and embolization, blood pressure control and temporaryparent artery blocking are common methods to prevent aneurysm rupture. Their influence on the prognosis isuncertain. In thi...Objective In cerebral aneurysm clipping and embolization, blood pressure control and temporaryparent artery blocking are common methods to prevent aneurysm rupture. Their influence on the prognosis isuncertain. In this study, we try to find out the association between methods above and prognostic indicators.展开更多
The current COVID-19 pandemic urges the extremely sensitive and prompt detection of SARS-CoV-2 virus.Here,we present a Human Angiotensin-converting-enzyme 2(ACE2)-functionalized gold“virus traps”nanostructure as an ...The current COVID-19 pandemic urges the extremely sensitive and prompt detection of SARS-CoV-2 virus.Here,we present a Human Angiotensin-converting-enzyme 2(ACE2)-functionalized gold“virus traps”nanostructure as an extremely sensitive SERS biosensor,to selectively capture and rapidly detect S-protein expressed coronavirus,such as the current SARS-CoV-2 in the contaminated water,down to the single-virus level.Such a SERS sensor features extraordinary 106-fold virus enrichment originating from high-affinity of ACE2 with S protein as well as“virus-traps”composed of oblique gold nanoneedles,and 109-fold enhancement of Raman signals originating from multi-component SERS effects.Furthermore,the identification standard of virus signals is established by machine-learning and identification techniques,resulting in an especially low detection limit of 80 copies mL^(−1) for the simulated contaminated water by SARS-CoV-2 virus with complex circumstance as short as 5 min,which is of great significance for achieving real-time monitoring and early warning of coronavirus.Moreover,here-developed method can be used to establish the identification standard for future unknown coronavirus,and immediately enable extremely sensitive and rapid detection of novel virus.展开更多
Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kaz...Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kazaks of Xinjiang Uyghur Autonomous Region,China.Methods These loci were analyzed by PCR-restriction fragment length polymorphism （PCR-PFLP）.Two hundred and five patients with CHD and two hundred and thirty six controls were involved.Results There were significant distinctions among low-density lipoprotein cholesterol （LDL-C）,triglyceride （TG） and the ApoAI/ApoB ratio between the two groups,but no significant distinction among the polymorphism frequencies of the four sites between the two groups.The polymorphism coalition frequency of X-/Ms＋＋/M1＋-/M2＋＋ （named Coalition 11） was significantly higher in CHD compared to the control group （14.6％ vs.7.2％,P ＜ 0.05）.The level of total cholesterol （TC） in Coalition 1 1 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1～10 in CHD patients.The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1～10 in control group.The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups,respectively.The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group.The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group.The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1～10 of the two groups,respectively.The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group.The ratio of ApoAI/ApoB was negatively related to TC,LDL-C and was positively related to HDL-C,both in CHD and control groups.Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks,and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters.CHD may also be associated with Coalition 5,and,perhaps,Coalition 3 may have been confirmed as a protection factor against CHD,if more samples were enrolled.展开更多
Food-microbiota-host interactions provide an overarching framework for understanding the function of the gut microbiota axis.Diet is a major modulator of gut microbiota.Plant-based foods are rich in phytochemicals;the...Food-microbiota-host interactions provide an overarching framework for understanding the function of the gut microbiota axis.Diet is a major modulator of gut microbiota.Plant-based foods are rich in phytochemicals;therefore,it is essential to assess such foods and elucidate the mechanisms underlying their action.In this review,we summarize the role of gut microbiota in the communication between the gut and the brain,liver,lung,kidney,and joints,as well as the role of the gut microbiota axis in diseases involving these organs.In addition,we assess the effects of phytochemicals from plant-based foods on the gut microbiota axis via different pathways.展开更多
Background: The treatment of hypertensive spontaneous intracranial hemorrhage(ICH) is still controversial. The purpose of the present study was to investigate whether minimally invasive puncture and drainage(MIPD) cou...Background: The treatment of hypertensive spontaneous intracranial hemorrhage(ICH) is still controversial. The purpose of the present study was to investigate whether minimally invasive puncture and drainage(MIPD) could provide improved patient outcome compared with decompressive craniectomy(DC).Methods: Eligible, consecutive patients with ICH(≥30 ml, in basal ganglia, within 24 hours of ictus) were nonrandomly assigned to receive MIPD(group A) or to undergo DC(group B) hematoma evacuation. The primary outcome was death at 30 days after onset. Functional independence was assessed at 1 year using the Glasgow Outcome Scale(GOS, scores range from 1 to 5, score 1 indicating death, ≥4 indicating functional independence, with lower scores indicating greater disability). Results: A total of 198 patients met the per protocol analysis(84 cases in group A and 114 cases in group B), including 9 cases lost during follow-up(2 cases in group A and 7 cases in group B). For these 9 patients, their last observed data were used as their final results for intention-to-treat analysis. The mean age of all patients was 57.1 years(range of 31-95 years), and 114 patients were male. The initial Glasgow Coma Scale(GCS) score was 8.1±3.4, and the National Institutes of Health Stroke Scale(NIHSS) score was 20.8±5.3. The mean hematoma volume(HV) was 56.7±23.0 ml(range of 30-144 ml), and there was extended intraventricular hemorrhage(IVH) in 134 patients(67.7%). There were no significant intergroup differences in the above baseline data, except group A had a higher mean age(59.4±14.5years) than the mean age of group B(55.3±11.1 years, P=0.025). The total cumulative mortalities at 30 days and 1 year were 32.3% and 43.4%, respectively, and there were no significant differences between groups A and B(30 days: 27.4% vs. 36.0%, P=0.203; 1 year: 36.1% vs. 48.2%, P=0.112, respectively). However, the mortality for patients ≤60 years, NIHSS【15 or HV≤60 ml was significantly lower in group A than that in group B(all P【0.05). The total cumulative functional independence at 1 year was 26.8%, and the difference between group A(33/43, 39.3%) and group B(20/144, 17.5%) was significant(absolute difference 21.7%, odds ratio [OR] 0.329, 95% confidence interval [CI] 0.171 to 0.631, P=0.001). For patient with severe IVH, the 30 days and 1 year mortality rates were significant lower in group B than those in group A(P=0.025, P=0.036). However, the number of favorable outcomes had no significant difference between groups at 1 year post ictus. Multivariate logistic regression analysis showed that a favorable outcome after 1 year was associated with the difference in therapies(OR 0.280, 95% CI 0.104–0.752, P=0.012), age(OR 0.215, 95% CI 0.069–0.671, P=0.008), GCS(OR 1.187, 95% CI 1.010–1.395, P=0.037), HV(OR 0.943, 95% CI 0.906–0.982, P=0.005), IVH(OR 0.655, 95% CI 0.506–0.849, P=0.001) and PI(OR 0.211, 95% CI 0.071–0.624, P=0.001). Conclusions: Our results suggest that for patients with hypertensive spontaneous ICH(HV≥30 ml in basal ganglia), MIPD may be a more effective treatment than DC, as assessed by a higher rate of functional independence at 1 year after onset as well as reduced mortality in patients ≤60 years of age, NIHSS【15 or HV≤60 ml. For patients with HV 】60 ml, deep coma and severe IVH, the outcomes of the two therapies were similar.展开更多
Objective To explore the inhibitory effect of recombinant mutant human tumor necrosis factor-α(rmhTNF-α) in combination with cisplatin on human lung adenocarcinoma cell line A549. Methods Human lung adenocarcinoma c...Objective To explore the inhibitory effect of recombinant mutant human tumor necrosis factor-α(rmhTNF-α) in combination with cisplatin on human lung adenocarcinoma cell line A549. Methods Human lung adenocarcinoma cell line A549 was treated with varying concentrations of rmhTNF-α(0.38, 0.75, 1.50, 6.00 and 12.00 IU/ml) or cisplatin(3.91, 7.81, 15.63, 31.25 and 62.50 μg/ml) for 24 hours. Viable cell number was analyzed by using crystal violet staining. The inhibitory rates of A549 cells growth by the two drugs were calculated. For analyzing whether there was a synergistic effect of rmhTNF-α with cisplatin, A549 cells were treated with 0.75 IU/ml rmhTNF-α and increased concentrations of cisplatin. Results rmhTNF-α or cisplatin inhibited the growth of A549 cell lines in a dose-dependent manner. The inhibitory effect of rmhTNF-α combined with cisplatin was significantly greater than cisplatin alone at the same concentration(all P<0.01). Conclusion rmhTNF-α combined with cisplatin might have synergistic inhibitory effect on human lung adenocarcinoma cell line A549.展开更多
Dear editor,Acute massive pulmonary embolism(PE) is a common life-threatening disease with high mortality of up to 30%–50%.[1,2]Potential heterogeneous reasons for PE remain controversial, and its treatment strategie...Dear editor,Acute massive pulmonary embolism(PE) is a common life-threatening disease with high mortality of up to 30%–50%.[1,2]Potential heterogeneous reasons for PE remain controversial, and its treatment strategies mainly include antithrombotics, fibrinolytics, and embolectomy.展开更多
BACKGROUND:The association of genetic variation in the IRAK-1 gene with sepsis outcome has been proved.However,few studies have addressed the impact of the IRAK-4 gene variants on sepsis risk.This study aimed to deter...BACKGROUND:The association of genetic variation in the IRAK-1 gene with sepsis outcome has been proved.However,few studies have addressed the impact of the IRAK-4 gene variants on sepsis risk.This study aimed to determine whether the polymorphisms in the IRAK-4 gene are associated with susceptibility to and prognosis of severe sepsis in the Chinese Han ethnic population.METHODS:In this case-control study,192 patients with severe sepsis hospitalized in the emergency department of Zhongshan Hospital from February 2006 to December 2009 and 192healthy volunteers were enrolled.Exclusion criteria included metastatic tumors,autoimmune diseases,AIDS or treatment with immunosuppressive drugs.This study was approved by the ethical committee of Zhongshan Hospital,Fudan University.Sepsis patients were divided into a survival group(n=124)and a non-survival group(n=68)according to the 30-day mortality.Primer 3 software was used to design PCR and sequencing primers.Genomic DNA was extracted from peripheral blood mononuclear cells.Seven tagSNPs in IRAK-4 were selected according to the data of the Chinese Han population in Beijing from the Hapmap project and genotyped by direct sequencing.The chi-square test was used to evaluate the differences in genotype and allele frequencies between the two groups.RESULTS:The distributions of all tagSNPs were consistent with Hardy-Weinberg equilibrium.The allele and genotype frequencies of rs4251545(G/A)were significantly different between the severe sepsis and healthy control groups(P=0.015,P=0.035,respectively).Carriers of the rs4251545A had a higher risk for severe sepsis compared with carriers of the rs4251545G(OR=1.69,95%CI:1.10-2.58).The allele and genotype frequencies of all SNPs were not significantly different between the survival group and non-survival group.CONCLUSION:These findings indicate that the variants in IRAK-4 are significantly associated with susceptibility to severe sepsis in the Chinese Han ethnic population.展开更多
The research of rogue waves is an advanced field which has important practical and theoretical significances in mathematics,physics,biological fluid mechanics,oceanography,etc.Using the reductive perturbation theory a...The research of rogue waves is an advanced field which has important practical and theoretical significances in mathematics,physics,biological fluid mechanics,oceanography,etc.Using the reductive perturbation theory and long wave approximation,the equations governing the movement of blood vessel walls and the flow of blood are transformed into high-order nonlinear Schrodinger(NLS)equations with variable coefficients.The third-order nonlinear Schrodinger equation is degenerated into a completely integrable Sasa–Satsuma equation(SSE)whose solutions can be used to approximately simulate the real rogue waves in the vessels.For the first time,we discuss the conditions for generating rogue waves in the blood vessels and effects of some physiological parameters on the rogue waves.Based on the traveling wave solutions of the fourth-order nonlinear Schrodinger equation,we analyze the effects of the higher order terms and the initial deformations of the blood vessel on the wave propagation and the displacement of the tube wall.Our results reveal that the amplitude of the rogue waves are proportional to the initial stretching ratio of the tube.The high-order nonlinear and dispersion terms lead to the distortion of the wave,while the initial deformation of the tube wall will influence the wave amplitude and wave steepness.展开更多
Cymbaria daurica L.has a long history as a folk medicine and tea for the treatment of diabetes.However,the biological activity and mechanism of its hypoglycemic effect have not been fully elucidated.In this study,the ...Cymbaria daurica L.has a long history as a folk medicine and tea for the treatment of diabetes.However,the biological activity and mechanism of its hypoglycemic effect have not been fully elucidated.In this study,the potential mechanism of C.daurica against type 2 diabetes mellitus(T2DM)was postulated via pharmacological network analysis.Based on data mining techniques involving topological parameters,gene ontology,and pathway enrichment,we established a compound-target,protein-protein interaction,and target-pathway network to identify central targets and pathways.Pathway enrichment analysis revealed that the most important pathway associated with C.daurica in treating T2DM is the PI3K-Akt signaling pathway.Molecular docking was performed to validate the predicted results.Then,a HepG2 cell insulin resistance model and a high-fat,high-glucose diet combined with a streptozotocin-induced T2DM rat model was established to assess the fasting glucose changes and lipid profile after C.daurica treatment,respectively.Finally,real-time PCR and western blotting were used to verify changes in key targets.The anti-diabetic mechanism of the active ingredient in C.daurica may involve the regulation of IRS-2,Akt1,GLUT4,and GSK3β.展开更多
基金supported by the National Natural Science Foundation of China(82174230)the Fundamental Research Funds for the Central Universities(2042022kf1213)。
文摘Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.
文摘Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (≥ 65 years old) patients with hypertension who prefer TCM treatment (n=112) or WM (n=126) were questioned about hypertension. Their answers were compared. Results Only 32.6% of participants correctly identified hypertension as a main risk factor of coronary heart disease and stroke, 22.3% of patients answered that the main purpose of hypertension control was preventing cardiovascular disease. Other major reasons for these patients to seek medical treatment for their hypertension included: persuasion by physicians or their family members (21.6%), alleviating symptoms such as headache and dizziness (16.8%), lowering blood pressure without knowing specific reason (12.4%). The predictors for poor knowledge of hypertension were similar irrespective of preference for WM or TCM treatment, and included those with lower levels of education and older age. Television and newspaper (46.8%) were the most frequent sources of hypertension information for both groups. Among those who preferred TCM treatment, "TCM has fewer side effects than WM" and"TCM cures disease while WM only alleviates symptoms" were common beliefs held. Conclusion This study shows that knowledge of hypertension is similar among Chinese urban patients with preferences for either WM or TCM treatment and that misunderstandings about hypertension are common among the elderly patients. In order to control hypertension effectively, public health education is necessary. This should target those with a lower level of education and older age.
基金supported by Natural Science Foundation of Guangdong Province,China(2022A1515011575)National Natural Science Foundation of China,China(81873154)President Foundation of Integrated Hospital of Traditional Chinese Medicine,Southern Medical University,China(1202103010)。
文摘Lycii Radicis Cortex(LRC)is a medicinal and food homologous plant with various pharmacological activities,including anti-tumor effects.This study explores the anti-tumor effect of LRC on non-small cell lung cancer(NSCLC)and its molecular mechanism using mice bearing Lewis lung carcinoma cells.LRC significantly suppressed the growth of NSCLC.Besides,RNA sequencing of mice tumors and hematoxylin&eosin and immunofluorescence staining revealed that LRC promoted the infiltration of T lymphocytes,specifically GZMB~+CD8~+T lymphocytes,in tumor tissues.The Gene Set Enrichment Analysis of spleen RNA indicated that LRC up-regulated PD-1-downstream pathways,suggesting that LRC exerted its effects through the PDL1/PD-1 pathway.Further experiments revealed that LRC interacted with PD-L1,blocking PD-L1/PD-1 binding and thus restoring the T cell killing activity on tumor cells.Together,these results support using LRC as healthy food to improve anti-tumor immunity in patients with NSCLC.
基金special fund for public welfare industry of health grant(200802150)(JSYRKJ2010-C1-001Jiangsu Provincial Medical Humanities and Social Science committee(No:JSYRKJ2010-C1-001)+1 种基金Philosophy and Social Science Special Project in Nanjing Medical University(No:2013NJZS40)Key Project supported by Medical Science and Technology Development Foundation Nanjing Department of Healt(No.YKK17246,YKK16241)
文摘Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare services. This study aims to explore the relationship between work-family confict （WFC） and burn-out among Chinese doctors and the mediating role of coping styles in this relationship.Methods A cross-sectional survey was conducted in China, with a questionnaire packet which consisted of the Chinese Maslach Burnout Inventory （CMBI）, WFC Scale and the Simplifed Coping Style Questionnaire （SCSQ）. A total of 2530 doctors participated in the survey. Correlation analysis was performed to explore the relationship between CMBI, WFC and SCSQ scores. A linear regression model was set to determine the mediating role of coping styles on the relationship between WFC and burn-out.Results Doctors who had higher scores on work interfering with family confict, reported more emotional exhaustion （r=0.514, P〈0.001） and had a sense of accomplishment （r= 0.149, P〈0.001）. Simultaneously, family interfering with work （FIW） was positively associated with all dimensions of burn-out （r=0.213, 0.504, 0.088, respectively, P〈0.001）. Coping styles had partial, complete and even mediating effects on the relationship between WFC and burn-out among Chinese doctors.Conclusions WFC was correlated with burn-out, and coping style was a mediator in this relationship among Chinese doctors. Coping style was a positive resource against burn-out.
基金financially supported by the National Natural Science Foundation of China(82074131,81774170,82260926)the Guangdong Basic and Applied Basic Research Foundation(2018B030306012,2022A1515220179,2021A1515011667)+2 种基金the Outstanding Youth Development Scheme project of Southern Medical University(G621299870)the Young Elite Scientists Sponsorship Program by CACM(2021-QNRC2-B28)the China Postdoctoral Science Foundation(2022M721532).
文摘Background:Nonalcoholic fatty liver disease(NAFLD)is associated with disordered lipid and iron metabolism.Our previous study has substantiated the pivotal role of Caveolin-1(Cav-1)in protecting hepatocytes and mediating iron metabolism in the liver.This study aimed to explore the specific mechanisms underlying the regulation of iron metabolism by Cav-1 in NAFLD.Methods:Hepatocyte-specific Cav-1 overexpression mice and knockout mice were used in this study.Cav-1-knockdown of RAW264.7 cells and mouse primary hepatocytes were performed to verify the changes in vitro.Moreover,a high-fat diet and palmitic acid plus oleic acid treatment were utilized to construct a NAFLD model in vivo and in vitro,respectively,while a high-iron diet was used to construct an in vivo iron overload model.Besides,iron concentration,the expression of Cav-1 and iron metabolism-related proteins in liver tissue or serum were detected using iron assay kit,Prussian blue staining,Western blotting,immunofluorescence staining,immunohistochemical staining and ELISA.The related indicators of lipid metabolism and oxidative stress were evaluated by the corresponding reagent kit and staining.Results:Significant disorder of lipid and iron metabolism occurred in NAFLD.The expression of Cav-1 was decreased in NAFLD hepatocytes(P<0.05),accompanied by iron metabolism disorder.Cav-1 enhanced the iron storage capacity of hepatocytes by activating the ferritin light chain/ferritin heavy chain pathway in NAFLD,subsequently alleviating the oxidative stress induced by excess ferrous ions in the liver.Further,CD68^(+) CD163^(+) macrophages expressing Cav-1 were found to accelerate iron accumulation in the liver,which was contrary to the effect of Cav-1 in hepatocytes.Positive correlations were also observed between the serum Cav-1 concentration and the serum iron-related protein levels in NAFLD patients and healthy volunteers(P<0.05).Conclusions:These findings confirm that Cav-1 is an essential target protein that regulates iron and lipid metabolic homeostasis.It is a pivotal molecule for predicting and protecting against the development of NAFLD.
基金supported by the National Natural Science Foundation of China(No.81970401,No.82270346,No.82170496)Jiangsu Provincial Key Medical Discipline(ZD2021023)+1 种基金Nanjing Municipal Health Science and Education Key Project(ZKX 21021)Nanjing Science and Technology Bureau Medical and Health International Joint Project(No.202002052).
文摘OBJECTIVES Misdiagnosis of acute aortic syndrome(AAS)significantly increases mortality.Tenascin-C(TN-C)is an extracellular matrix glycoprotein related to cardiovascular injury.The elevation of TN-C in AAS and whether it can discriminate suddenonset of acute chest pain in Chinese remains unclear.METHODS We measured the plasma concentration of TN-C by ELISA in a cohort of 376 patients with chest or back pain.Measures to discriminate AAS from acute coronary syndrome(ACS)were compared and calculated.RESULTS From October 2016 to September 2021,376 undiagnosed patients with chest or back pain were enrolled.166 of them were finally diagnosed as AAS,100 were ACS and 110 without cardiovascular diseases(NCV).TN-C was significantly elevated in AAS at 18.18 ng/mL(IQR:13.10–27.68)compared with 7.51 ng/mL(IQR:5.67–11.38)in ACS(P<0.001)and 3.68 ng/mL(IQR:2.50–5.29)in NCV(P<0.001).There was no significant difference in TN-C level among the subtypes of AAS.Of the 166 AAS patients,the peaked level of TN-C was at acute stage(P=0.012),then a slight of decrease was observed at subacute stage.The area under receiver operating characteristic curve for AAS patients versus NCV was 0.979(95%CI:0.964-0.994)for TN-C.At a cutoff level of 11.474 ng/mL,TN-C has a sensitivity of 76.0%,specificity of 85.5%,accuracy of 82.0%,positive predictive value(PPV)of 76.0%,negative predictive value(NPV)of 85.5%.Diagnostic performance of TN-C was superior to D-dimer and hs-cTnT.CONCLUSIONS The concentration of serum TN-C in AAS patients was significantly higher than that in ACS patients and NCV.TN-C could be a new biomarker to distinguish AAS patients in the early stage after symptoms onset from other pain diseases.
基金supported by grant from the Capital health research and development of special project (2016-15011)
文摘Objective To observe the effect of Danhong injection(DI)in patients with acute ST-segment elevation myocardial infarction(STEMI)at a high risk of no-reflow(NR)during primary percutaneous coronary intervention(PCI).Methods Patients were placed in a DI group and control group.The DI group was given DI and the control group was given physiologic saline.The administration lasted 4 to 6 days in both groups after PCI.Cardiac magnetic resonance(CMR)was carried out during the perioperative period(7±2 days).The primary endpoint of the study was myocardial infarct size(IS)imaged on delayed-enhancement CMR.The secondary endpoint was major adverse cardiac events observed 6 months after PCI.Results In total,160 high-risk NR patients were enrolled,and 110 patients completed the CMR examination.According to postoperative CMR,the Myocardial Salvage Index and left ventricular ejection fraction were higher in the DI group(0.57±0.13 vs.0.48±0.17,P<0.01;49.3%±6.9%vs.46.2%±7.7%,P=0.03,respectively),whereas the IS was lower(19.7%±5.6%vs.22.2%±6.5%,P=0.04),compared with that in the control group.These differences were observed to be significant.After 6 months,the prevalence of major adverse cardiac events in the DI group decreased compared with that in the control group,but the differences were not observed to be significant(P>0.05).Conclusion The application of DI can reduce the myocardial infarct size in STEMI patients at a high risk of NR during primary PCI.
文摘Objective To prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy. Methods A total of 138 patients with proximal ureteral calculi underwent ureteroscopic Ho:YAG laser lithotripsy by a single endocrinologist. Stone size varied from 10 to 15 mm. After operation, the patients were randomly divided into three groups: the control group(group A), tamsulosin group(group B), and Removing Stasis and Reducing Heat Formula group(group C). The treatment lasted for 4 weeks or until stone clearance. The primary and secondary outcomes of the three groups at follow-up were assessed. Results Of the 131 patients available for follow-up, 44 cases were in the group A, 45 in the group B, and 42 in the group C, respectively. The stone free rate at 2 weeks in the groups B and C were significantly higher than that in the group A(95.56%, 97.62% vs. 79.55%; all P<0.05). The ureteral colic rate and mean time of fragment expulsion were significantly reduced in the groups B(4.44% and 7.86±4.99 days) and C(2.43% and 6.76±4.37 days) compared with the group A(22.73% and 11.54±9.89 days, all P<0.05). On the day of double-J ureteric stent removal, the group C differed significantly from the group A in the total International Prostate Symptom Score, irritative subscore, obstructive subscore, and quality of life score(all P<0.05). Conclusion Removing Stasis and Reducing Heat Formula in the medical expulsive therapy might be an effective modality for patients with calculus in the proximal uretera after ureteroscopic Ho:YAG laser lithotripsy.
文摘THE technical achievements during the past decade have changed the modalities for the removal of ureteral calculi.The introduction of small-caliber semirigid ureteroscopes,as well as the development of holmium:yttrium-aluminum-garnet(Ho:YAG)laser and NTrap stone occlusion device,has improved the stone-free rate of ureteroscopy and reduced the incidence of complications.Recently,medical expulsive therapy has shown encouraging results in
文摘Objective In cerebral aneurysm clipping and embolization, blood pressure control and temporaryparent artery blocking are common methods to prevent aneurysm rupture. Their influence on the prognosis isuncertain. In this study, we try to find out the association between methods above and prognostic indicators.
基金the National Natural Science Foundation of China(No.51471182)this work is also supported by Shanghai international science and Technology Cooperation Fund(No.17520711700)the National Key Research and Development Project(No.2017YFB0310600).
文摘The current COVID-19 pandemic urges the extremely sensitive and prompt detection of SARS-CoV-2 virus.Here,we present a Human Angiotensin-converting-enzyme 2(ACE2)-functionalized gold“virus traps”nanostructure as an extremely sensitive SERS biosensor,to selectively capture and rapidly detect S-protein expressed coronavirus,such as the current SARS-CoV-2 in the contaminated water,down to the single-virus level.Such a SERS sensor features extraordinary 106-fold virus enrichment originating from high-affinity of ACE2 with S protein as well as“virus-traps”composed of oblique gold nanoneedles,and 109-fold enhancement of Raman signals originating from multi-component SERS effects.Furthermore,the identification standard of virus signals is established by machine-learning and identification techniques,resulting in an especially low detection limit of 80 copies mL^(−1) for the simulated contaminated water by SARS-CoV-2 virus with complex circumstance as short as 5 min,which is of great significance for achieving real-time monitoring and early warning of coronavirus.Moreover,here-developed method can be used to establish the identification standard for future unknown coronavirus,and immediately enable extremely sensitive and rapid detection of novel virus.
文摘Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kazaks of Xinjiang Uyghur Autonomous Region,China.Methods These loci were analyzed by PCR-restriction fragment length polymorphism （PCR-PFLP）.Two hundred and five patients with CHD and two hundred and thirty six controls were involved.Results There were significant distinctions among low-density lipoprotein cholesterol （LDL-C）,triglyceride （TG） and the ApoAI/ApoB ratio between the two groups,but no significant distinction among the polymorphism frequencies of the four sites between the two groups.The polymorphism coalition frequency of X-/Ms＋＋/M1＋-/M2＋＋ （named Coalition 11） was significantly higher in CHD compared to the control group （14.6％ vs.7.2％,P ＜ 0.05）.The level of total cholesterol （TC） in Coalition 1 1 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1～10 in CHD patients.The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1～10 in control group.The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups,respectively.The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group.The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group.The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1～10 of the two groups,respectively.The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group.The ratio of ApoAI/ApoB was negatively related to TC,LDL-C and was positively related to HDL-C,both in CHD and control groups.Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks,and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters.CHD may also be associated with Coalition 5,and,perhaps,Coalition 3 may have been confirmed as a protection factor against CHD,if more samples were enrolled.
基金supported by the National Key Research and Development Program(2021YFE0190100)National Natural Science Foundation of China(81760776,81874336)。
文摘Food-microbiota-host interactions provide an overarching framework for understanding the function of the gut microbiota axis.Diet is a major modulator of gut microbiota.Plant-based foods are rich in phytochemicals;therefore,it is essential to assess such foods and elucidate the mechanisms underlying their action.In this review,we summarize the role of gut microbiota in the communication between the gut and the brain,liver,lung,kidney,and joints,as well as the role of the gut microbiota axis in diseases involving these organs.In addition,we assess the effects of phytochemicals from plant-based foods on the gut microbiota axis via different pathways.
基金supported by grant from the National Natural Science Foundation of China (81070948)
文摘Background: The treatment of hypertensive spontaneous intracranial hemorrhage(ICH) is still controversial. The purpose of the present study was to investigate whether minimally invasive puncture and drainage(MIPD) could provide improved patient outcome compared with decompressive craniectomy(DC).Methods: Eligible, consecutive patients with ICH(≥30 ml, in basal ganglia, within 24 hours of ictus) were nonrandomly assigned to receive MIPD(group A) or to undergo DC(group B) hematoma evacuation. The primary outcome was death at 30 days after onset. Functional independence was assessed at 1 year using the Glasgow Outcome Scale(GOS, scores range from 1 to 5, score 1 indicating death, ≥4 indicating functional independence, with lower scores indicating greater disability). Results: A total of 198 patients met the per protocol analysis(84 cases in group A and 114 cases in group B), including 9 cases lost during follow-up(2 cases in group A and 7 cases in group B). For these 9 patients, their last observed data were used as their final results for intention-to-treat analysis. The mean age of all patients was 57.1 years(range of 31-95 years), and 114 patients were male. The initial Glasgow Coma Scale(GCS) score was 8.1±3.4, and the National Institutes of Health Stroke Scale(NIHSS) score was 20.8±5.3. The mean hematoma volume(HV) was 56.7±23.0 ml(range of 30-144 ml), and there was extended intraventricular hemorrhage(IVH) in 134 patients(67.7%). There were no significant intergroup differences in the above baseline data, except group A had a higher mean age(59.4±14.5years) than the mean age of group B(55.3±11.1 years, P=0.025). The total cumulative mortalities at 30 days and 1 year were 32.3% and 43.4%, respectively, and there were no significant differences between groups A and B(30 days: 27.4% vs. 36.0%, P=0.203; 1 year: 36.1% vs. 48.2%, P=0.112, respectively). However, the mortality for patients ≤60 years, NIHSS【15 or HV≤60 ml was significantly lower in group A than that in group B(all P【0.05). The total cumulative functional independence at 1 year was 26.8%, and the difference between group A(33/43, 39.3%) and group B(20/144, 17.5%) was significant(absolute difference 21.7%, odds ratio [OR] 0.329, 95% confidence interval [CI] 0.171 to 0.631, P=0.001). For patient with severe IVH, the 30 days and 1 year mortality rates were significant lower in group B than those in group A(P=0.025, P=0.036). However, the number of favorable outcomes had no significant difference between groups at 1 year post ictus. Multivariate logistic regression analysis showed that a favorable outcome after 1 year was associated with the difference in therapies(OR 0.280, 95% CI 0.104–0.752, P=0.012), age(OR 0.215, 95% CI 0.069–0.671, P=0.008), GCS(OR 1.187, 95% CI 1.010–1.395, P=0.037), HV(OR 0.943, 95% CI 0.906–0.982, P=0.005), IVH(OR 0.655, 95% CI 0.506–0.849, P=0.001) and PI(OR 0.211, 95% CI 0.071–0.624, P=0.001). Conclusions: Our results suggest that for patients with hypertensive spontaneous ICH(HV≥30 ml in basal ganglia), MIPD may be a more effective treatment than DC, as assessed by a higher rate of functional independence at 1 year after onset as well as reduced mortality in patients ≤60 years of age, NIHSS【15 or HV≤60 ml. For patients with HV 】60 ml, deep coma and severe IVH, the outcomes of the two therapies were similar.
文摘Objective To explore the inhibitory effect of recombinant mutant human tumor necrosis factor-α(rmhTNF-α) in combination with cisplatin on human lung adenocarcinoma cell line A549. Methods Human lung adenocarcinoma cell line A549 was treated with varying concentrations of rmhTNF-α(0.38, 0.75, 1.50, 6.00 and 12.00 IU/ml) or cisplatin(3.91, 7.81, 15.63, 31.25 and 62.50 μg/ml) for 24 hours. Viable cell number was analyzed by using crystal violet staining. The inhibitory rates of A549 cells growth by the two drugs were calculated. For analyzing whether there was a synergistic effect of rmhTNF-α with cisplatin, A549 cells were treated with 0.75 IU/ml rmhTNF-α and increased concentrations of cisplatin. Results rmhTNF-α or cisplatin inhibited the growth of A549 cell lines in a dose-dependent manner. The inhibitory effect of rmhTNF-α combined with cisplatin was significantly greater than cisplatin alone at the same concentration(all P<0.01). Conclusion rmhTNF-α combined with cisplatin might have synergistic inhibitory effect on human lung adenocarcinoma cell line A549.
基金This work was partly supported by grant from the Youth Fund of National Natural Science Foundation of China(81800441)Start-up Fund from Shanghai Fourth People’s Hospital Affiliated to Tongji University,Clinical Science and Technology Innovation Project of Shanghai Hospital Development Center,Construction and Application of Emergency and Critical Care Integrated Management Mode(SHDC22021211).
文摘Dear editor,Acute massive pulmonary embolism(PE) is a common life-threatening disease with high mortality of up to 30%–50%.[1,2]Potential heterogeneous reasons for PE remain controversial, and its treatment strategies mainly include antithrombotics, fibrinolytics, and embolectomy.
文摘BACKGROUND:The association of genetic variation in the IRAK-1 gene with sepsis outcome has been proved.However,few studies have addressed the impact of the IRAK-4 gene variants on sepsis risk.This study aimed to determine whether the polymorphisms in the IRAK-4 gene are associated with susceptibility to and prognosis of severe sepsis in the Chinese Han ethnic population.METHODS:In this case-control study,192 patients with severe sepsis hospitalized in the emergency department of Zhongshan Hospital from February 2006 to December 2009 and 192healthy volunteers were enrolled.Exclusion criteria included metastatic tumors,autoimmune diseases,AIDS or treatment with immunosuppressive drugs.This study was approved by the ethical committee of Zhongshan Hospital,Fudan University.Sepsis patients were divided into a survival group(n=124)and a non-survival group(n=68)according to the 30-day mortality.Primer 3 software was used to design PCR and sequencing primers.Genomic DNA was extracted from peripheral blood mononuclear cells.Seven tagSNPs in IRAK-4 were selected according to the data of the Chinese Han population in Beijing from the Hapmap project and genotyped by direct sequencing.The chi-square test was used to evaluate the differences in genotype and allele frequencies between the two groups.RESULTS:The distributions of all tagSNPs were consistent with Hardy-Weinberg equilibrium.The allele and genotype frequencies of rs4251545(G/A)were significantly different between the severe sepsis and healthy control groups(P=0.015,P=0.035,respectively).Carriers of the rs4251545A had a higher risk for severe sepsis compared with carriers of the rs4251545G(OR=1.69,95%CI:1.10-2.58).The allele and genotype frequencies of all SNPs were not significantly different between the survival group and non-survival group.CONCLUSION:These findings indicate that the variants in IRAK-4 are significantly associated with susceptibility to severe sepsis in the Chinese Han ethnic population.
基金Project supported by the National Natural Science Foundation of China(Grant No.11975143)Nature Science Foundation of Shandong Province of China(Grant No.ZR2018MA017)+1 种基金the Taishan Scholars Program of Shandong Province,China(Grant No.ts20190936)the Shandong University of Science and Technology Research Fund(Grant No.2015TDJH102).
文摘The research of rogue waves is an advanced field which has important practical and theoretical significances in mathematics,physics,biological fluid mechanics,oceanography,etc.Using the reductive perturbation theory and long wave approximation,the equations governing the movement of blood vessel walls and the flow of blood are transformed into high-order nonlinear Schrodinger(NLS)equations with variable coefficients.The third-order nonlinear Schrodinger equation is degenerated into a completely integrable Sasa–Satsuma equation(SSE)whose solutions can be used to approximately simulate the real rogue waves in the vessels.For the first time,we discuss the conditions for generating rogue waves in the blood vessels and effects of some physiological parameters on the rogue waves.Based on the traveling wave solutions of the fourth-order nonlinear Schrodinger equation,we analyze the effects of the higher order terms and the initial deformations of the blood vessel on the wave propagation and the displacement of the tube wall.Our results reveal that the amplitude of the rogue waves are proportional to the initial stretching ratio of the tube.The high-order nonlinear and dispersion terms lead to the distortion of the wave,while the initial deformation of the tube wall will influence the wave amplitude and wave steepness.
基金funded by the National Natural Science Foundation of China(81760776)the Natural Science Foundation of Inner Mongolia Autonomous Region(2018ZD13,2018LH08082,2019MS08208).
文摘Cymbaria daurica L.has a long history as a folk medicine and tea for the treatment of diabetes.However,the biological activity and mechanism of its hypoglycemic effect have not been fully elucidated.In this study,the potential mechanism of C.daurica against type 2 diabetes mellitus(T2DM)was postulated via pharmacological network analysis.Based on data mining techniques involving topological parameters,gene ontology,and pathway enrichment,we established a compound-target,protein-protein interaction,and target-pathway network to identify central targets and pathways.Pathway enrichment analysis revealed that the most important pathway associated with C.daurica in treating T2DM is the PI3K-Akt signaling pathway.Molecular docking was performed to validate the predicted results.Then,a HepG2 cell insulin resistance model and a high-fat,high-glucose diet combined with a streptozotocin-induced T2DM rat model was established to assess the fasting glucose changes and lipid profile after C.daurica treatment,respectively.Finally,real-time PCR and western blotting were used to verify changes in key targets.The anti-diabetic mechanism of the active ingredient in C.daurica may involve the regulation of IRS-2,Akt1,GLUT4,and GSK3β.
