Heart failure (HF) is one of the most serious diseases worldwide. Astragaloside IV (ASI) is widely used for the treatment of cardiovascular disease in China.To evaluate the protective effect of ASI on the HF in a Sprague-Dawley rat model of left coronary artery ligation, and investigate the angiogenesis-related mechanisms.Left coronary artery was ligated to induce a rat model of HF, and the rats were treated with vehicle (saline) or different doses of ASI (0.1, 0.3 and 1 mg/kg/day) by oral gavage for 6 weeks. Cardiac function was evaluated by echocardiography. Infarct size was determined by triphenyltetrazolium chloride staining. Cardiac vascular density was analyzed by microangiography. Real-time PCR, Western blot and chromatin immunoprecipitation were performed to investigate the mechanisms.ASI treatment improved the body weight and survival rate of HF rats, as well as the cardiac function of HF rats, with significantly improved ejection fraction (75.27 ± 5.75% vs. 36.26 ± 4.14%) and fractional shortening (45.39 ± 3.66% vs. 17.88 ± 1.32%). ASI reduced the infarct size of the HF rats by 47%. ASI promoted angiogenesis, with increased vascular density (2.08-fold) and induced mRNA expression of CD31 (1.81-fold) and VEGF (2.70-fold) in the ischemic heart. Furthermore, ASI induced the phosphorylation of JAK (1.89-fold) and STAT3 (2.95-fold), as well as the activity of VEGF promoter which was regulated by STAT3.ASI alleviated HF by promoting angiogenesis through JAK-STAT3 pathway, providing novel alternative strategies to prevent HF in the future.
Abstract Objective The demographic characteristics, ratio of aetiologies and biochemical parameters of adult patients with pulmonary hypertension (PH) living in plain and high‐altitude regions were investigated and analysed. Methods In total, 2846 adult patients with PH hospitalized from 2010 to 2015 in the Second Xiangya Hospital of Central South University and Qinghai Red Cross Hospital were retrospectively investigated. Results (1) In the present study, the numbers of patients with PH in both the plain and high‐altitude regions increased annually ( P < 0.05), and the in‐hospital prevalence of PH significantly increased over time in the high‐altitude region. PH was more common in women in the plain region. Furthermore, compared with PH patients living in the plain region, those living in the high‐altitude region were older ( P < 0.05) and had higher smoking rates ( P < 0.05). In the plain region, the greatest proportion of patients with PH belonged to group 2 (PH because of left heart disease), while in the high‐altitude region, group 3 (PH because of lung diseases and/or hypoxia) was the most common ( P < 0.05). (2) Haemoglobin levels, red blood cell counts, mean platelet volumes and platelet volume distribution widths were lower in PH patients living in the plain region than in those living in the high‐altitude region. Furthermore, platelet counts were higher in patients living in the plain region than in those living in the high‐altitude region ( P < 0.05). The BNP/NT‐proBNP levels were higher in PH patients living in the plain region (45.5%), which were mostly in group 4, than in those living the high‐altitude region ( P < 0.05). Conclusions The data from the hospitals in both the plain and high‐altitude regions show a tendency towards increased in‐hospital prevalence of PH over the last 6 years. The most common aetiologies of PH in patients living in the plain region and high‐altitude regions were left heart disease and lung disease, respectively. Compared with PH patients living in the plain region, those living in the high‐altitude region had better cardiac function and less severe PH.
Abstract Background: Rapid progress has been made in research of cadmium-zinc-telluride (CZT) technology in the last few years, which might serve as a new method to diagnose coronary artery disease. However, compared with coronary angiography, the diagnostic value of CZT is still controversial. We aimed to evaluate diagnosis value of coronary angiography versus CZT in coronary artery disease. Methods: We searched the database for eligible researches associated with CZT- myocardial perfusion imaging (MPI) and invasive coronary angiography, extracted the relevant data, and rigorously screened it according to the inclusion and exclusion criteria. The accuracy indicators included sensitivity, specificity, accuracy, positive and negative likelihood ratios. Results: According to the inclusion and exclusion criteria, we finally found 20 studies containing 2350 patients in this search. Pooled results showed that sensitivity of CZT-MPI was 0.84% and 95% confidence interval (95% CI): 0.78 to 0.89, specificity was 0.72, 95% CI (0.62–0.76), the specificity was lower apparently. The positive likelihood ratio was 3.0, 95% CI (2.4–3.8), the negative likelihood ratio was 0.22, 95% CI (0.16–0.31), diagnostic odds ratio was 14, 95% CI (7.84–17.42). Conclusion: This meta-analysis showed that CZT-MPI had satisfactory sensitivity and specificity for diagnosing coronary artery disease. Larger studies are required for further evaluation.
The results of clinical and experimental studies suggest that endotoxin/toll-like receptor 4 (TLR4)-mediated proinflammatory and profibrotic signaling activation is critical in the development of hepatic fibrosis. However, studies examining the role of specific TLR4 inhibitor are still lacking. The present study was aimed to prepare a human anti-TLR4 Fab fragment, named hTLR4-Fab01, and to explore its immune activity. We screened the positive clone of anti-human TLR4 phagemid from a human phage-display antibody library using recombinant TLR4 protein, which was used as template cDNA for the amplification of variable regions of the heavy (VH) chain and light chain (VL), then coupled with highly conserved regions of the heavy chain domain 1 (CH1) and the light chain (CL), respectively. Thus, the prokaryotic expression vector pETDuet-1 of hTLR4-Fab01 was constructed and transformed into Escherichia coli (E. coli) BL21. The characteristic of hTLR4-Fab01 was examined by SDS-PAGE, Western blotting, ELISA, affinity and kinetics assay. Further, our data demonstrate that hTLR4-Fab01 could specifically bind to TLR4, and its treatment obviously attenuated the proinflammatory effect, characterized by less LPS-induced TNF-α, IL-1, IL-6 and IL-8 production in human macrophages. In conclusion, we have successfully prepared the hTLR4-Fab01 with efficient activity for blocking LPS-induced proinflammatory cytokines production, suggesting that the hTLR4-Fab01 may be a potential candidate for the treatment of hepatic fibrosis.
Using the complex network technology, the characteristics of the core acupoint prescriptions and the application of acupuncture-moxibustion techniques were analyzed in treatment of rheumatoid arthritis (RA) so as to provide the evidences for acupoint selection and therapeutic methods for RA treated with acupuncture and moxibustion. The articles of acupuncture and moxibustion for treatment of RA in recent 20 years were collated and imported, and the database of the acupoint prescriptions was developed. Using Cytoscape 3.9.2 software, the acupoints in the prescriptions were visualized for the common occurrence network analysis. The association rule analysis was performed with IBM SPSS Modeler 18.0 software and the complex network analysis was by Gephi 0.9.2 software. A total of 798 articles were screened, in which, 3 258 prescriptions were extracted with 253 acupoints involved. The analysis of acupoint selection was conducted in terms of syndrome/pattern differentiation, acupoint locations and main acupoints, and therapeutic methods. The results showed that the most common TCM syndromes of RA included painful bi syndrome, wandering bi syndrome, fixed bi syndrome and bi syndrome due to wind, damp and heat. Regarding the core combination of acupoints, painful bi syndrome: Guanyuan (CV 4) and Shenshu (BL 23); fixed bi syndrome: Yinlingquan (SP 9), Sanyinjiao (SP 6), Zusanli (ST 36), Pishu (BL 20) and Fenglong (ST 40); wandering bi syndrome: Fengchi (GB 20), Geshu (BL 17), Fengmen (BL 12), Xuehai (SP 10) and Waiguan (TE 5); bi syndrome due to wind, damp and heat: Dazhui (GV 14), Quchi (LI 11) and Hegu (LI 4). Regarding the acupoint locations, the acupoints located in the upper limbs, lower limbs and spinal region were generally selected. Quchi (LI 11) was one of the main acupoints in prescriptions with the highest use frequency. Zusanli (ST 36) and Shenshu (BL 23) presented the highest co-occurrence intensity, while Zusanli (ST 36) and Quchi (LI 11) indicated the highest correlation. The treatment of acupuncture-moxibustion for RA is generally complied with the principle as "the synthesis of main acupoints, supplementary acupoints in local affected area and those based on syndrome differentiation". Warm needling and the combination of acupuncture and herbal medication are the most common therapeutic methods for RA.利用复杂网络技术分析针灸治疗类风湿关节炎的核心腧穴处方以及刺灸法应用特点，为临床针灸治疗类风湿关节炎提供选穴、治法依据。对近20年针灸治疗类风湿关节炎的文献进行收集、整理、录入，建立针灸处方数据库，对处方中的腧穴运用Cytoscape3.9.0进行共现网络可视化、运用IBM SPSS Modeler 18.0进行关联规则分析、利用Gephi0.9.2软件进行复杂网络分析。共筛选出798篇文献，提取3 258条针灸处方，涉及253个腧穴，主要从辨证分型选穴、分部选穴、主穴处方及疗法进行分析。结果表明最常见的中医证型为痛痹、行痹、着痹及风湿热痹；辨证选穴核心腧穴组合为痛痹：关元、肾俞；着痹：阴陵泉、三阴交、足三里、脾俞、丰隆；行痹：风池、膈俞、风门、血海、外关；风湿热痹：大椎、曲池、合谷。分部选穴以上肢部、下肢部、脊柱部腧穴多见。曲池在主穴处方中使用频次最高，足三里-肾俞的共现强度最高；相关性最高的腧穴组合为足三里-曲池。针灸治疗类风湿关节炎选穴多遵循“主穴-局部配穴-辨证配穴”的原则，温针灸及针药联合为最常用的施治方法。.
The aim of this study was to investigate the safety and efficacy of anti-programmed death ligand 1 (PD-L1) immunotherapy plus chemoradiotherapy for patients with limited-stage small cell lung cancer (LS-SCLC) in clinical practice. Patients with LS-SCLC treated with anti-PD-L1 (atezolizumab/durvalumab) plus chemoradiotherapy (CRT) as the initial treatment at three general hospitals between March 2020 and December 2021 were retrospectively analysed. 1:2 propensity score matching for controls that receive CRT only was performed. Clinical data (age, sex, history of cancer treatment, adverse events, etc.) were collected to evaluate toxicity, progression-free survival (PFS) and objective response rate (ORR). Researchers used univariate Chi-squared analyses to determine if anti-PD-L1 immunotherapy had a significant association with toxicity or ORR. Kaplan-Meier survival analysis, and the log-rank test were used to compare survival curves between the two groups. In the anti-PD-L1 plus CRT and CRT groups, 15 and 30 patients were analyzed; median follow-up was 16.39 months and 16.64 months, respectively. Incidence of toxicity between the two groups was similar and there were no new safety signals. Anti-PD-L1 immunotherapy significantly improved PFS (P = 0.02). The median PFS was not reached in the anti-PD-L1 plus CRT group versus 8.18 months [95% confidence interval (CI), 6.14-10.22 months] in the CRT group. The ORR were 93.33% and 76.67%, respectively (P = 0.34). This study supports adding anti-PD-L1 immunotherapy (atezolizumab/durvalumab) to CRT as an initial treatment option in patients with LS-SCLC for its favorable safety profile and efficacy.
This study aims to discuss an experience in the treatment of lacerations in different parts of the skin in emergency surgery, and summarize the clinical application value of medical adhesives for wound debridement and adhesion. The signs for application, usage methods and steps in the treatment of wounds, as well as the effect observation recorded in literatures and case records were reviewed. Application of medical adhesives in the treatment of head and face skin lacerations can reduce scars. It can also reduce pain caused by trauma, and the incidence of wound abscess and inflammation in the treatment of limb and nail bed injuries. The application of medical adhesives for debridement simplifies the operation and shortens operation time, saves the requirement of stitch removal, and reduces the patient's pain and difficulties, and patient visits. The standard use of medical adhesives can achieve a better effect on trauma repair, and avoid erythema, induration, scar hyperplasia and other needle reactions in debridement of skin lacerations; achieving the cosmetic repair of trauma. By reviewing past experiences in the use of medical adhesives, this study summarizes the methods and precautions for the application of medical adhesives for injuries in different parts of the skin.
Objective:To approach the treatment for preterm premature rupture of the membranes(PPROM)complicated with premature delivery by examining the clinical data of these cases.Methods:The clinical data of 80 cases with PPROM,collected from January to December in our hospital,were assigned to groups by gestational weeks of 28 or 36 for this retrospective study.Results:The incidence of asphyxia in the newborns occurred in 3 out of 20 cases during the gestation of weeks 28 to 32,7 in 27 between 32 and 34 and 1out of 33 in weeks of 34 to 36.Non intra-amniotic inflammation developed in all 80 cases.Conclusion:For those cases whose gestation period is under 32 weeks with no marked intra-uterine asphyxia and intrauterine infection,delayed delivery should be recommended,and for those beyond gestational weeks of 32,administering antenatal corticosteroids must be recommended to improve the fetal survival rate.
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