最新刊期
卷 43 ， 期 6 ， 2022
- 摘要：With the postponement of marriage and childbirth age and the opening of the "three child" policy， the reproductive demand of advanced ages is increasing， and reproductive aging has become an important public health issue facing social development. Previous studies have shown that 40~55 years old may be the "watershed" of male fertility during aging. However， compared with female reproductive aging， male reproductive aging lacks distinctive characteristics， and its impact on the elderly men is multifaceted. In this review， we elaborated our understanding of the male reproductive aging from multiple perspectives of aging-related changes in male reproductive endocrine， gonads， and accessory sex glands.关键词：male reproductive aging;fertility;reproductive endocrine;accessory sex glands
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发布时间：2024-02-19 - 摘要：ObjectiveTo summarize the effect of visual electrophysiological diagnosis and treatment technology on postoperative urinary incontinence in early intervention after transurethral enucleation and resection of the prostate （TUERP）.MethodsTotally 86 patients with benign prostatic hyperplasia （BPH） who underwent TUERP in the Puji Branch Hospital of Dongguan People's Hospital from December 2020 to June 2022 were selected as the treatment group， who received electrophysiological treatment after postoperative removal of the catheter on the 6th day after surgery， while 79 cases who received no electrophysiological treatment after surgery were selected as the control group. The urinary incontinence rates of the two groups on the 6th day， at 1 month and 3 months after surgery were observed.ResultsThere was no statistical difference between the two groups in the preoperative basic data. The rates of urinary incontinence after removal of the catheter in the two groups on the 6th day after surgery were 13 cases （15.1%） in the treatment group and 12 cases （15.2%） in the control group. There was no significant difference between the two groups （P >0.05）， and the overall postoperative urinary incontinence rate in the two groups was 15.2% （25/165）. At one month after surgery， only 4 cases （4.65%） had slight urinary incontinence in the treatment group， while 13 cases （16.5%） in the control group still had urinary incontinence， and the difference between the two groups was statistically significant （ P=0.019）. After follow-up to three months after operation， there was no case of urinary incontinence in the treatment group， and there were still 7 cases （8.86%） of urinary incontinence in the control group. The difference between the two groups was statistically significant （P=0.005）.ConclusionThe early intervention of visual electrophysiological diagnosis and treatment technology can effectively prevent the occurrence of urinary incontinence after TUERP， and has good value in clinical application.关键词：benign prostatic hyperplasia;transurethral enucleation and resection of the prostate;urinary incontinence;electrophysiology
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发布时间：2024-02-19 - 摘要：ObjectiveTo investigate the efficacy and treatment options of precise electrophysiological diagnosis combined with percutaneous low-frequency electrical stimulation for penile scleroderma in high-altitude hypoxic areas.MethodsA total of 54 patients with electrophysiological diagnosis and treatment of corpora cavernosa were included in the retrospective analysis. Their age ranged from 20 to 70 years with a mean of 45.5±11.6 years and disease duration from 2 to 16 months. PDE5i， levocarnitine oral solution， and traditional Chinese medicine for invigorating blood circulation and eliminating stasis were administered orally before treatment. The visual precision electrophysiological diagnosis was performed after discontinuation of all oral drugs for 1 week before treatment. The electrophysiological diagnostic parameters were recorded and contrasted before and after the set-up treatment， and the corresponding parameters for precision electrophysiology were adjusted for percutaneous low-frequency electrical stimulation treatment， 2-3 hours each time， once daily， and 10 times per course. At the same time was administered assisted nasal cannula oxygen inhalation for 2 to 3 hours （4L/min）. Before and after electrophysiological diagnosis and treatment were evaluated by using the numeric assessment scale of pain extent， the international index of erectile function score （IIEF-5）， penile curvature measurement， color Doppler measurement of plaque areas and comparison of whole body and disease local infrared thermogram temperature changes.ResultsAll patients successfully completed 2-4 sessions of percutaneous low-frequency electrical stimulation （20 sessions to 40 sessions）. There was a significant statistical difference （P < 0.01） between the mean values before and after treatment for the degree of weakness / erection pain （7.1±1.6 vs 2.0±1.0）；（8.2±3.2 vs 16.0±5.1） before and after IIEF-5 treatment， respectively （P < 0.01），Pre- and post-treatment of PCDDU measured mean plaque size was 0.23（0.09~0.54）cm2 vs 0.23（0.09~0.54）cm2，with no statistically different change in improvement value （P = 0.189）. Four cases had no penile camptodactyly， Before electrical stimulation， 50 （92.6%） patients had different degrees of penile curvature deformity， and there was no change in the improvement of the contrast bending angle before and after treatment （P >0.05）. The comparison of TMT images before and after treatment with visual precision electrophysiology diagnosis suggested that temperature change >1.5℃ in the whole body and penile and bilateral inguinal regions， etc. could be considered effective electrical stimulation treatment. There were no recurrences of induration， increased pain and penile curvature at 3~10 months follow-up， and no patient required subsequent surgery.ConclusionThe results of this study show that visualizing the electrophysiological diagnosis situation to set local and holistic combined treatment parameters， and treating PD by means of percutaneous low-frequency electrical stimulation at meridian and neuromuscular acupoints of traditional Chinese medicine could achieve good safety and efficacy， especially in the early stage，which has a clear effect on pain treatment， thus opening new avenues for PD treatment.关键词：Peyronie’s disease;TMT image;electrophysiological diagnosis;percutaneous low frequency electrical stimulation
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发布时间：2024-02-19 - 摘要：ObjectiveTo analyze the clinical characteristics and influencing factors of premature ejaculation （PE） in andrology outpatient population.MethodsFrom January 2020 to May 2022， a total of 973 male subjects aged 20-60 years were enrolled in the andrology outpatient department of our hospital， and the subjects’ demographic data， medical history and sexual history were recorded in detail. Subjects with complete data were further evaluated by the Premature Ejaculation Diagnostic Tool （PEDT）， self-estimated intra-vaginal ejaculation latency time （IELT）， International Index of Erectile Function 5 （IIEF-5）， Erectile Hardness Score （EHS）， General Anxiety Disorder-7 （GAD-7） and Patients Health Questionnaire-9 （PHQ-9）. Among the subjects， 445 cases （31.12±6.72 years old） were assigned to the PE group and 528 cases （32.78±7.95 years old） to the non-PE group based on their medical and sexual histories， and results of the evaluation. Multiple linear regression and Logistic regression were used to analyze the correlation factors and independent risk factors of PE.ResultsThere were significant differences in the indicators including age， PEDT， IELT， IIEF-5， EHS， GAD-7 and PHQ-9 between the two groups （P<0.05）. Linear regression analysis showed that PEDT was significantly correlated with age （adjusted b =-0.11， P=0.001）， IIEF-5 （adjusted b =-0.17， P<0.001） and PHQ-9 （adjusted b =0.19， P<0.001）. After multivariate adjustment of Logistic regression， the variables such as age ≤30 years， erectile dysfunction and depression status were the independent risk factors for PE， and their Odds Ratio（OR） （95%CI） were 1.63（1.23， 2.16）， 2.05（1.45，2.92） and 1.90（1.37， 2.65）， respectively.ConclusionsPE significantly correlates with age， erectile function scale scores， anxiety and depression scale scores. Age ≤30 years， erectile dysfunction and depression status are the independent risk factors for PE.关键词：premature ejaculation;erectile dysfunction;anxiety;depression
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发布时间：2024-02-19
New diagnostic and therapeutic strategies for male diseases
- 摘要：ObjectiveTo investigate the analgesic effect and mechanism of dexmedetomidine （DEX） on dynamic allodynia （DA） in mice with trigeminal neuropathic pain.MethodsWe established the model of trigeminal neuropathic pain in male mice by a chronic constriction injury （CCI） of the infraorbital branch of the trigeminal nerve （ION）. Mice were randomly separated into the following groups： Sham， CCI-ION， CCI-ION+vehicle， CCI-ION+DEX， Sham+DEX （each group contained four to six mice）. For the measurement of DA， the ipsilateral and contralateral skin of the whisker pad within the infraorbital territory （V2） or the lower jaw within the mandibular nerve territory （V3） were stimulated by light-moving brush strokes. We used immunofluorescence staining to evaluate the possible mechanisms.ResultsCompare with the sham group， light-moving brush strokes induced obvious DA in ipsilateral and contralateral skin of V2 territory and V3 territory at 3 d or 7 d after CCI-ION surgery （P=0.004 8； P<0.000 1）， and the number of c-Fos （a marker for neuronal excitability） positive cells in bilateral mPFC increased significantly （P=0.044 1 ， P=0.044 4）. In addition， 15 μg/kg and 30 μg/kg DEX separately alleviated bilateral primary and secondary DA induced by light-moving mechanical facial stimuli in mice with trigeminal neuropathic pain （P<0.000 1）， and decreased the excitability of neurons in bilateral mPFC （P=0.012 5， P=0.048 8）. Furthermore， there was no significant difference in analgesic effect between the two concentrations of DEX （P>0.05）.ConclusionsDEX is a useful therapeutic approach for attenuating DA in trigeminal neuropathic pain disorders. This effect is associated with the inhibition of hyperexcitability of neurons in mPFC induced by light-moving mechanical facial stimuli after trigeminal neuropathic pain.关键词：dexmedetomidine;medial prefrontal cortex;c-Fos;neuropathic pain
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发布时间：2024-02-19 - 摘要：ObjectiveTo compare the effects of metformin and montelukast on airway inflammation and remodeling in the acute and chronic house dust mite （HDM）-induced asthma mouse models.MethodsHDM-induced acute and chronic asthma mouse models were established and treated with 1mg/kg of budesonide， 200 mg/kg of metformin， or 10 mg/kg of montelukast， respectively. The drugs were administrated via intranasal instillation or intraperitoneal injection 1 h or 30 min prior to each HDM challenge. Hematoxylin-Eosin and Masson’s trichrome staining were used to analyze the lungpathological characteristics of mice. The score analysis of airway inflammatory cell infiltration and collagen deposition and the measurement of bronchial morphological parameters including bronchial wall thickness and bronchial smooth muscle thickness were determined by Image J software. Total serum IgE level， mRNA transcription level of inflammatory factors IL-4， IL-5， and IL-13 were detected by ELISA and qRT-PCR.ResultsHDM-induced chronic model had significantly increased total serum IgE level， airway collagen deposition and thickness of airway smooth muscle than the acute model （P<0.05）. Budesonide significantly attenuated airway inflammation in the HDM-induced acute model （P<0.05）. Metformin significantly improved airway inflammation （P<0.05） and had no significant effect on airway remodeling （P>0.05） in the HDM-induced acute model. Both metformin and montelukast had no significant effect on airway inflammation and remodeling （P>0.05） in the chronic model.ConclusionCompared with the 26-day acute model， the 59-day chronic asthma mouse model has a higher level of serum IgE， pulmonary Th2 cytokine transcripts and airway collagen deposition. Metformin can effectively ameliorate airway inflammation in the HDM-induced acute mouse model， and montelukast has no significant effect on airway inflammation and remodeling in the HDM-induced chronic mouse model.关键词：chronic house dust mite （HDM）-induced asthma mouse model;airway inflammation;airway remodeling;metformin;montelukast
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发布时间：2024-02-19 - 摘要：ObjectiveTo investigate the preventive effects of Astragaloside IV （ASIV） on the formation of colonic adenomatous polyps （CAP） in high-fat-fed （HF） mice with adenomatous polyposis mutation （Apc Min/+） and its regulation mechanism on serum metabolite disorders.MethodsA total of 24 mice were evenly assigned to Apc Min/+ mice group （Con， n=8）， high-fat diet-fed Apc Min/+ mice group （HF， n=8）， and ASIV treatment group （HF-ASIV， n=8）. Apc Min/+ mice in HF group and HF-ASIV group were given high-fat diet for 8 consecutive weeks to construct CAP mouse model. Meanwhile， Apc Min/+ mice in HF-ASIV group were given 50 mg/kg ASIV every other day for 8 weeks. Daily amount of water intake， food intake and body weight of mice in each group were recorded. At the end of the 8th week， mice were sacrificed for serum and the distal and proximal colon. The number of colonic polyps in each group was recorded. Hematoxylin-eosin （H&E） staining was used to observe the morphological changes of the proximal colon. Immunohistochemistry （IHC） was applied to analyze the amount of COX2 positive cells in the proximal colon. The expression levels of IL-1 β and TNFα in intestinal wall were detected by QRT PCR. Non-targeted metabolic profiling of mouse gut by liquid-phase mass spectrometry was used to screen for differential metabolites and perform functional enrichment.ResultsNo mice died in each group during experiment.ASIV effectively reduced the size and the number of the CAPs that accompanied with the downregulation of inflammatory signaling molecules （COX-2， IL-1 β and TNFα）. Alcian blue and lysozyme staining showed ASIV improved the gut epithelium by promoting goblet and Paneth cells population. Significant differences in metabolite OPLS-DA scores between groups were noted （P < 0.001； P = 0.02）. Compared with HF group， 13 differential metabolites in the serum of HF-ASIV group were significantly recalled， and the levels of the metabolites functionally enriched to N-acetyl-α-D-glucosaminyl-diphosphate were significantly increased in the positive and negative ion modes （P < 0.05） ， which was negatively correlated with the number of medium-sized adenomas （P < 0.01）.ConclusionASIV reduced the number of colonic adenomatous polyps in high-fat-fed Apc Min/+ mice and was closely associated with reduced intestinal wall inflammation and regulation of serum metabolite N-acetyl-α-D-glucosamine-diphosphate levels.关键词：adenomastous polyps;Astragaloside IV;colon;metabolomics;N-Acetyl-α-D-Glucosamine
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发布时间：2024-02-19 - 摘要：ObjectiveSepsis associated acute kidney injury （SA-AKI） is a critical clinical disease. The purpose of this study was to investigate the role and molecular mechanism of miR-4321 in the HK2 cellular damage induced by lipopolysaccharides （LPS）.MethodsRT-qPCR was conducted to detect the expression of miR-3165， miR-4270 and miR-4321 in LPS-induced HK2 cell model and cecal ligation and puncture （CLP）-induced renal injury model. In LPS-induced HK2 cell model， miR-4321-inhibitor was used to inhibit the miR-4321 expression. The effects of miR-4321 on cell proliferation， cell viability， cytokines and apoptosis-related protein levels were evaluated by CCK-8 analysis， EdU staining analysis and western blotting analysis， respectively. In CLP-induced renal injury model， miR-4321-Antago was used to intervene the miR-4321 expression. The changes of renal tissue structure were examined by H&E staining. The levels of serum creatinine and blood urea nitrogen （BUN） were measured by colorimetric method. ELISA was employed to assess the expression of interleukin-6 （IL-6）， interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α） in serum. IHC staining and western blotting were performed to determine the mTOR level and apoptosis-related protein expression in kidney tissues. Target genes of miR-4321 were predicted by Targetscan software and verified by dual-luciferase reporter assay.ResultsCompared with the control group， the miR-4321 expression was increased in LPS-induced HK2 cell model （n=3， t=7.154， P=0.001 3）. miR-4321 inhibitor promoted the proliferation and viability of HK2 cells， decreased the expression of LPS-induced IL-6， IL-1β and TNF-α and apoptosis-related proteins. In vivo experiments showed that miR-4321-Antago inhibited serum creatinine and BUN levels in CLP mice， improved renal injury， reduced levels of IL-1β， IL-6 and TNF-α， promoted the mTOR expression in renal tissues and inhibited the apoptosis-related protein expression. mTOR signaling pathway was believed the target gene of miR-4321.ConclusionInhibition of miR-4321 significantly alleviates SA-AKI， which may be achieved by increasing the expression of mTOR.关键词：sepsis associated acute kidney injury;lipopolysaccharide;miR-4321;mTOR
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发布时间：2024-02-19 - 摘要：ObjectiveTo study the effect of morphine on the function of CD8+ T cells， tumor growth of melanoma and immunotherapy efficacy of PD-1.MethodIsolated CD8+ T cells were activated in vitro and stimulated with different concentrations of morphine. Flow cytometry was used to analyze the percentage of activated CD8+ T cell and the secretion of IFN+. Female C57/BL6 mice were inoculated with mouse melanoma tumor cells. On day 7 after inoculation， middle dose of morphine was injected intraperitoneally and the tumor volume was recorded. The tumor growth curve and survival curve of mice were plotted. Female C57/BL6 mice were inoculated with mouse melanoma tumor cells and were intraperitoneally treated with 200ug PD-1 antibody for 3 times continuously. Meanwhile， middle dose of morphine was injected intraperitoneally and tumor volume was measured. The tumor growth curve and survival curve of the mice were plotted.ResultsCompared with control group ， middle and high doses of morphine significantly inhibited the activation of CD8+ T cells and the secretion of IFN+（P<0.05）； middle doses of morphine also promoted tumor growth （P<0.01） and shortened the survival time of tumor bearing mice. Combined treatment with PD-1 antibody， morphine significantly increased tumor growth（P<0.01） and shortened the survival time of bearing tumor mice.ConclusionsMorphine promote tumor growth and antagonize the efficacy of PD-1 immunotherapy. These effects may be related to the inhibition of morphine on the activation and function of CD8+ T cells.关键词：morphine;CD8+ T cell;melenoma;immunotherapy efficacy
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发布时间：2024-02-19 - 摘要：ObjectiveTo investigate the attentional bias and its time course towards emotional faces in three different rumination types of college students.MethodsThe positive and negative rumination scale was used to identify three rumination types among college students， and we selected 28 students from each type to explore attentional bias within a dot probe paradigm combined with eye-tracking techonology. The emotional stimuli included positive-neutral， negative-neutral and neutral-neutral emotional face pairs.ResultsThe reaction time indices showed that for negative-neutral face pairs， the effects of rumination type on bias index （BI） and disengaging index （DI） were statistically significant （F = 20.11，P < 0.001， η2 = 0.33）， （F = 11.46，P < 0.001， η2 = 0.22］. But no statistical significance was found for positive-neutral face pairs. BI （t = 7.06， P < 0.001， d = 1.34） and DI （t = 5.92， P < 0.001， d = 1.12） in the negative ruminators towards negative faces and BI in the positive ruminators towards positive faces （t = 2.78， P < 0.01， d = 0.53） were all statistically different from 0. No statistical difference between orienting index （OI） and 0 was found in three types towards any emotional stimuli （P > 0.05）. Eye movement indicators revealed that the probabilities of the first fixation were statistically different from 0.5 in all participants under all conditions and the deviation of first fixation latency was statistically different from 0 in normal ruminators tworards positive and negative faces. In all participants towards positive and negative faces， statistical differences were found between the deviation of first fixation duration and 0， the percentage of dwell time and 0.5； and the main effects of face pictures were observed （F = 8.24，P = 0.005， η2 = 0.033）， （F = 9.31，P = 0.003， η2 = 0.036）.ConclusionsReaction time indices showed that negative ruminators had attentional bias to negative stimuli， manifested as difficulty in disengaging attention， while positive ruminators had attentional bias to positive stimuli. Eye movement indicators showed that all types of ruminators had orienting bias of first fixation， initial and overall attention maintenance to emotional stimuli， and the attention maintenance effect towards negative stimuli was greater.关键词：rumination;attentional bias;emotional faces;eye-tracking technology;college students
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发布时间：2024-02-19 - 摘要：ObjectiveTo investigate the mechanism of Sishencong electroacupuncture on preventing the apoptosis of hippocampal neurons in rats with acute sleep deprivation and its effect on anxiety behavior.MethodsAdult Sprague-Dawley （SD） rats were randomly divided into Sham group （control group）， SD group （sleep deprivation group）， and EA+SD group （eletroacupuncture group）. Modified multiple platform method was used to induce sleep deprivation for 4 days. EA+SD group received Sishencong electroacupuncture in each day during sleep deprivation with 20 minutes needling for 4 days. The open field test was used to detect the exploration of rats to evaluate the degree of anxiety， and the co-labeling of NeuN+ and Cleaved Caspase-3 in different regions of the hippocampus was detected by immunofluorescence staining； the astrocyte marker glial fibrillary acidic protein （GFAP） in the hippocampus was labeled by immunofluorescence. GFAP and the morphological changes of astrocytes were analyzed by Sholl analysis， and the co-labeling with C3+ and S100A+ were detected to analyze the A1 and A2 types of astrocytes in the hippocampus.ResultsOpen field test showed that the time spent in the center of rats was increased in EA+SD group， but the movement speed was decreased compared with SD group. Immunofluorescence staining confirmed that the expression of Cleaved caspase-3 on neurons in different regions of the hippocampus （CA1， CA2， CA3， DG1， DG2） in the EA+SD group was lower than that of the SD group （P<0.05）. The number of intersections of astrocytes and concentric circles in the EA+SD group at 12 μm，15 μm， 18 μm and 21 μm were higher than those of the SD group. Immunofluorescence showed that electroacupuncture could regulate the proportion of C3+/GFAP+ and S100A+/GFAP+ in the hippocampus of rats during sleep deprivation.ConclusionElectroacupuncture could improve the exploration during sleep deprivation by reducing the apoptosis of neurons in the hippocampus， repairing the morphological damage of astrocytes and balancing the proportion of A1 and A2 astrocytes in the hippocampus.关键词：sleep deprivation;electroacupuncture;neuronal apoptosis;astrocytes;open field test
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发布时间：2024-02-19
Basic Research
- 摘要：ObjectiveTo investigate the association between intrahepatic portoportal venous collateral vascular formation and postoperative liver hyperplasia in patients undergoing liver partition and portal vein ligation.MethodsThe clinical data of patients with hepatocellular carcinoma who underwent liver partition and portal vein ligation at the Center of Hepato-Pancreatico-Biliary Surgery in the First Affiliated Hospital of Sun Yat-sen University from April 2013 to June 2022 were retrospectively analyzed. All the patients were grouped according to the number of open collateral vessels in the liver after first-stage surgery， including the group with no formation of intrahepatic portoportal venous collateral vessel （IPCs=0）， the group with 1 formation of intrahepatic portoportal venous collateral vessel （IPCs=1）， and the group with more than 2 formations of intrahepatic portoportal venous collateral vessels （IPCs ≥ 2）. The differences in the distribution of the three groups in terms of preoperative， intraoperative and postoperative liver function， formation of intrahepatic portoportal venous collateral vessels on both sides， and second-stage surgery were analyzed firstly， and then multiple linear regression analysis was used to explore the factors affecting the number of IPCs.ResultsOf all the 37 patients with hepatocellular carcinoma who were finally included in this study， there were no significant differences in preoperative data between the three groups （P>0.05）. The surgical procedure was different between the three groups. The proportion of patients with ≥ 2 open vessels who underwent laparoscopic microwave ablation liver partition was greater than that of patients with split liver （57.14% vs. 42.56%，P=0.031）. There was a statistically significant difference in the daily hypertrophy volume of future liver remnant （FLR） ［IPCs ≥ 2 vs. IPCs=1 vs. IPCs=0，（14.25±8.81 vs. 20.65±9.85 vs. 30.10±19.31） mL，P=0.018］. There was no difference in the proportion of patients between the three groups who underwent second-stage resection （P=0.363）. However， the number of days between surgeries was significantly longer in those with ≥2 open collateral vessels than in those with no opening or only 1 opening （16.31±5.44 vs. 10.30±3.40 vs. 12.78±3.35） days，P=0.023. Multiple linear regression analysis found that the surgical procedure was the only factor affecting the number of intrahepatic collateral vessel openings （P=0.031）. The number of IPCs after laparoscopic microwave ablation liver partition and split liver was ［2.0 （1.5） vs. 1.0 （1.0），P=0.031］.ConclusionsThe number of IPCs after liver partition and portal vein right branch ligation is negatively associated with the hypertrophy rate of FLR and split of liver is recommended to reduce the formation of IPCs.关键词：intrahepatic portoportal venous collateral vascular;liver partition and portal vein ligation;future liver remnant hypertrophy;hepatocellular carcinoma
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发布时间：2024-02-19 - 摘要：ObjectiveThe purpose of this article is to explore the relationship between lymphocyte and the severity of immunocompromised host pneumonia， and to examine the effect of different doses of glucocorticoid on the survival outcome of severe group.MethodsThe clinical data of immunocompromised host pneumonia patients were collected. The patients were divided into severe group and non-severe group according to the official clinical practice guideline of the ATS/IDSA. Logistic regression analysis was used to search for independent risk factors of severe immunocompromised host pneumonia. Meanwhile， the receiver operating characteristic curves （ROCs） were created to evaluate the predictive value of each risk factor. Furthermore， the severe group were divided into three sub-groups according to the dose of glucocorticoid during hospitalization： severe+ high-dose glucocorticoid group （≥1 mg·kg-1·d-1 prednisolone or other equivalent dose of glucocorticoid）， severe+ low-dose glucocorticoid group （＜1 mg·kg-1·d-1 prednisolone or other equivalent dose of glucocorticoid）， and severe+ non-glucocorticoid group. The 28-day survival rates of the three groups were compared to evaluate the effect of glucocorticoid on severe immunocompromised host pneumonia.ResultsThe levels of lymphocyte absolute value， T lymphocytes percentage， T lymphocyte absolute value， CD4+T lymphocyte absolute value in severe pneumonia group were lower than those in non-severe pneumonia group. The results of logistic regression showed that the increase of CRP and PCT and the prolongation of PT were independent risk factors for the severe immunocompromised host pneumonia， while the increase of platelet and T lymphocyte absolute value were independent protective factors for the severe immunocompromised host pneumonia. The ROCs analysis showed that compared with other risk factors， the decrease of T lymphocyte absolute value had better predictive value for the risk assessment of immunocompromised host pneumonia. When the absolute value of T lymphocytes was lower than 874.65 cells /μL， the sensitivity and specificity were 90.9% and 43.5%， respectively. The area under the curve （AUC） was 0.723 ［95% confidence interval （0.649， 0.797）］. The survival rate of the severe + high-dose glucocorticoid group was 45.5%. The survival rate of the severe + low-dose glucocorticoid group was 66.7%. The survival rate of the severe + non-dose glucocorticoid group was 25.0%. The survival rate of the severe + low-dose glucocorticoid group was higher than the survival rate of the severe + non-dose（P＜0.05）. Meanwhile， the survival rate of the severe + low-dose glucocorticoid group was higher than the survival rate of the severe + high-dose glucocorticoid group， but no statistically significant difference was found （P>0.05）.ConclusionsThe increase of T lymphocyte absolute value is the independent protective factor for immunocompromised host pneumonia. The absolute value of T lymphocytes have a good predictive value for the severity of immunocompromised host pneumonia. When the absolute value of T lymphocytes is lower than 874.65 cells/μL， the sensitivity is up to 90.9% . Low-dose glucocorticoid therapy can improve the 28-day survival rate of patients with severe immunosuppressive host pneumonia.关键词：immunocompromised host;pneumonia;T lymphocytes;risk factors;glucocorticoid
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发布时间：2024-02-19 - 摘要：ObjectiveThe purpose of this study was to explore the difference in expression of gene between the osteosarcoma metastasis and primary specimens through NGS detection， in order to find the molecular mechanism of inducing osteosarcoma occurrence and metastasis.MethodsNext generation sequencing （NGS） was used to detect the tumor tissue samples of paired primary and metastatic lesions in 12 patients with metastasis， including 9 pairs of Panel detection （678 genes） and 3 pairs of whole exon detection （WES）. Copy number variation was detected by Excavator. DNA mutations were detected by Lumpy fusion， and RNA mutations were detected with Defuse + Star fusion. The distribution of mutations was shown by Circos. Metascape was used to analyze the enrichment of Go and KEGG signal pathways of differential genes. Pyclone+Citup/LICHEE was used for clonal evolution analysis.ResultsThe most frequent gene mutation mode of osteosarcoma was gene amplification， high-frequency mutation genes were FLCN（37.5%），GID4（37.5%），TP53（33.3%），ATRX（25%），CALR（25%），CCND3（25%），CCNE1（25%），NOCR1（25%），TFEB（25%），VEGFA（25%）， and the mutation frequency of cell cycle pathway was the highest. KT1， PLCG2 and EGFR were closely related to the metastasis of osteosarcoma. The frequency of tumor mutation burden （TMB） in metastatic lesions was significantly higher than primary lesions （P = 0.013）. Three patients detected by WES showed linear clonal evolution， suggesting that the mutations of osteosarcoma metastasis genes may be accumulated sequentially. We identified new candidate genes that may play an important role in the progression of osteosarcoma， including PLCG2， MYO15A and PEX6.ConclusionsThe most frequent gene mutation pattern of osteosarcoma occurrence and metastasis is gene amplification， and the frequency of tumor mutation burden （TMB） in metastatic lesions is significantly higher than that in primary lesions. There is an interrelated linear gene clonal evolution in patients with metastasis. This study suggests that PLCG2， MYO15A and PEX6 may play an important role in the progression of osteosarcoma.关键词：osteosarcoma;lung metastasis;NGS;gene map;gene mutation
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发布时间：2024-02-19 - 摘要：ObjectiveTo investigate the effect of circ_0018478 on the fibrotic phenotype of cardiac fibroblasts and the potential mechanism involved.MethodsThe expression of circ_0018478 and its host gene of HECT and RLD domain containing E3 ubiquitin protein ligase 4 （HERC4） in the myocardium of patients with heart failure （HF） （n=28） and healthy donors （n=18） was analyzed by real-time quantitative polymerase chain reaction （RT-qPCR） assay. The distribution of circ_0018478 was identified by fluorescence in situ hybridization （FISH） assay and RT-qPCR assay based on nucleocytoplasmic RNA in human AC16 cardiomyocytes. Actinomycin D and RNase R exonuclease digestion were used to test the stability of circ_0018478 in AC16 cells. RNA and protein expression of fibrosis-related genes was detected in mouse cardiac fibroblasts （mCFs） with adenovirus-mediated over-expression of circ_0018478. EdU staining and transwell migration assay were performed to detect the effects of circ_0018478 on mCFs proliferation and migration activities. The potential circ_0018478-translated protein in mCFs was identified by mass spectrometry （MS） shot-gun assay. HERC4-193 was inhibited by small interfering RNA （siRNA）， and the effect of HERC4-193 knock-down on the fibrotic phenotype of mCFs with over-expression of circ_0018478 was studied.ResultsThe expression of circ_0018478 was up-regulated in the myocardium of HF patients， with no significant difference in its host gene of HERC4. The results of FISH and RT-qPCR assay showed that circ_0018478 was mainly in the cytoplasm of AC16 cardiomyocytes. The characteristic RNA stability of circ_0018478 was verified by Actinomycin D and RNase R assay， respectively. The enforced expression of circ_0018478 suppressed proliferation and migration of mCFs， and inhibited the expression of fibrosis-related genes in mCFs. The results of MS shot-gun assay and Western blotting showed that circ_0018478 could translate protein HERC4-193. Overexpression of the circ_0018478 and protein HERC4-193 could consistently inhibit the fibrotic phenotype of mCFs. Knock-down of HERC4-193 could attenuate the inhibitory effect of circ_0018478 on fibrosis-related gene expression in mCFs （P<0.05）.ConclusionsCirc_0018478 inhibits the fibrotic phenotype of cardiac fibroblasts via translating HERC4-193 protein.关键词：cardiac fibrosis;circ_0018478;translation;cardiac fibroblast
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发布时间：2024-02-19 - 摘要：ObjectiveTo establish a population pharmacokinetic （PPK） model of teicoplanin in septic patients from Intensive Care Unit （ICU） and to explore its pharmacokinetic characteristics and related covariates.MethodsThe study included 66 septic patients hospitalized in the department of critical care medicine from November 2017 to February 2020. After intravenous dosing of teicoplanin in septic patients， the trough concentration of teicoplanin was determined by high performance liquid chromatography （HPLC） and the concentration-time data was analyzed by non-linear mixed effect model. The pharmacokinetic parameters and residual errors were evaluated. The influence of covariates on model parameters was tested by forward addition and backward elimination. The predictive performance of the final model was assessed by internal validation.ResultsA two-compartment model best described the teicoplanin concentration-time data. The PPK parameter estimates were central clearance of 0.45 L/min， peripheral clearance of 0.72 L/min， central volume of distribution of 39.74 L and peripheral volume of distribution of 152.41 L. Creatinine， total protein， and lactate were found to significantly affect central clearance of teicoplanin （P<0.05）.ConclusionThe two-compartment PPK model of teicoplanin established in this study could be used for individualized treatment in septic patients from ICU due to its good stability and high predictive accuracy.关键词：teicoplanin;intensive care unit （ICU）;sepsis;population pharmacokinetics;two-compartment model
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发布时间：2024-02-19 - 摘要：ObjectiveTo explore the application of simultaneous bilateral uniportal video-assisted thoracic surgery in the treatment of bilateral multiple pulmonary nodules.MethodsThe clinical and pathological characteristics ， and perioperative data were analyzed in thoracic surgery from August 2021 to August 2021 at Department of Thoracic Surgery， the First Affiliated Hospital of University of Science and Technology of China. During the study period， 40 patients were included in the study， of which 12 were male， 28 were female， the average age was （52±8.8） ［52.5（47.25～58）］ years.ResultsA total of 107 nodules were resected， with 85 malignancy nodules， including 30 patients with bilateral primary lung cancer， 6 patients with primary lung cancer on one side. All patients underwent bilateral uniportal video-assisted thoracoscopic surgery （Uni-portal VATS）， the average intraoperative blood loss was （48.87±19.29） ［40（30～67.5）］ mL， the average operation time was （147.70±54.24） ［145（113.5～170）］ min， the average number of resected lymph nodes was （6.20±9.13） ［3（0～12）］，the average NRS score in the 1th postoperative day was （5.08±2.23）， the average pleural drainage was （375.95±243.69） ［292.5（215.0～517.5）］ mL. the average thoracic drainage time was（3.38±1.49） ［3（3～4）］ days， and the average postoperative hospital stay was （4.08±1.81） ［4（3～5）］ days. Postoperative complications including： 2 cases of infection， 3 cases of atrial fibrillation， 1 case of hemoptysis for more than 1 week and 1case of persistent air leakage for more than 3 days. All of them improved after treatment， and there were no serious complications and deaths in perioperative period.ConclusionSimultaneous bilateral pulmonary resections via uniportal VATS is a safe and feasible minimally invasive procedure for patients with bilateral multiple pulmonary nodules.关键词：uniportal video-assisted thoracoscopic surgery;simultaneous;bilateral multiple pulmonary nodules;multiple primary lung cancers
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发布时间：2024-02-19 - 摘要：ObjectiveTo analyze the correlation between complete blood count （CBC）， glycosylated hemoglobin（GHbA1c）and thyroid function in late pregnancy on Tibetan Plateau.MethodsA retrospective analysis was performed on 374 patients of single pregnancies who had delivered in the department of Obstetrics and Gynecology， Chaya People's Hospital， Changdu City， Tibet Autonomous Region， between January 1， 2021 and December 31， 2021. All subjects completed CBC， GHbA1c and total triiodothyronine（TT3）， total thyroxine（TT4）， thyroid stimulating hormone（TSH）before delivery. According to the altitude of long-term residence， they were divided into three groups： the altitude of group A is <3500 m； the altitude of group B is 3 500~4 000 m； and the altitude of group C is ＞4 000 m. The anemia of Tibetan pregnant women in late pregnancy before and after adjustment， the levels of CBC， GHbA1c and thyroid function in different altitudes， and their correlations were analyzed.Results① The mean actual hemoglobin（HB）was 120.0（108.0~130.0）g/L， and the prevalence of anemia was 27.8%（104/374）. After adjustment， the mean HB was 93.0（80.0~104.0）g/L， and the prevalence of anemia was 84.3 %（315/374）； ② Actual HB levels increased with the rise of altitude， but the difference was not statistically significant（P>0.05）， and there was no difference among the three groups in the prevalence of anemia. After adjustment， HB levels showed a downward trends， while the prevalence of anemia increased with the rise altitude， and the difference was statistically significant（P＜0.001）. ③ Red blood cell count（RBC）and mean erythrocyte hemoglobin concentration（MCHC）increased， while TSH decreased with the rise of altitude， and the difference was statistically significant（P＜0.05）. ④ The actual HB and MCHC were positively correlated with TT4， GHbA1c was negatively correlated with TT4， and positively correlated with Platelet count （PLT）； spearman correlation analysis showed statistical significance（P＜0.05）.ConclusionsThe actual HB of Tibetan Plateau pregnant women in late pregnancy does not increase significantly with the rise of altitude. The prevalence of anemia increases significantly after adjustment according to the altitude. TSH decreases with the rise of altitude， and the altitude may have an effect on thyroid function in late pregnancy. Actual anemia in late pregnancy is associated with low T4， and low T4 and high PLT might be associated with increased GHbA1c. Actual HB， PLT and T4 in late pregnancy are expected to be predictors of thyroid disease and GDM.关键词：Tibetan;Plateau;late pregnancy;complete blood count;glycosylated hemoglobin;thyroid function
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发布时间：2024-02-19 - 摘要：ObjectiveTo explore the effect of health locus of control on the early rehabilitation after anterior cruciate ligament（ACL） reconstruction.MethodsFrom July 2019 to October 2019， a prospective cohort study of 155 ACL patients receiving reconstruction （male=124 and female=31） in our hospital was conducted. The general data questionnaire， MHLC-C， Tegner activity score， IKDC Score， Lysholm Score and Y-Balance Test were used for further analysis. The correlation between HLC and early rehabilitation after ACL reconstruction was explored by Wilcoxon signed-rank tests， correlation analysis and Logistics regression analysis.ResultsPositive correlations were found between the internality health locus of control （IHLC） and the IKDC score （r3m=0.77， r6m=0.70， P<0.001）， as well as the Lysholm scores （r3m=0.68， r6m=0.64， P<0.001） and the Tegner activity score （r3m=0.24， r6m=0.46， P<0.05） in 3 and 6 months after surgery， and higher IHLC score indicated a better y-balance test outcome［OR 95%CI=0.86（0.76， 0.97）， P=0.016］. Chance health locus of control （CHLC） was negatively correlated with the IKDC score （r3m=-0.71， r6m=-0.67， P<0.001）， the Lysholm score （r3m=-0.49， r6m=-0.43， P<0.001） and the Tegner activity score （r3m=-0.22， r6m=-0.35， P<0.05） in 3 and 6 months after surgery， and higher CHLC score indicated worse outcome of y-balance test ［OR 95%CI=1.26（1.12， 1.41）， P<0.001］. There was a negative correlation between the Powerful others health locus of control （PHLC） and the IKDC score （r3m=-0.51， r6m=-0.50， P<0.001）， the Lysholm scores （r3m=-0.36， r6m=-0.40， P<0.001）， but there was no correlation with the Tegner activity score in 3 and 6 months after surgery（P>0.05）. The risk of poor y-balance test increased by higher score of PHLC ［OR 95%CI=1.74（1.29， 2.34）， P<0.001］.ConclusionA significant correlation was found between the health locus of control and the early rehabilitation effect after ACL reconstruction. Higher internality health locus of control scores indicated a better rehabilitation outcome， while higher scores of external loci of control indicated higher risk of worse rehabilitation outcome.关键词：anterior cruciate ligament;internal-external control;rehabilitation
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发布时间：2024-02-19 - 摘要：ObjectiveTo investigate the clinicopathological characteristics of parathyroid lesions in fine-needle aspiration cytology.MethodsThe clinical and pathological features of 12 cases of parathyroid lesions in fine-needle aspiration cytology in our hospital were retrospectively analyzed.ResultsThere are 6 males and 6 females， with the median age of 47 years （39.25~ 63.25 years）. Ultrasound results demonstrated that the majority of cases were solid nodules with clear boundary and uneven internal echoes. Liquid-based cytology showed that the cellularity ranged from minimal to abundant. The majority of cases showed small and round cells with finely or coarsely granular （salt and pepper） chromatin. The cytoplasm of parathyroid cells was moderate to scant， and had indistinct cytoplasmic border. The architectural patterns included small cluster， small follicular， trabecular， small flake or large flake， the boundary of large cell groups was generally fuzzy. All twelve samples were positive for parathyroid hormone （PTH） and negative for thyroglobulin （TG） on cell blocks.ConclusionsParathyroid lesions in fine-needle aspiration cytology are rare and pose a diagnostic challenge. When cells arranged in small clusters or trabecular on liquid-based smears， and the cells were small and round with finely or coarsely granular （salt and pepper） chromatin， pathologists should be aware of the possibility of parathyroid lesions. PTH positivity and TG negativity on cell blocks is helpful in confirming the diagnosis in this instance.关键词：parathyroid lesions;diagnostic pitfall and challenge;fine-needle aspiration;cytology
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发布时间：2024-02-19
Clinical Research
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