简介：AbstractBackground:The eosinophilic chronic obstructive pulmonary disease (COPD) is known to be more sensitive to corticosteroid. The sputum microbiome has been shown to affect COPD prognosis, but its role in acute exacerbations of eosinophilic COPD is unclear. This study aimed to investigate the dynamic changes of the airway microbiome in patients with acute exacerbations of eosinophilic COPD.Methods:Fifty-seven patients with acute exacerbations of COPD from the First Affiliated Hospital of Guangxi Medical University between June 2017 and June 2018 were divided into two groups. Patients with eosinophils ≥300 cells/μL in the peripheral venous blood were assigned to the eosinophilic group (Eos) and the rest to the non-eosinophilic group (Noneos). All patients received similar treatment including inhaled budesonide according to the guidelines. The induced sputum microbiome was analyzed on the 1st and 7th day of treatment using the 16S ribosomal RNA (rRNA) method. The levels of interleukin (IL)-6 and IL-8 were measured in the plasma and the sensitivity to corticosteroids was determined in isolated peripheral blood mononuclear cells. Quantitative data were compared between the two groups using the independent samples t test or Mann-Whitney U test. Categorical data were evaluated using Chi-squared test or Fisher’s exact test.Results:Twenty-six patients were classified into Eos group and 31 patients were classified into Noneos group. Prior to treatment, the alpha diversity (Shannon index) (2.65 ± 0.63 vs. 2.56 ± 0.54, t = 0.328, P = 0.747) and the structure of the sputum microbiome were similar in the Eos group and the Noneos group. After 7 days of treatment, alpha diversity increased in both groups, while the microbiome richness (Ace index) was significantly lower in the Eos group (561.87 ± 109.13 vs. 767.88 ± 148.48, t = -3.535, P = 0.002). At the same time, IL-6 (12.09 ± 2.85 pg/mL vs. 15.54 ± 2.45 pg/mL, t = -4.913, P < 0.001) and IL-8 (63.64 ± 21.69 pg/mL vs. 78.97 ± 17.13 pg/mL, t = -2.981, P = 0.004) decreased more significantly in the Eos group, and the percentages of inhibition of IL-8 at dexamethasone concentrations 10-8 to 10-6 mol/L were significantly higher in the Eos group than those in the Noneos group (all P < 0.05).Conclusions:The induced sputum microbiome richness decreased more significantly following treatment in the Eos patients compared to the Noneos patients. The lower plasma inflammatory factor levels and the higher percentage of inhibition of IL-8 might be due to higher corticosteroid sensitivity in Eos patients.

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简介：ObjectivesToinvestigatethechangesofβ3-adrenoceptor(β3-AR)mRNAexpressionintheratswithchronicheartfailure(CHF),andtoexploretheeffectofβblockers(βBs)onβ3mRNAexpression.MethodsThirty-fourratswererandomlydividedintoShamgroup(n=10)andheartfailuregroup(n=24).Ratmodelwasestablishedbyaorticconstriction.Thesurvivalratsinheartfailuregroupweredividedintoheartfailurecontrolgroup(HFgroup,n=6),metoprololgroup(METgroup,n=8)andcarvedilolgroup(CARgroup,n=8)threemonthsafteroperation.Metoprololtartartewasstartedorallywith12mg·kg-1·d-1,carvedilolwith6mg·kg-1·d-1,isometricsalinewasstartedinHFgroup.Afterthreemonthsofdrugtherapy,measurementofhemodynamics,indexofventricularmass,thelevelofβ3-ARmRNAexpressionwereperformed.ResultsComparedwithShamgroup,leftventricularendsystolicpressure(LVESP),andtheabsolutevaluesofmaximalrateofriseandfall(±dp/dtmax)ofleftventricularpressurewereallsignificantlydecreased(P<0.01),leftventricularenddiastolicpressure(LVEDP)wassignificantlyincreasedinHFgroup(P<0.01).ThehemodynamicparameterswereimprovedbyβBs,andcarvedilolwasmoreeffectivethanmetoprolol(P<0.01).TheindexofventricularmasswashigherinHFgroupthanMETgroup,CARgroupandShamgroup(P<0.01).βBssignificantlydecreasedtheindexofleftventricularmass(LVMI),andCarvedilolwasmoreeffectivethanmetoprolol(P<0.01).Theindexofrightventricularmass(RVMI)didnotchangeinMETgroup(P>0.05),butsignificantdecreasecouldbeseeninCARgroup(P<0.01).Thelevelofβ3-ARexpressioninleftventriclewasgreaterthanthatinrightventriclewhetherinthefailingheartorinthenon-failingheart.ComparedwithShamgroup,thelevelofβ3-ARmRNAexpressionwassignificantlyincreasedinHFgroup(P<0.01).Thelevelsofβ3-ARmRNAexpressionshowedaremarkabledecreaseinCARgroup(P<

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简介：AIMToinvestigatetheroleofthecomplement5a(C5a)/C5areceptor(C5aR)pathwayinthepathogenesisofacuteliverfailure(ALF)inamousemodel.METHODSBALB/cmicewererandomlyassignedtodifferentgroups,andintraperitonealinjectionsoflipopolysaccharide(LPS)/D-galactosamine(D-GalN)(600mg/kgand10μg/kg)wereusedtoinduceALF.TheKaplanMeiermethodwasusedforsurvivalanalysis.Serumalanineaminotransferase(ALT)levels,atdifferenttimepointswithina1-wkperiod,weredetectedwithabiochemistryanalyzer.Pathologicalexaminationoflivertissuewasperformed36hafterALFinduction.Serumcomplement5(C5),C5a,tumornecrosisfactor-α(TNF-α),interleukin(IL)-1β,IL-6,high-mobilitygroupproteinB1(HMGB1)andsphingosine-1-phosphatelevelsweredetectedbyenzyme-linkedimmunosorbantassay.Hepaticmorphologicalchangesat36hafterALFinductionwereassessedbyhematoxylinandeosinstaining.ExpressionofC5aR,sphingosinekinase1(SphK1),p38-MAPKandp-p38-MAPKinlivertissue,peripheralbloodmononuclearcells(PBMCs)andperitonealexudativemacrophages(PEMs)ofmiceorRAW264.7cellswasanalyzedbywesternblotting.C5aRmRNAlevelsweredetectedbyquantitativereal-timePCR.RESULTSActivationofC5andup-regulationofC5aRwereobservedinlivertissueandPBMCsofmicewithALF.BlockadeofC5aRwithaC5aRantagonist(C5aRaC5aRa)significantlyreducedthelevelsofserumALT,inflammatorycytokines(TNF-α,IL-1βandIL-6)andHMGB1,aswellasthelivertissuedamage,butincreasedthesurvivalrates(P<0.01forall).BlockadeofC5aRdecreasedSphK1expressioninbothlivertissueandPBMCssignificantlyat0.5hafterALFinduction.C5aRapretreatmentsignificantlydownregulatedthephosphorylationofp38-MAPKinlivertissuesofALFmiceandC5astimulatedPEMsorRAW264.7cells.Moreover,inhibitionofp38-MAPKactivitywithSB203580reducedSphK1proteinproductionsignificantlyinPEMsafterC5astimulation.CONCLUSIONTheC5a/C5aRpath

简介：AbstractAcute kidney injury (AKI), characterized by acute renal dysfunction, is an increasingly common clinical problem and an important risk factor in the subsequent development of chronic kidney disease (CKD). Regardless of the initial insults, the progression of CKD after AKI involves multiple types of cells, including renal resident cells and immune cells such as macrophages. Recently, the involvements of macrophages in AKI-to-CKD transition have garnered significant attention. Furthermore, substantial progress has also been made in elucidating the pathophysiological functions of macrophages from the acute kidney to repair or fibrosis. In this review, we highlight current knowledge regarding the roles and mechanisms of macrophage activation and phenotypic polarization, and transdifferentiation in the development of AKI-to-CKD transition. In addition, the potential of macrophage-based therapy for preventing AKI-to-CKD transition is also discussed.

简介：AIM:Todiscussandcomparethefundusautofluorescence(FAF)andopticalcoherencetomography(OCT)inacuteorchroniccentralserouschorioretinopathy(CSCR).METHODS:Medicalrecordsof100casesofCSCRwerereviewed.Acuteandchroniccaseswereevaluatedaccordingtothedurationofdecreasedvisualacuity,serousretinaldetachment(RD)andfocalleakageonfluoresceinangiography(FA).Chi-squaretestwasusedforstatisticalanalysis.RESULTS:Fortycaseshadacuteand60caseshadchronicCSCR.FAFshowedfocalhypo-autofluorescencein34(85%)andiso-autofluorescencein6(15%)ofacutecasesandhypo-autofluorescencein51(85%),hyperautofluorescencein6(10%)andiso-autofluorescencein3(5%)ofchroniccases.OCTshowedserousRDwithdistinctborderscorrelatedwithFAFfindings(hypoautofluorescence)inallacuteCSCRcases.InchronicCSCRgroup,OCTshowedserousRDwithindistinctborderscorrelatedwithFAFfindings.ThedifferencesbetweentheOCTandFAFfindingsofthetwogroupsweresignificant(P=0.000).CONCLUSION:OCTandFAFfindingscansupporttheclinicalobservationsindifferentialdiagnosisofacuteandchronicCSCRandhelpclinicianstoevaluateretinalpigmentepithelium,outersegmentsofphotoreceptorsandthecomponentsofserousRD.

简介：ObjectivesTostudywhetherchangeofBNPlevelsreflectthechangeofcardiacfunctionandtoinvestigatetheshort-termprognosticpotentialofBNPandQOLinpatientswithCHF.Methods96consecutivepatientsadmittedwithCHFbetweenSeptember2002andJanuary2003werestudied,uponentrythestudy,BNPlevelsweremeasured,Patientsadministeredthedisease-specificqualityoflifequestionnaireMinnesotalivingwithheartfailurequestionnaire(LiHFe)within1day.BNPlevelsandadministeringLiHFewererepeatedthreemonthslater.ResultsBNPlevelswereincreasedproportionaltotheseverityofcardiacfunction.PhysicaldomainandtotalscoreofLiHFeweresignificantlycorrelatedtotheseverityofCHF(p＜0.05).BNPlevelsweredecreasedinimprovinggroup(p=0.032).IndeterioratinggroupBNPlevelsincreased(P=0.043).Kaplan-meieranalysisaccordingtoBNPlevelcutoffpoint150ng/l,thelifecurveofhigherBNPlevelgroupwassignificantlylowerthanthelowergroup(p=0.001).Inunivariatelogisticregression,NYHAclass,BNP,LVEF,LVEDD,heartsize,totalscoreofLiHFe,physicaldomainofLiHFeandtheemotionaldomainofLiHFewereallsignificantprognosticfactorsofCHF(p＜0.05forall).Whileinmultipleregression,onlyBNPlevel(p=0.036)andtheemotionaldomainofLiHFe(p=0.025)wereindependentprognosticfactors.ConclusionsChangeofBNPreflectsthetreatmentefficacyofCHF.BNPandQOLarethetwomajorshort-timeprognosticfactorsofthechronicheartfailurepatients.

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简介：Purpose:Acuteexercisehasbeenlinkedtothefacilitationofexecutivefunction,butlittleisknownregardingexecutivefunctionassessedbytheWisconsinCardSortingTest(WCST).ThepresentresearchconsistedoftwoexperimentsaimedtodeterminewhetheracuteaerobicexerciseinfluencessuccessiveWCSTperformance.Methods:InStudy1,27youngadultswererandomlyassignedtotheexerciseorreadingcontrolgroupandtheninstructedtoperformtheWCSTbeforeandafterassignedtreatment.Inexercisegroup,participantscompletedasingleboutaerobicexercisewithmoderateintensityfor20minonastationarybike.AsimilarexperimentalprotocolwasreplicatedinStudy2with24latemiddle-agedadultstolookforagedifferencesduringadulthoodandcontrolforapotentialceilingeffectatyoungadultage.Results:Althoughasignificanttimeeffectwasobservedinyoungadults,bothstudiesrevealedthattherewasnomaineffectfortreatmentoraninteractionbetweentreatmentandtimeonanyoftheWCSTindices.Conclusion:AcuteaerobicexercisefailedtoinfluenceexecutivefunctionasassessedbytheWCST,revealingthatthisclassicalneuropsychologicaltesttappingexecutivefunctionmaynotbesensitivetoacuteexercise.Ourfindingssuggestthatacuteexercisedoesnotbroadlyaffecttheentirefamilyofexecutivefunctions,oritseffectonaspecificaspectofexecutivefunctionmaybetask-dependent,asproposedbyEtnierandChang(2009).

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简介：ObjectivesToinvestigatetheassociationofsolubleFasligand(sFasL)andsolubleFasreceptor(sFas)withhumanchroniccongestiveheartfailure(CHF).MethodsTheserumlevelofsFasLandsFasin33patientswithCHF(13incardiacfunctionclassⅡ,17inclassⅢ,3inclassⅣ,NYHA)wasassessedwithenzyme-linkedimmunosorbentassay,andwascomparedwiththatof18age-,bloodpressure-matchedpatientswithcardiacfunctionclassⅠ(NYHA).ResultsTherewasnodifferenceinthelevelofsFasLbetweenthetwogroups[CHFgroup:231.50+/-84.50(cardiacfunctionclassⅡ216.50+/-96.00,classⅢ226.80+/-85.70,classⅣ244.00+/-73.00)vs.cardiacfunctionclassIgroup:217.50+/-89.00pg/mL,P>0.05].However,thelevelofsFaswassignificantlyhigherinthepatientswithCHFthanthoseofcardiacfunctionclassIgroup[CHFgroup:1353.30+/-507.71(cardiacfunctionclassⅡ1154.85+/-371.20,classⅢ1412.88+/-493.62,classⅣ1875.67+/-806.

简介：AbstractAcute fatty liver of pregnancy (AFLP) is a rare but critical obstetric-specific disease with a high fatality rate, posing a serious threat to the safety of mothers and infants. These guidelines were specially formulated to standardize AFLP clinical pathways and to improve maternal and infant outcomes. Based on a two-round questionnaire survey, the guideline development team identified the following nine clinical issues that clinicians were most concerned about, and developed recommendations for each of them: prenatal outpatient screening for AFLP, diagnosis, preoperative risk assessment, delivery modes and timing, anesthesia methods, perinatal complications, selecting AFLP patients for artificial liver treatment, prognostic assessment, and monitoring during treatment. The guidelines cover the key issues related to AFLP diagnosis and treatment that concern clinicians.

简介：Sincethe1960's,hundredsofarticleshavebeenpublishedontheeffectsofexerciseoncognitionandmorerecentlyonexecutivefunctions.Alargevarietyofeffectshavebeenobserved:acuteorlong-lasting,facilitatingordebilitating.Severaltheoreticalframeworkshavebeenproposedtoexplaintheseeffectswithplausiblemechanisms.However,asyetnoneofthesemodelshassucceededinunifyingalltheobservationsinasingleframeworkthatsubsumesalleffects.Theaimofthepresentreviewistorevisitthestrengthmodelofself-controlinitiatedbyBaumeisterandhiscolleaguesinthe1990'sinordertoextenditsassumptionstoexercisepsychology.Thismodelprovidesaheuristicframeworkthatcanexplainandpredicttheeffectsofacuteandchronicexerciseoneffortfultaskstappingself-regulationorexecutivefunctions.Areconsiderationofexerciseasaself-controltaskresultsfromthisperspective.Anewavenueforfutureresearchisdelineatedbesidesmoretraditionalapproaches.

简介：ObjectivesToinvestigatetherelationshipofserumleptinconcentrationwiththelipidsandbodymassindex(BMI)inpatientswithchroniccongestiveheartfailure(CHF).MethodsTheserumconcentrationofleptinin39patientswithCHF(14incardiacfunctionclassⅡ,21inclassⅢ,4inclassⅣ,NYHA)andin46patientswithcardiacfunctionclassⅠ(NYHA)wereassessedbyradioimmunoassay.ResultsTheserumconcentrationofleptinwere9.018±4.519μg/linCHFgroup(cardiacfunctionclassⅡ11.492±5.649μg/l,classⅢ7.763±3.321μg/l,classⅣ6.100±2.657μg/l);11.674±6.911μg/linclassⅠgroup.TheserumconcentrationsofleptinweresignificantlylowerinCHFgroup,ascomparedwithclassⅠgroup(P<0.05).Moreover,thedecreaseofserumleptinconcentrationwassignificantlycorrelatedwiththedecreasedserumconcentrationsoftotalcholesterol,triglyceride,bodymassindexandleftventricularejectionfractioninCHFgroup,respectively(P<0.05).ConclusionsThesignificanceofthedecreaseinserumleptininCHFpatientsneedsfurtherstudy.

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简介：ObjectivesTocomparethedifferentpatternsofcoronaryarterycalcification(CAC)inacuteandchroniccoronarysyndromesutilizingelectronbeamcomputedtomography.BackgroundPathologic,angiographic,andintracoronaryultrasoundstudiesrevealedsharpdifferencesintheplaquemorphologybetweenpatientswithacuteversuschroniccoronarysyndromes.Whethertherearedifferentpatternsofcoronaryarterycalcificationinpatientswithstableanginapectoris(SAP)andinthosewithunstableanginapectoris(UAP)oracutemyocardialinfarction(AMI),however,remainsunclear.MethodsTwohundredandsixty-fourpatients,including67withSAP,94withUAPand103withAMIwerestudiedwithelectronbeamcomputedtomographyforanalysisofcoronaryarterycalcificationandwithselectivecoronaryangiographyfordeterminationofatheroscleroticlesions.CACprevalenceandcalciumscorewerecomparedamongthreegroups,andrelationofCACtotheseverityofatheroscleroticdiseaseintheSAPandUAP

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简介：[摘要]目的：分析浅谈急性心功能衰竭病人的心理护理的应用效果。方法：选取我院2019年1月～2020年6月收治的心功能衰竭患者138例作为本文研究对象，将138例患者分为实验组和对照组，对照组实施常规护理，实验组在对照组护理基础上实施心理护理，对比两组患者的心功能改善指标心理状态改善情况。结果：实验组实施心理护理后，SAS评分和SDS评分均低于对照组，两组患者的心理状态改善水平存在差异表示统计学有意义。实验组患者护理后的左心室射血分数、血浆脑钠肽指标以及6min步行距离均优于对照组，因此实施心理护理后在改善患者心理状态的情况下，也能提高患者对治疗的配合度，从而促进了心功能各项指标的改善，两组患者心功能衰竭患者的心功能改善指标对比具有差异表示统计学有意义。结论：为心功能衰竭患者实施心理护理，有效改善患者焦虑、抑郁等不良情绪，从而提高患者对护理干预的满意度和配合度，促进自身心功能指标的改善，保证治疗效果，促进患者机体康复。

简介：Objective:Thissystematicreviewaimedtocriticallyanalyzetheliteraturetodeterminehowhigh-intensityintermittenttraining(HIIT)affectsrecreationalendurancerunnersintheshort-andlong-term.Methods:ElectronicdatabasesweresearchedforliteraturedatingfromJanuary2000toOctober2015.Thesearchwasconductedusingthekeywords'high-intensityintermittenttraining'or'high-intensityintervalexercise'or'intervalrunning'or'sprintintervaltraining'and'endurancerunners'or'longdistancerunners'.Asystematicapproachwasusedtoevaluatethe783articlesidentifiedforinitialreview.StudieswereincludediftheyinvestigatedHIITinrecreationalendurancerunners.ThemethodologicalqualityofthestudieswasevaluatedusingthePhysiotherapyEvidenceDatabase(PEDro)scale(forinterventionstudies)andthemodifiedDownsandBlackQualityIndex(forcross-sectionalstudies).Results:Twenty-threestudiesmettheinclusionarycriteriaforreview.Theresultsarepresentedin2parts:cross-sectional(n=15)andinterventionstudies(n=8).Inthe15cross-sectionalstudiesselected,endurancerunnersperformedatleast1HIITprotocol,andtheacuteimpactonphysiological,neuromuscular,metabolicand/orbiomechanicalvariableswasassessed.Interventionstudieslastedaminimumof4weeks,with10weeksbeingthelongestinterventionperiod,andincluded2to4HIITsessionsperweek.MostofthesestudiescombinedHIITsessionswithcontinuousrun(CR)sessions;2studies’subjectsperformedHIITexclusively.Conclusion:HIIT-basedrunningplans(2to3HIITsessionsperweek,combiningHIITandCRruns)showathleticperformanceimprovementsinendurancerunnersbyimprovingmaximaloxygenuptakeandrunningeconomyalongwithmuscularandmetabolicadaptations.Tomaximizetheadaptationstotraining,bothHIITandCRmustbepartoftrainingprogramsforendurancerunners.