BACKGROUND Traumatic brain injury(TBI)imposes a substantial societal and familial burden due to its high disability and fatality rates,rendering it a serious public health problem.Some patients with TBI have poor trea...BACKGROUND Traumatic brain injury(TBI)imposes a substantial societal and familial burden due to its high disability and fatality rates,rendering it a serious public health problem.Some patients with TBI have poor treatment outcomes and are prone to postoperative delirium(POD),which affects their quality of life.Anxiety has been linked to increased POD incidence in some studies,while others have found no correlation.AIM To investigate the correlation of POD risk factors,preoperative inflammatory factors,and mood disorders in patients with TBI.METHODS We retrospectively collected data on the treatment of 80 patients with TBI from November 2021 to September 2023.Patients were grouped as POD and non-POD,according to their POD status,and the general data of the two groups were compared.Inflammatory factor levels were detected preoperatively,and the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were used to investigate the risk factors associated with POD in these patients.Logistic regression was used to identify the independent risk factors.RESULTS Twenty-one patients(26.25%)developed POD,including 7,10,and 4 cases of the excitatory,inhibitory,and mixed types,respectively.There were 59 cases(73.75%)in the non-POD group.Compared with the non-POD group,the POD group had a significantly higher proportion of patients with low Glasgow Coma Scale(GCS)scores before admission,unilateral mydriasis,preoperative hemorrhagic shock,intraventricular hemorrhage(IVH),and postoperative hyperglycemic hyperosmolar disease(P<0.05).In the POD group,interleukin-6(IL-6),human tumor necrosis factor-α(TNF-α),myeloperoxidase levels,HAMA,and HAMD scores were higher than those in the non-POD group(all P<0.05).Logistic multivariate analysis showed that GCS score at admission,IVH,IL-6,TNF-α,HAMA,and HAMD were independent risk factors for POD in patients with TBI(P<0.05).CONCLUSION Low GCS score at admission,IVH,elevated IL-6 and TNF-α,other inflammatory indicators,anxiety,and depression,can increase the risk of POD in patients with TBI after surgery.展开更多
目的:研究帕金森病(Parkinson’s d i sease,PD)患者心血管自主神经功能障碍的影响因素。方法:选取2018年3月至2019年8月在河北港口集团有限公司港口医院接受诊治的80例PD患者作为PD组,并选取同期健康志愿者50例作为对照组。PD组进行Hoe...目的:研究帕金森病(Parkinson’s d i sease,PD)患者心血管自主神经功能障碍的影响因素。方法:选取2018年3月至2019年8月在河北港口集团有限公司港口医院接受诊治的80例PD患者作为PD组,并选取同期健康志愿者50例作为对照组。PD组进行Hoehn-Yahr(H-Y)分期、统一PD评定量表Ⅲ(Unified PD Rating Scale Ⅲ,UPDRS Ⅲ)评分及PD自主神经症状量表(Scale for Outcomes in PD for Autonomic Symptoms,SCOPA-AUT)评分;所有受试者均进行24 h动态血压和24 h动态心电图监测,分析两组受试者血压变异性(blood pressure variability,BPV)、心率变异性(hear t rate variability,HRV)指标的变化,探讨PD心血管自主神经功能障碍的影响因素,并进行多元线性回归分析。结果:PD组BPV指标24 h收缩压标准差(standard deviation of 24-hour systolic blood pressure,24h-SBPSD)、日间收缩压标准差(standard deviation of daytime systolic blood pressure,dSBPSD)及夜间收缩压标准差(standard deviation of systolic blood pressure at night,nSBPSD)均高于对照组(均P<0.05);两组24 h心率(24-hour average heart rate,24hHR)、夜间平均心率(average heart rate at night,nHR)、日间平均心率(average heart rate at daytime,dHR)差异具有统计学意义(均P<0.05);PD组HRV指标24 h内全部窦性R-R间期的标准差(standard deviation of all sinus R-R intervals within 24 hours,SDNN)、相邻NN间期差异≥50 ms占所有NN间期总数的百分比(percentage of adjacent NN intervals that differ from each other by more than 50 ms,pNN50%)、24 h内全部相邻窦性R-R间期差值的均方根值(root mean square value of all adjacent sinus R-R interval differences within 24 hours,RMSSD)、高频成分(high f requency component,HF)、低频成分(low f requency component,LF)及LF/HF均明显低于对照组(均P<0.05);PD组nSBPSD指标与病程呈正相关(r=0.301,P=0.020);PD组SDNN指标与H-Y分期、UPDRS III评分及SCOPA-AUT评分呈负相关(r=−0.312、−0.356、−0.212,P=0.042、0.023、0.036);RMSSD指标与病程呈负相关(r=−0.345,P=0.026);LF/HF指标与H-Y分期呈负相关(r=−0.213,P=0.046)。多元线性回归分析结果表明:1)nSBPSD与病程独立相关(P<0.05);2)SDNN与UPDRS Ⅲ评分及SCOPA-AUT评分独立相关(P<0.05);3)RMSSD与病程独立相关(P<0.05);4)LF/HF与H-Y分期独立相关(P<0.05)。结论:BPV升高和HRV降低是反映PD患者心血管自主神经功能障碍的指标,且PD患者心血管自主神经功能障碍与患者疾病持续时间、疾病严重程度、运动症状严重程度及植物神经功能调节障碍相关。展开更多
基金Supported by Hunan Provincial Natural Science Foundation of China,No.2021JJ70001.
文摘BACKGROUND Traumatic brain injury(TBI)imposes a substantial societal and familial burden due to its high disability and fatality rates,rendering it a serious public health problem.Some patients with TBI have poor treatment outcomes and are prone to postoperative delirium(POD),which affects their quality of life.Anxiety has been linked to increased POD incidence in some studies,while others have found no correlation.AIM To investigate the correlation of POD risk factors,preoperative inflammatory factors,and mood disorders in patients with TBI.METHODS We retrospectively collected data on the treatment of 80 patients with TBI from November 2021 to September 2023.Patients were grouped as POD and non-POD,according to their POD status,and the general data of the two groups were compared.Inflammatory factor levels were detected preoperatively,and the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were used to investigate the risk factors associated with POD in these patients.Logistic regression was used to identify the independent risk factors.RESULTS Twenty-one patients(26.25%)developed POD,including 7,10,and 4 cases of the excitatory,inhibitory,and mixed types,respectively.There were 59 cases(73.75%)in the non-POD group.Compared with the non-POD group,the POD group had a significantly higher proportion of patients with low Glasgow Coma Scale(GCS)scores before admission,unilateral mydriasis,preoperative hemorrhagic shock,intraventricular hemorrhage(IVH),and postoperative hyperglycemic hyperosmolar disease(P<0.05).In the POD group,interleukin-6(IL-6),human tumor necrosis factor-α(TNF-α),myeloperoxidase levels,HAMA,and HAMD scores were higher than those in the non-POD group(all P<0.05).Logistic multivariate analysis showed that GCS score at admission,IVH,IL-6,TNF-α,HAMA,and HAMD were independent risk factors for POD in patients with TBI(P<0.05).CONCLUSION Low GCS score at admission,IVH,elevated IL-6 and TNF-α,other inflammatory indicators,anxiety,and depression,can increase the risk of POD in patients with TBI after surgery.
文摘目的:研究帕金森病(Parkinson’s d i sease,PD)患者心血管自主神经功能障碍的影响因素。方法:选取2018年3月至2019年8月在河北港口集团有限公司港口医院接受诊治的80例PD患者作为PD组,并选取同期健康志愿者50例作为对照组。PD组进行Hoehn-Yahr(H-Y)分期、统一PD评定量表Ⅲ(Unified PD Rating Scale Ⅲ,UPDRS Ⅲ)评分及PD自主神经症状量表(Scale for Outcomes in PD for Autonomic Symptoms,SCOPA-AUT)评分;所有受试者均进行24 h动态血压和24 h动态心电图监测,分析两组受试者血压变异性(blood pressure variability,BPV)、心率变异性(hear t rate variability,HRV)指标的变化,探讨PD心血管自主神经功能障碍的影响因素,并进行多元线性回归分析。结果:PD组BPV指标24 h收缩压标准差(standard deviation of 24-hour systolic blood pressure,24h-SBPSD)、日间收缩压标准差(standard deviation of daytime systolic blood pressure,dSBPSD)及夜间收缩压标准差(standard deviation of systolic blood pressure at night,nSBPSD)均高于对照组(均P<0.05);两组24 h心率(24-hour average heart rate,24hHR)、夜间平均心率(average heart rate at night,nHR)、日间平均心率(average heart rate at daytime,dHR)差异具有统计学意义(均P<0.05);PD组HRV指标24 h内全部窦性R-R间期的标准差(standard deviation of all sinus R-R intervals within 24 hours,SDNN)、相邻NN间期差异≥50 ms占所有NN间期总数的百分比(percentage of adjacent NN intervals that differ from each other by more than 50 ms,pNN50%)、24 h内全部相邻窦性R-R间期差值的均方根值(root mean square value of all adjacent sinus R-R interval differences within 24 hours,RMSSD)、高频成分(high f requency component,HF)、低频成分(low f requency component,LF)及LF/HF均明显低于对照组(均P<0.05);PD组nSBPSD指标与病程呈正相关(r=0.301,P=0.020);PD组SDNN指标与H-Y分期、UPDRS III评分及SCOPA-AUT评分呈负相关(r=−0.312、−0.356、−0.212,P=0.042、0.023、0.036);RMSSD指标与病程呈负相关(r=−0.345,P=0.026);LF/HF指标与H-Y分期呈负相关(r=−0.213,P=0.046)。多元线性回归分析结果表明:1)nSBPSD与病程独立相关(P<0.05);2)SDNN与UPDRS Ⅲ评分及SCOPA-AUT评分独立相关(P<0.05);3)RMSSD与病程独立相关(P<0.05);4)LF/HF与H-Y分期独立相关(P<0.05)。结论:BPV升高和HRV降低是反映PD患者心血管自主神经功能障碍的指标,且PD患者心血管自主神经功能障碍与患者疾病持续时间、疾病严重程度、运动症状严重程度及植物神经功能调节障碍相关。
基金supported by grants from The National Natural Science Foundation of China(NSFC)(U1432102,31700664,31470742,31700664,31270783)the 100 Talents Program of the Chinese Academy of Sciences~~
文摘在细菌DNA复制中,Dna G引物酶合成RNA引物,然后合成的引物通过DNA聚合酶进行延伸. Dna G引物酶由3个结构域组成,N端锌结合结构域(zinc-binding domain,ZBD)、RNA聚合酶结构域(RNA polymerase domain,RPD)和C端解旋酶结合结构域(helicase binding domain,HBD).在合成引物的过程中,引物酶的3个结构域协同作用,缺一不可.尽管引物酶3个结构域的结构均已有研究报道,但到目前为止,引物酶的全长结构尚不清楚.我们在上海光源利用小角X射线散射技术研究了枯草芽孢杆菌全长引物酶的溶液结构,首次构建了全长引物酶结构模型.我们发现,枯草芽孢杆菌引物酶在溶液中处于伸展状态,且ZBD和HBD结构域相对于RPD结构域呈现出连续的构象变化.本文研究表明Dna G引物酶中的结构域重排可能有助于其在DNA复制中发挥功能.
