AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergenc...AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergence insufficiency and to compare their diagnostic value in clinical applications.METHODS:Using the diagnostic test method,62 adult patients with convergence insufficiency(age:24.74±3.75y)and 62 normal participants(age:23.61±3.13y)who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included.All subjects completed the CISS and COVD-QOL.Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed.RESULTS:The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5%and 71.0%,respectively,while the specificity was 96.8%and 67.7%,respectively.Compared to the CISS alone,the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity.The areas under the receiver operating characteristic curve of CISS,COVD-QOL and CISS combined with COVD-QOL were 0.806,0.694 and 0.782,respectively.CONCLUSION:Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL,it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency.展开更多
Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is cruc...Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is crucial for effective treatment.Chronic venous insufficiency(CVI)is frequently overlooked by pain physicians.Moreover,many pain physicians lack sufficient knowledge about CVI.CVI is a common condition resulting from malfunctioning or damaged valves in lower limb veins.Symptoms of CVI,ranging from mild to severe,include pain,heaviness,fatigue,itching,swelling,skin color changes,and ulcers in the lower limbs.Recently,it has become more widely known that these symptoms can be attributed to CVI.Even slight or mild CVI can cause related symptoms.Pain physicians primarily consider neuromusculoskeletal disorders when assessing patients with leg pain,and often neglect the possibility of CVI.In clinical practice,when pain physicians encounter patients with unresolved leg pain,they must assess whether the patients exhibit symptoms of CVI and conduct tests to differ-entiate CVI from other potential causes.展开更多
The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complic...The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complications that profoundly affect female reproductive function and overall health.Unfortunately,current clinical treatment strategies for this condition are limited and often yield unsatisfactory outcomes.These approaches typically involve hormone repla-cement therapy combined with psychological support.Recently,mesenchymal stem cell(MSC)therapies for POI have garnered considerable attention in global research.MSCs can restore ovarian reproductive and endocrine functions through diverse mechanisms,including controlling differentiation,promoting angiogenesis,regulating ovarian fibrosis,inhibiting apoptosis,enhancing autocrine and paracrine effects,suppressing inflammation,modulating the immune system,and genetic regulation.This editorial offers a succinct summary of the application of MSC therapy in the context of POI,providing evidence for groundbreaking medical approaches that have potential to enhance reproductive health and overall well-being for women.展开更多
BACKGROUND Premature ovarian insufficiency(POI)is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage.Early follicular depletion results in intractable infertility,thereby cons...BACKGROUND Premature ovarian insufficiency(POI)is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage.Early follicular depletion results in intractable infertility,thereby considerably reducing the quality of life of females.Given the continuum in weakened ovarian function,progressing from incipient ovarian failure(IOF)to transitional ovarian failure and further to POI,it is necessary to develop biomarkers for predicting POI.The oxidative stress states in IOF and POI were comprehensively evaluated via oxidative stress[diacron-reactive oxygen metabolites(d-ROMs)]test and anti-oxidant capacity[biological antioxidant potential(BAP)].METHODS Females presenting with secondary amenorrhea over 4 mo and a follicle stimulating hormone level of>40 mIU/mL were categorized into the POI group.Females presenting with a normal menstrual cycle and a follicle stimulating hormone level of>10.2 mIU/mL were categorized into the IOF group.Healthy females without ovarian hypofunction were categorized into the control group.Among females aged<40 years who visited our hospital from January 2021 to June 2022,we recruited 11 patients into both POI and IOF groups.For the potential antioxidant capacity,the relative oxidative stress index(BAP/d-ROMs×100)was calculated,and the oxidative stress defense system was comprehensively evaluated.RESULTS d-ROMs were significantly higher in the POI and IOF groups than in the control group,(478.2±58.7 U.CARR,434.5±60.6 U.CARR,and 341.1±35.1 U.CARR,respectively)(U.CARR is equivalent to 0.08 mg/dL of hydrogen peroxide).However,no significant difference was found between the POI and IOF groups.Regarding BAP,no significant difference was found between the control,IOF,and POI groups(2078.5±157.4μmol/L,2116.2±240.2μmol/L,and 2029.0±186.4μmol/L,respectively).The oxidative stress index was significantly higher in the POI and IOF groups than in the control group(23.7±3.3,20.7±3.6,and 16.5±2.1,respectively).However,no significant difference was found between the POI and IOF groups.CONCLUSION High levels of oxidative stress suggest that evaluating the oxidative stress state may be a useful indicator for the early detection of POI.展开更多
Previous studies have shown that reduced sleep duration,sleep fragmentation,and decreased sleep quality in patients with Alzheimer's disease are related to dysfunction in orexin signaling.At the same time,blood-br...Previous studies have shown that reduced sleep duration,sleep fragmentation,and decreased sleep quality in patients with Alzheimer's disease are related to dysfunction in orexin signaling.At the same time,blood-brain barrier disruption is considered an early biomarker of Alzheimer's disease.However,currently no report has examined how changes in orexin signaling relate to changes in the blood-brain barrier of patients who have Alzheimer's disease with sleep insufficiency.This cross-sectional study included 50 patients with Alzheimer's disease who received treatment in 2019 at Beijing Tiantan Hospital.Patients were divided into two groups:those with insufficient sleep(sleep duration≤6 hours,n=19,age 61.58±8.54 years,10 men)and those with normal sleep durations(sleep duration>6 hours,n=31,age 63.19±10.09 years,18 men).Demographic variables were collected to evaluate cognitive function,neuropsychiatric symptoms,and activities of daily living.The levels of orexin,its receptor proteins,and several blood-brain barrier factors were measured in cerebrospinal fluid.Sleep insufficiency was associated with impaired overall cognitive function that spanned multiple cognitive domains.Furthermore,levels of orexin and its receptors were upregulated in the cerebrospinal fluid,and the blood–brain barrier was destroyed.Both these events precipitated each other and accelerated the progression of Alzheimer's disease.These findings describe the clinical characteristics and potential mechanism underlying Alzheimer's disease accompanied by sleep deprivation.Inhibiting the upregulation of elements within the orexin system or preventing the breakdown of the blood-brain barrier could thus be targets for treating Alzheimer's disease.展开更多
Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) are frequently discussed together and considered two closely related diseases.APS involves multiple organ systems,but APS-related endocrine manife...Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) are frequently discussed together and considered two closely related diseases.APS involves multiple organ systems,but APS-related endocrine manifestations are rare.^([1])Among them,adrenal insufficiency (AI) is the first endocrine manifestation of APS.The prompt diagnosis of AI is critical,as this disorder has high morbidity and mortality if left untreated.Here,we report a rare case of acute AI caused by APS secondary to SLE.CASEIn August 2022,a 39-year-old woman without a significant family history of medical diseases presented to our emergency department (ED) for low back pain,nausea,anorexia,fatigue,hypoglycemia,and hypotension.One month prior,she had fatigue,loss of appetite,low back pain,cough with sputum.展开更多
Background: The suppression of the hypothalamic-pituitary-adrenal axis by cortisol-secreting adrenocortical tumors is well recognized and requires peri- and postoperative hydrocortisone substitution. Case Presentation...Background: The suppression of the hypothalamic-pituitary-adrenal axis by cortisol-secreting adrenocortical tumors is well recognized and requires peri- and postoperative hydrocortisone substitution. Case Presentation: A 48-year-old female patient with hypertension and progressive weight gain, the clinical signs of hypercorticism motivated a hormonal workup revealing an independent ACTH Cushing’s syndrome: with urinary free cortisol (UFC) at 649 nmol/24h (4× normal), adrenocorticotropin hormone (ACTH) at 1.5 ng/l. The rest of the hormonal workup was not performed due to a lack of financial means. An Adrenal CT scan showed a 4 cm right adrenal adenoma. The patient underwent a right adrenalectomy with an adrenal adenoma on pathological examination. The contralateral side was normal. The patient was treated with hydrocortisone 30 mg/d for 6 weeks then 15 mg/d, during the monitoring we noted a persistence of the adrenal insufficiency for now 4 years. Basal cortisol levels during follow-up were very low (<3 μg/dl) ruling out the need for synacthen stimulation tests. Conclusion: Adrenal cortisol tumors are recognized by suppression, the duration of hypothalamic-pituitary-adrenal axis suppression is variable from 11 to 60 months depending on the series, which depends on the duration, severity of hypercortisolism, tumor size and other unknown factors. A longer follow-up of these patients is necessary to look for recovery of the contralateral adrenal gland.展开更多
AIM:To observe the surgical effects of slanted bilateral lateral recession(S-BLR)versus conventional bilateral lateral recession(C-BLR)in convergence insufficiency intermittent exotropia(CI-IXT).METHODS:Using a random...AIM:To observe the surgical effects of slanted bilateral lateral recession(S-BLR)versus conventional bilateral lateral recession(C-BLR)in convergence insufficiency intermittent exotropia(CI-IXT).METHODS:Using a randomized,double-blind,prospective design,22 patients with CI-IXT who were admitted to Renmin Hospital of Wuhan University from July 2019 to December 2020 were included.Patients were randomly divided into either S-BLR or C-BLR group for their subsequent strabismus surgery.All patients were followed up for 12mo.Near deviation,distant deviation,and neardistance difference(NDD)were measured in all patients.RESULTS:Twelve months after surgery,NDD improvement was 10(8,13)prismatic degrees(PD)in S-BLR group and 3(1,6)PD in C-BLR group(P=0.011).The near deviation of S-BLR group was 0(-2,2)PD,while that of C-BLR group was-4(-6,-3)PD(P=0.005).Before and after surgery,the difference in the distant deviation between the two groups was not statistically significant.There was no statistically significant difference in near stereopsis between the two groups(P=0.380)at 12mo.The success rate at 12mo after operation was 90.91%and 72.73%in the two groups(P=0.280).CONCLUSION:CI-IXT patients treated with S-BLR have better surgical outcomes than those treated with C-BLR,which indicates S-BLR is a safe and effective operation pattern.展开更多
BACKGROUND Premature ovarian insufficiency(POI)is characterized by an early decline in ovarian function,inducing secondary amenorrhea.While the cause of POI has not yet been identified,the function of mitochondria in ...BACKGROUND Premature ovarian insufficiency(POI)is characterized by an early decline in ovarian function,inducing secondary amenorrhea.While the cause of POI has not yet been identified,the function of mitochondria in the ovaries and the cytotoxicity associated with reactive oxygen species(ROS)have been implicated in follicle pool depletion and a decline in follicle quality.Recently developed tests have enabled easy measurement of diacron-reactive oxygen metabolites(d-ROMs)and biological antioxidant potential(BAP).The combination of these two tests is used to comprehensively assess oxidative stress in the blood.AIM To comprehensively assess the oxidative stress of d-ROMs and BAP in POI.METHODS Participants were classified into two groups:A POI group of 11 women aged<40 years examined between January 2021 and June 2022 with a history of secondary amenorrhea for at least 4 mo in our hospital and an FSH value of≥40 mIU/mL;and a control group of healthy women of the same age with normal ovarian function in our hospital.Plasma d-ROMs and BAP were measured in both these groups underwent.Differences between groups were assessed using the t-test.RESULTS The mean age and mean body mass index(BMI)were 35.8±3.0 years and 20.1±1.9 kg/m2 in the control group and 35.8±2.7 years and 19.4±2.5 kg/m2 in the POI group,respectively.The mean gravidity and parity in control and POI groups were 0.6±0.7 and 0.4±0.5 and 0.6±0.9 and 0.3±0.5,respectively.The two groups did not differ significantly in terms of mean age,BMI,gravidity,or parity.The d-ROMs level was significantly higher in the POI group than in the control group(478.2±58.7 vs 341.1±35.1 U.CARR;P<0.001);however,the BAP level did not significantly differ between the two groups(2078.5±157.4 vs 2029.0±186.4μmol/L).The oxidase stress index(d-ROMs/BAP×100)was significantly higher in the POI group than in the control group(23.7±3.3 vs 16.5±2.1;P<0.001).CONCLUSION Oxidative stress was significantly greater in the POI group than in the control group,suggesting oxidative stress as a factor that can serve as a POI biomarker.展开更多
[Objectives]To observe the protective effects of Mongolian medicine Borantunggal on rats with chronic renal insufficiency.[Methods]Male Wister rats were gavaged with 50 mg/kg/d adenine for 12 consecutive weeks,and wer...[Objectives]To observe the protective effects of Mongolian medicine Borantunggal on rats with chronic renal insufficiency.[Methods]Male Wister rats were gavaged with 50 mg/kg/d adenine for 12 consecutive weeks,and were intervened with positive control drug Niaoduqing and three groups of different doses of Mongolian medicine Borantunggal.The rats general state,such as body posture,hair color,activity status,renal function,thyroid gland,adrenal gland,and gonadal hormone levels,expression levels of inflammatory mediators,α-smooth muscle actin(α-SMA)and nuclear factor-κB(P65)in renal tissue,and histopathological changes of rat kidney were observed before and after treatment.[Results]The recovery of the general state of rats with chronic renal insufficiency in the low dose group after intervention with Mongolian medicine Borantunggal was the most obvious.Compared with the model group,the level of CRE in the low dose Mongolian medicine group decreased,and the difference was statistically significant(P<0.05).Compared with the normal group,the 24-h urinary protein in the low dose Mongolian medicine group had a declining trend,but the difference was not statistically significant(P>0.05).The urea level in low,medium and high dose Mongolian medicine groups showed a declining trend,and the effect of low dose Mongolian medicine was better.Compared with the model group,the feed intake of the low dose Mongolian medicine group had an increasing trend,while P and TCHO also had a declining trend.Compared with the model group,the levels of LH and COR in the low,medium and high dose Mongolian medicine groups decreased significantly,and the difference was statistically significant(P<0.05).The levels of T,T3 and T4 were significantly increased,the difference was statistically significant(P<0.05),and the effect of low dose Mongolian medicine was better.Compared with the model group,the levels of IL-6,TNF-αand HIF-1 in the low,medium and high dose Mongolian medicine groups were significantly reduced,and the difference was statistically significant(P<0.05).The levels of TGF-β1 and Ang II in the low dose Mongolian medicine group were significantly reduced,and the difference was statistically significant(P<0.05).The level of TGF-β1 in the medium and high dose Mongolian medicine groups decreased,and the difference was statistically significant(P<0.05).The expression of NF-κB P65 andα-SMA proteins in the low dose Mongolian medicine group showed a declining trend,which was better than Niaoduqing.[Conclusions]Mongolian medicine Borantunggal has significant protective and preventive effects on rats with adenine-induced chronic renal insufficiency.In particular,the dose of 0.31 kg/d had the most significant protective effect.Its action mechanism may be related to regulating hormone levels in the body,improving renal function,reducing renal inflammatory response,reducing the"three highs"in the kidney,and inhibiting renal tubular epithelial cell-to-mesenchymal transition and deposition of extracellular matrix(ECM).展开更多
目的:探究温肾汤治疗慢性肾功能不全脾肾阳虚证的效果及其对肾脏纤维化的影响。方法:选择符合纳入标准的慢性肾功能不全脾肾阳虚证患者96例,依据随机数字表随机分为对照组和观察组。对照组采用常规西药治疗,观察组在对照组基础上口服温...目的:探究温肾汤治疗慢性肾功能不全脾肾阳虚证的效果及其对肾脏纤维化的影响。方法:选择符合纳入标准的慢性肾功能不全脾肾阳虚证患者96例,依据随机数字表随机分为对照组和观察组。对照组采用常规西药治疗,观察组在对照组基础上口服温肾汤治疗,2周为1个疗程,两组均治疗2个疗程。比较治疗前后两组患者中医症状评分(畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛)、肾功能相关损伤指标(24 h Pro、BUN、Ccr和GFR)及肾纤维化相关指标(CTGF、CIV、PCⅢ和BMP-7)变化情况及临床疗效。结果:对照组临床总有效率为77.1%(37/48),观察组临床总有效率为91.7%(44/48),差异有统计学意义(P<0.05);治疗后两组患者畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛的中医症状评分均较治疗前显著降低(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者24 h Pro、BUN水平均较治疗前显著降低(P<0.05),Ccr、GFR水平显著升高(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者CTGF、CIV及PCⅢ水平较治疗前明显降低(P<0.05),BMP-7水平明显升高(P<0.05),且观察组改善程度优于对照组(P<0.05)。结论:温肾汤可以有效改善慢性肾功能不全脾肾阳虚证患者的肾功能,降低蛋白尿,显著抑制肾脏纤维化。展开更多
文摘AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergence insufficiency and to compare their diagnostic value in clinical applications.METHODS:Using the diagnostic test method,62 adult patients with convergence insufficiency(age:24.74±3.75y)and 62 normal participants(age:23.61±3.13y)who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included.All subjects completed the CISS and COVD-QOL.Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed.RESULTS:The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5%and 71.0%,respectively,while the specificity was 96.8%and 67.7%,respectively.Compared to the CISS alone,the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity.The areas under the receiver operating characteristic curve of CISS,COVD-QOL and CISS combined with COVD-QOL were 0.806,0.694 and 0.782,respectively.CONCLUSION:Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL,it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency.
基金Supported by The National Research Foundation of Korea Grant Funded by The Korea Government(MSIT),No.00219725.
文摘Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is crucial for effective treatment.Chronic venous insufficiency(CVI)is frequently overlooked by pain physicians.Moreover,many pain physicians lack sufficient knowledge about CVI.CVI is a common condition resulting from malfunctioning or damaged valves in lower limb veins.Symptoms of CVI,ranging from mild to severe,include pain,heaviness,fatigue,itching,swelling,skin color changes,and ulcers in the lower limbs.Recently,it has become more widely known that these symptoms can be attributed to CVI.Even slight or mild CVI can cause related symptoms.Pain physicians primarily consider neuromusculoskeletal disorders when assessing patients with leg pain,and often neglect the possibility of CVI.In clinical practice,when pain physicians encounter patients with unresolved leg pain,they must assess whether the patients exhibit symptoms of CVI and conduct tests to differ-entiate CVI from other potential causes.
基金Supported by the Cohort Construction Project of Peking University Third Hospital,No.BYSYDL2022013Clinical Key Project of Peking University Third Hospital,No.BYSY2023049+1 种基金Special Grant for Capital Health Research and Development,No.2022-2-4097and Funding from State Key Laboratory of Female Fertility Promotion,Center for Reproductive Medicine,Department of Obstetrics and Gynecology,Peking University Third Hospital,No.BYSYSZKF2023027.
文摘The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complications that profoundly affect female reproductive function and overall health.Unfortunately,current clinical treatment strategies for this condition are limited and often yield unsatisfactory outcomes.These approaches typically involve hormone repla-cement therapy combined with psychological support.Recently,mesenchymal stem cell(MSC)therapies for POI have garnered considerable attention in global research.MSCs can restore ovarian reproductive and endocrine functions through diverse mechanisms,including controlling differentiation,promoting angiogenesis,regulating ovarian fibrosis,inhibiting apoptosis,enhancing autocrine and paracrine effects,suppressing inflammation,modulating the immune system,and genetic regulation.This editorial offers a succinct summary of the application of MSC therapy in the context of POI,providing evidence for groundbreaking medical approaches that have potential to enhance reproductive health and overall well-being for women.
文摘BACKGROUND Premature ovarian insufficiency(POI)is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage.Early follicular depletion results in intractable infertility,thereby considerably reducing the quality of life of females.Given the continuum in weakened ovarian function,progressing from incipient ovarian failure(IOF)to transitional ovarian failure and further to POI,it is necessary to develop biomarkers for predicting POI.The oxidative stress states in IOF and POI were comprehensively evaluated via oxidative stress[diacron-reactive oxygen metabolites(d-ROMs)]test and anti-oxidant capacity[biological antioxidant potential(BAP)].METHODS Females presenting with secondary amenorrhea over 4 mo and a follicle stimulating hormone level of>40 mIU/mL were categorized into the POI group.Females presenting with a normal menstrual cycle and a follicle stimulating hormone level of>10.2 mIU/mL were categorized into the IOF group.Healthy females without ovarian hypofunction were categorized into the control group.Among females aged<40 years who visited our hospital from January 2021 to June 2022,we recruited 11 patients into both POI and IOF groups.For the potential antioxidant capacity,the relative oxidative stress index(BAP/d-ROMs×100)was calculated,and the oxidative stress defense system was comprehensively evaluated.RESULTS d-ROMs were significantly higher in the POI and IOF groups than in the control group,(478.2±58.7 U.CARR,434.5±60.6 U.CARR,and 341.1±35.1 U.CARR,respectively)(U.CARR is equivalent to 0.08 mg/dL of hydrogen peroxide).However,no significant difference was found between the POI and IOF groups.Regarding BAP,no significant difference was found between the control,IOF,and POI groups(2078.5±157.4μmol/L,2116.2±240.2μmol/L,and 2029.0±186.4μmol/L,respectively).The oxidative stress index was significantly higher in the POI and IOF groups than in the control group(23.7±3.3,20.7±3.6,and 16.5±2.1,respectively).However,no significant difference was found between the POI and IOF groups.CONCLUSION High levels of oxidative stress suggest that evaluating the oxidative stress state may be a useful indicator for the early detection of POI.
基金supported by the National Key Research and Development Program of China,Nos.2016YFC1306300(to XMW),2016YFC1306000the National Key R&D Program of China-European Commission Horizon 2020,No.2017YFE0118800-779238(to YXW)+15 种基金the Notional Natural Science Foundation of Chino,Nos.81970992(to WZ),81571229(to WZ),81071015(to WZ),30770745(to WZ)Capital's Funds for Health Improvement and Research(CFH),No.2022-2-2048(to WZ)the Key Technology R&D Program of Beijing Municipal Education Commission,No.kz201610025030(to WZ)the Natural Science Foundation of Beijing,No.7082032(to WZ)the Key Project of the Natural Science Foundation of Beijing,No.4161004(to WZ)Capitol Clinical Characteristic Applicotion Research,No.Z121107001012161(to WZ)Project of Scientific and Technological Development of Traditional Chinese Medicine in Beijing,No.JJ2018-48(to WZ)High Level Technical Personnel Training Project of Beijing Health System of China,No.2009-3-26(to WZ)Excellent Personnel Training Project of Beijing,No.20071D0300400076(to WZ)Important National Science&Technology Specific Project,No.2011ZX09102-003-01(to WZ)Beijing Healthcare Research Project,No.JING-15-2(to WZ)Basic-Clinicol Research Cooperation Funding of Capitol Medical University of China,Nos.2015-JL-PT-X04(to WZ),10JL49(to WZ),14JL15(to WZ)the Natural Science Foundation of Capital Medical UniversityBeijingChina,No.PYZ2018077(to PG)Youth Research Fund of Beijing Tianton Hospital of Capital Medical University of China,Nos.2015-YQN-14(to PG),2015-YQN-15,2015-YQN-17。
文摘Previous studies have shown that reduced sleep duration,sleep fragmentation,and decreased sleep quality in patients with Alzheimer's disease are related to dysfunction in orexin signaling.At the same time,blood-brain barrier disruption is considered an early biomarker of Alzheimer's disease.However,currently no report has examined how changes in orexin signaling relate to changes in the blood-brain barrier of patients who have Alzheimer's disease with sleep insufficiency.This cross-sectional study included 50 patients with Alzheimer's disease who received treatment in 2019 at Beijing Tiantan Hospital.Patients were divided into two groups:those with insufficient sleep(sleep duration≤6 hours,n=19,age 61.58±8.54 years,10 men)and those with normal sleep durations(sleep duration>6 hours,n=31,age 63.19±10.09 years,18 men).Demographic variables were collected to evaluate cognitive function,neuropsychiatric symptoms,and activities of daily living.The levels of orexin,its receptor proteins,and several blood-brain barrier factors were measured in cerebrospinal fluid.Sleep insufficiency was associated with impaired overall cognitive function that spanned multiple cognitive domains.Furthermore,levels of orexin and its receptors were upregulated in the cerebrospinal fluid,and the blood–brain barrier was destroyed.Both these events precipitated each other and accelerated the progression of Alzheimer's disease.These findings describe the clinical characteristics and potential mechanism underlying Alzheimer's disease accompanied by sleep deprivation.Inhibiting the upregulation of elements within the orexin system or preventing the breakdown of the blood-brain barrier could thus be targets for treating Alzheimer's disease.
文摘Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) are frequently discussed together and considered two closely related diseases.APS involves multiple organ systems,but APS-related endocrine manifestations are rare.^([1])Among them,adrenal insufficiency (AI) is the first endocrine manifestation of APS.The prompt diagnosis of AI is critical,as this disorder has high morbidity and mortality if left untreated.Here,we report a rare case of acute AI caused by APS secondary to SLE.CASEIn August 2022,a 39-year-old woman without a significant family history of medical diseases presented to our emergency department (ED) for low back pain,nausea,anorexia,fatigue,hypoglycemia,and hypotension.One month prior,she had fatigue,loss of appetite,low back pain,cough with sputum.
文摘Background: The suppression of the hypothalamic-pituitary-adrenal axis by cortisol-secreting adrenocortical tumors is well recognized and requires peri- and postoperative hydrocortisone substitution. Case Presentation: A 48-year-old female patient with hypertension and progressive weight gain, the clinical signs of hypercorticism motivated a hormonal workup revealing an independent ACTH Cushing’s syndrome: with urinary free cortisol (UFC) at 649 nmol/24h (4× normal), adrenocorticotropin hormone (ACTH) at 1.5 ng/l. The rest of the hormonal workup was not performed due to a lack of financial means. An Adrenal CT scan showed a 4 cm right adrenal adenoma. The patient underwent a right adrenalectomy with an adrenal adenoma on pathological examination. The contralateral side was normal. The patient was treated with hydrocortisone 30 mg/d for 6 weeks then 15 mg/d, during the monitoring we noted a persistence of the adrenal insufficiency for now 4 years. Basal cortisol levels during follow-up were very low (<3 μg/dl) ruling out the need for synacthen stimulation tests. Conclusion: Adrenal cortisol tumors are recognized by suppression, the duration of hypothalamic-pituitary-adrenal axis suppression is variable from 11 to 60 months depending on the series, which depends on the duration, severity of hypercortisolism, tumor size and other unknown factors. A longer follow-up of these patients is necessary to look for recovery of the contralateral adrenal gland.
基金Supported by“323”Action Plan for Prominent Issues Affecting People’s Health of Hubei Province,Health Commission of Hubei Province,China。
文摘AIM:To observe the surgical effects of slanted bilateral lateral recession(S-BLR)versus conventional bilateral lateral recession(C-BLR)in convergence insufficiency intermittent exotropia(CI-IXT).METHODS:Using a randomized,double-blind,prospective design,22 patients with CI-IXT who were admitted to Renmin Hospital of Wuhan University from July 2019 to December 2020 were included.Patients were randomly divided into either S-BLR or C-BLR group for their subsequent strabismus surgery.All patients were followed up for 12mo.Near deviation,distant deviation,and neardistance difference(NDD)were measured in all patients.RESULTS:Twelve months after surgery,NDD improvement was 10(8,13)prismatic degrees(PD)in S-BLR group and 3(1,6)PD in C-BLR group(P=0.011).The near deviation of S-BLR group was 0(-2,2)PD,while that of C-BLR group was-4(-6,-3)PD(P=0.005).Before and after surgery,the difference in the distant deviation between the two groups was not statistically significant.There was no statistically significant difference in near stereopsis between the two groups(P=0.380)at 12mo.The success rate at 12mo after operation was 90.91%and 72.73%in the two groups(P=0.280).CONCLUSION:CI-IXT patients treated with S-BLR have better surgical outcomes than those treated with C-BLR,which indicates S-BLR is a safe and effective operation pattern.
文摘BACKGROUND Premature ovarian insufficiency(POI)is characterized by an early decline in ovarian function,inducing secondary amenorrhea.While the cause of POI has not yet been identified,the function of mitochondria in the ovaries and the cytotoxicity associated with reactive oxygen species(ROS)have been implicated in follicle pool depletion and a decline in follicle quality.Recently developed tests have enabled easy measurement of diacron-reactive oxygen metabolites(d-ROMs)and biological antioxidant potential(BAP).The combination of these two tests is used to comprehensively assess oxidative stress in the blood.AIM To comprehensively assess the oxidative stress of d-ROMs and BAP in POI.METHODS Participants were classified into two groups:A POI group of 11 women aged<40 years examined between January 2021 and June 2022 with a history of secondary amenorrhea for at least 4 mo in our hospital and an FSH value of≥40 mIU/mL;and a control group of healthy women of the same age with normal ovarian function in our hospital.Plasma d-ROMs and BAP were measured in both these groups underwent.Differences between groups were assessed using the t-test.RESULTS The mean age and mean body mass index(BMI)were 35.8±3.0 years and 20.1±1.9 kg/m2 in the control group and 35.8±2.7 years and 19.4±2.5 kg/m2 in the POI group,respectively.The mean gravidity and parity in control and POI groups were 0.6±0.7 and 0.4±0.5 and 0.6±0.9 and 0.3±0.5,respectively.The two groups did not differ significantly in terms of mean age,BMI,gravidity,or parity.The d-ROMs level was significantly higher in the POI group than in the control group(478.2±58.7 vs 341.1±35.1 U.CARR;P<0.001);however,the BAP level did not significantly differ between the two groups(2078.5±157.4 vs 2029.0±186.4μmol/L).The oxidase stress index(d-ROMs/BAP×100)was significantly higher in the POI group than in the control group(23.7±3.3 vs 16.5±2.1;P<0.001).CONCLUSION Oxidative stress was significantly greater in the POI group than in the control group,suggesting oxidative stress as a factor that can serve as a POI biomarker.
基金Supported by Natural Science Foundation of Inner Mongolia Autonomous Region(2019MS08015).
文摘[Objectives]To observe the protective effects of Mongolian medicine Borantunggal on rats with chronic renal insufficiency.[Methods]Male Wister rats were gavaged with 50 mg/kg/d adenine for 12 consecutive weeks,and were intervened with positive control drug Niaoduqing and three groups of different doses of Mongolian medicine Borantunggal.The rats general state,such as body posture,hair color,activity status,renal function,thyroid gland,adrenal gland,and gonadal hormone levels,expression levels of inflammatory mediators,α-smooth muscle actin(α-SMA)and nuclear factor-κB(P65)in renal tissue,and histopathological changes of rat kidney were observed before and after treatment.[Results]The recovery of the general state of rats with chronic renal insufficiency in the low dose group after intervention with Mongolian medicine Borantunggal was the most obvious.Compared with the model group,the level of CRE in the low dose Mongolian medicine group decreased,and the difference was statistically significant(P<0.05).Compared with the normal group,the 24-h urinary protein in the low dose Mongolian medicine group had a declining trend,but the difference was not statistically significant(P>0.05).The urea level in low,medium and high dose Mongolian medicine groups showed a declining trend,and the effect of low dose Mongolian medicine was better.Compared with the model group,the feed intake of the low dose Mongolian medicine group had an increasing trend,while P and TCHO also had a declining trend.Compared with the model group,the levels of LH and COR in the low,medium and high dose Mongolian medicine groups decreased significantly,and the difference was statistically significant(P<0.05).The levels of T,T3 and T4 were significantly increased,the difference was statistically significant(P<0.05),and the effect of low dose Mongolian medicine was better.Compared with the model group,the levels of IL-6,TNF-αand HIF-1 in the low,medium and high dose Mongolian medicine groups were significantly reduced,and the difference was statistically significant(P<0.05).The levels of TGF-β1 and Ang II in the low dose Mongolian medicine group were significantly reduced,and the difference was statistically significant(P<0.05).The level of TGF-β1 in the medium and high dose Mongolian medicine groups decreased,and the difference was statistically significant(P<0.05).The expression of NF-κB P65 andα-SMA proteins in the low dose Mongolian medicine group showed a declining trend,which was better than Niaoduqing.[Conclusions]Mongolian medicine Borantunggal has significant protective and preventive effects on rats with adenine-induced chronic renal insufficiency.In particular,the dose of 0.31 kg/d had the most significant protective effect.Its action mechanism may be related to regulating hormone levels in the body,improving renal function,reducing renal inflammatory response,reducing the"three highs"in the kidney,and inhibiting renal tubular epithelial cell-to-mesenchymal transition and deposition of extracellular matrix(ECM).
文摘目的:探究温肾汤治疗慢性肾功能不全脾肾阳虚证的效果及其对肾脏纤维化的影响。方法:选择符合纳入标准的慢性肾功能不全脾肾阳虚证患者96例,依据随机数字表随机分为对照组和观察组。对照组采用常规西药治疗,观察组在对照组基础上口服温肾汤治疗,2周为1个疗程,两组均治疗2个疗程。比较治疗前后两组患者中医症状评分(畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛)、肾功能相关损伤指标(24 h Pro、BUN、Ccr和GFR)及肾纤维化相关指标(CTGF、CIV、PCⅢ和BMP-7)变化情况及临床疗效。结果:对照组临床总有效率为77.1%(37/48),观察组临床总有效率为91.7%(44/48),差异有统计学意义(P<0.05);治疗后两组患者畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛的中医症状评分均较治疗前显著降低(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者24 h Pro、BUN水平均较治疗前显著降低(P<0.05),Ccr、GFR水平显著升高(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者CTGF、CIV及PCⅢ水平较治疗前明显降低(P<0.05),BMP-7水平明显升高(P<0.05),且观察组改善程度优于对照组(P<0.05)。结论:温肾汤可以有效改善慢性肾功能不全脾肾阳虚证患者的肾功能,降低蛋白尿,显著抑制肾脏纤维化。