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Current Medical Science 2022年第1期42卷 39-47页

作者： Hu-ping WANG Hong-yan WU Chun-lin MA Qing-tao ZENG Kai-min ZHU Shu-mei CUI Hai-long LI Guo-tai WU Zhi-wei WU Jian-zheng HE Basic medicine college Gansu University of Chinese MedicineLanzhou 730000 Clinical medicine college Gansu University of Chinese MedicineLanzhou 730000 Pharmacy college Gansu University of Chinese MedicineLanzhou 730000

Objective:Angelica(A.)sinensis is used as a traditional medical herb for the treatment of neurodegeneration,aging,and inflammation in Asia.A.sinensis optimal formula(AOF)is the best combination in A.sinensis that has been screened to rescue the cognitive ability in P-amyloid peptide(Ap25-35)-treated Alzheimer’s disease(AD)rats.The objective of this study was to investigate the effect of AOF on the learning and memory of AD rats as well as to explore the underlying mechanisms.

关键词： optimal formula of Angelica sinensis Alzheimer's disease amyloid P aggregation oxidative stress neuroinflammation

Promise of metformin for preventing age-related cognitive dysfunction

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Neural Regeneration Research 2022年第3期17卷 503-507页

作者： Leelavathi N.Madhu Maheedhar Kodali Ashok K.Shetty Institute for Regenerative medicine Department of Molecular and Cellular MedicineTexas A&M University College of MedicineCollege StationTXUSA

The expanded lifespan of people,while a positive advance,has also amplified the prevalence of age-related disorders,which include mild cognitive impairment,dementia,and Alzheimer's disease.Therefore,competent therapies that could improve the healthspan of people have great significance.Some of the dietary and pharmacological approaches that augment the lifespan could also preserve improved cognitive function in old age.Metformin,a drug widely used for treating diabetes,is one such candidate that could alleviate age-related cognitive dysfunction.However,the possible use of metformin to alleviate age-related cognitive dysfunction has met with conflicting results in human and animal studies.While most clinical studies have suggested the promise of metformin to maintain better cognitive function and reduce the risk for developing dementia and Alzheimer's disease in aged diabetic people,its efficacy in the nondiabetic population is still unclear.Moreover,a previous animal model study implied that metformin could adversely affect cognitive function in the aged.However,a recent animal study using multiple behavioral tests has reported that metformin treatment in late middle age improved cognitive function in old age.The study also revealed that cognitionenhancing effects of metformin in aged animals were associated with the activation of the energy regulator adenosine monophosphate-activated protein kinase,diminished neuroinflammation,inhibition of the mammalian target of rapamycin signaling,and augmented autophagy in the hippocampus.The proficiency of metformin to facilitate these favorable modifications in the aged hippocampus likely underlies its positive effect on cognitive function.Nonetheless,additional studies probing the outcomes of different doses and durations of metformin treatment at specific windows in the middle and old age across sex in nondiabetic and non-obese prototypes are required to substantiate the promise of metformin to maintain better cognitive function in old age.

关键词： activated microglia aging autophagy cognitive dysfunction memory metformin mTOR signaling neuroinflammation

Acetylsalicylic acid for metal stent in malignant distal common bile duct obstruction:A randomized controlled trial

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Hepatobiliary & Pancreatic Diseases International 2022年第5期21卷 493-499页

作者： Jin Ho Choi Kyong Joo Lee Woo Hyun Paik Namyoung Park Jung Won Chun Sang Hyub Lee Ji Kon Ryu Yong-Tae Kim Department of Internal medicine Liver Research InstituteSeoul National University College of MedicineSeoulKorea Department of Internal medicine Yonsei University Wonju College of MedicineWonjuKorea

Background:Endoscopic biliary drainage is the treatment of choice for patients with malignant distal common bile duct obstruction.Self-expandable metal stents have clinical advantages including an increased duration of patency that may be prolonged by acetylsalicylic acid(ASA)use.The aim of this study was to investigate whether ASA had a positive effect on the patency of self-expandable metal stents compared with placebo.Methods:This prospective,multicenter,double-blinded,and randomized placebo-controlled trial was conducted from October 2017 to May 2020 in Korea.Patients who underwent palliative endoscopic biliary drainage with self-expandable metal stents for malignant distal bile duct obstruction were enrolled,and allocated to ASA treatment or placebo.The study outcomes were the rate of stent dysfunction at 6 months,duration of stent patency,risk factors for stent dysfunction,and any adverse events.Results:Interim analysis included 24 and 28 patients in the ASA and placebo groups,respectively.There was no significant difference between the ASA and placebo groups in stent dysfunction(25.0%vs.20.7%,P=0.761)or the duration of stent patency(150.97±10.55 vs.158.07±8.70 days,P=0.497).Six patients experienced suspected ASA-related adverse events,and there was one lethal case.Conclusions:ASA did not prolong stent patency.This study was terminated early because of the possibility of serious adverse events related to ASA treatment of these patients receiving palliative care.

关键词： Endoscopic retrograde cholangiopancreatography Self expandable metallic stents Randomized controlled trial Acetylsalicylic acid

Post-op cocaine use resulting in catastrophic cardiovascular compromise

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Journal of Geriatric Cardiology 2023年第2期20卷 155-158页

作者： Abhinav Karan Aleem Azal Ali Khadeeja Esmail Temitope Akinjogbin Sanjay Lamsal Emil Missov Internal medicine University of Florida College of Medicine-JacksonvilleFloridaUSA Division of Cardiology University of Florida College of Medicine-JacksonvilleFloridaUSA Department of Radiology University of Florida College of Medicine-JacksonvilleFloridaUSA

Cardiac tamponade can result from a variety of intrapericardial or extrapericardial sources of compression of the heart and great vessels.Cardiac tamponade can be acute or subacute and results from fluid or gas collection in the pericardial space leading to impairment in cardiac function.Postoperative cardiac tamponade following open heart surgery can be caused by hemorrhage within the pericardial sac or by mediastinal hematoma formation.

关键词： cardiac function acute

Postvaccination breakthrough SARS-CoV-2 infections among adults in Malaysia and attitudes towards future vaccination

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Asian Pacific Journal of Tropical medicine 2023年第7期16卷 296-304页

作者： Praneetha Kumar Nair Kai Ern Koh Christine Yvonne Bede Lee Ai Ren Natasha Mevuni Dinethma Mahanama Thin Mon Kyaw Htoo Htoo Kyaw Soe Soe Moe Kazi Majidur Rahaman Mila Nu Nu Htay Faculty of medicine Manipal University College MalaysiaMalaysia Department of Community medicine Faculty of MedicineManipal University College MalaysiaMalaysia Department of medicine Faculty of MedicineManipal University College MalaysiaMalaysia

Objective:To determine the frequency and severity of the breakthrough infections and the associated factors in Malaysia.Methods:This cross-sectional study was conducted among the adult general population in Malaysia who completed at least one dose of vaccination.The validated online questionnaires were used for data collection between December 2022 to February 2023.The participants were recruited by a convenient sampling method.The data were analysed by descriptive statistics,and logistic regression by using SPSS(Version 27).Qualitative data from open-ended questions were analysed as thematic analysis by using RQDA software.Results:A total of 524 participants'data were analyzed and 77.5%of them completed three doses of COVID-19 vaccination.Breakthrough infections after vaccination were reported in 57.3%of the participants.Age group of 18 and 30 years(aOR 2.32,95%CI 1.01-5.32)and other ethnicities(aOR 2.00,95%CI 1.02-3.93)significantly associated with the occurrence of breakthrough infections.A total of 35.5%of the participants were not willing to take another booster dose in the future because of their attitudes towards fear of long-term side effects,lack of trust to the vaccine,less susceptibility to severe infection,belief in natural immunity,and myths.Conclusions:Future public health policies and interventions should be focused on disseminating the information about safety of booster doses of vaccine,management and re-assurance of side effects,and targeted vaccination to the working(younger age group)and ethnic minorities.

关键词： COVID-19 SARS CoV-2 Breakthrough infection Vaccine Malaysia

Tricuspid valve avulsion

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Journal of Geriatric Cardiology 2023年第4期20卷 317-318页

作者： Abhinav Karan Anamarys Blanco Emil Missov Srinivasan Sattiraju Internal medicine University of Florida College of Medicine-JacksonvilleFloridaUSA Department of Cardiology University of Florida College of Medicine-JacksonvilleFloridaUSA

A 71-year-old male with a medical history of sick sinus syndrome with dual-chamber pacemaker system implantation six years prior,and hypertension presented to the emergency department with complaints of generalized ma... 详细信息

关键词： hypertension implantation fever

Analysis of intrahepatic sarcomatoid cholangiocarcinoma:Experience from 11 cases within 17 years

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World Journal of Gastroenterology 2019年第5期25卷 608-621页

作者： Dong Kyun Kim Bo Ra Kim Jin Sook Jeong Yang Hyun Baek Department of Internal medicine Dong-A University College of Medicine Department of Radiology Dong-A University College of Medicine Department of Pathology Dong-A University College of Medicine

BACKGROUND Intrahepatic sarcomatoid chonalgiocarcinoma(s-CCC) is an extremely rare disease, accounting for less than 1% of hepatobiliary system malignancies, and its pathophysiology is not well known. On the hypothesis that its clinical, serologic,or radiologic diagnosis are not fully understood and its prognosis is poor, we investigated the distinguishing features of s-CCC compared with those of intrahepatic bile duct adenocarcinoma [cholangiocellular carcinoma(CCC)] in patients from a single center.AIM To analyze the clinical, serologic, imaging, and histopathologic characteristics of intrahepatic s-CCC patients diagnosed in a single center.METHODS The clinical, serologic, imaging, and histopathologic features of 227 patients diagnosed with intrahepatic cholangiocarcinoma(IHCC) in a single medical center during the last 17 years were analyzed. The characteristics of 11 patients with s-CCC were compared with those of 216 patients with CCC.RESULTS The number of patients with s-CCC who presented fever and abdominal pain and past history of chronic viral hepatitis or liver cirrhosis(LC) was higher than that of patients with CCC. In imaging studies, patients with s-CCC showed relatively aggressive features. However, no clear distinction was observed between s-CCC and CCC based on other clinical, serologic or radiologic examination results. An accurate diagnosis could be made only via a histopathologic examination through immunohistochemical staining. The clinical course of s-CCC was generally aggressive, and patients had a relatively poor prognosis.CONCLUSION In patients with s-CCC, early diagnosis through biopsy and aggressive treatment,including surgical resection, are important.

关键词： Intrahepatic sarcomatoid cholangiocarcinoma Immunohistochemical staining Survival Prognosis Surgical resection

Respiratory questionnaire-based analysis of awareness of COPD in a large multicenter rural population-based study in India

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Chronic Diseases and Translational medicine 2022年第4期8卷 322-330页

作者： Shital Patil Rajesh Patil Mukund Bhise Anil Jadhav Pulmonary medicine MIMSR Medical CollegeVenkatesh Chest HospitalLaturIndia Internal medicine MIMSR Medical CollegeLaturIndia Preventive medicine MIMSR Medical CollegeLaturIndia

Background:Chronic obstructive pulmonary disease(COPD)is a more prevalent chronic lung disease with a significant health burden,and the majority of these cases receive inadequate treatment.Methods:Prospective,observational,interview(questionnaire)based complete workup COPD study,screened 12,000 cases with chronic respiratory symptoms with cough,sputum production,and shortness of breath.A total of 6000 COPD cases were enrolled after the spirometry test.COPD cases were assessed as disease knowledge and methods of treatment offered by applying questionnaires to patients and treating physicians.Results:In the present study,3%of study cases were aware of their COPD illness,54%were not having knowledge about the disease,and 43%cases were not accepting the COPD diagnosis(p<0.0001).A total of 58%of cases received inhalation treatment as levosalbutamol monotherapy in 31%cases,levosalbutamol plus beclometasone in 18%cases,and formoterol plus budesonide or salmeterol plus fluticasone only in 9%of COPD cases(p<0.0001).Total 42%cases received oral treatment as theophylline in 16%cases,salbutamol in 7%cases,oral steroids in 19%cases(p<0.0001).Conclusion:"Doctor–patient–drug trio"discordance clubbed as"difficult doctor,difficult patient,and difficult treatment"is a very crucial issue observed during diagnosis and management of COPD in peripheral settings in India.

关键词： chronic obstructive pulmonary disease difficult doctor inhalation treatment salmeterol fluticasone spirometry

Invasive versus non-invasive hemodynamic monitoring of heart failure patients and their outcomes

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Journal of Geriatric Cardiology 2022年第4期19卷 315-318页

作者： Fadi Kandah Pooja Dhruva Raj Shukla Maedeh Ganji Carlos Palacio Emil Missov Jose Ruiz-Morales Internal medicine University of Florida College of Medicine-JacksonvilleJacksonvilleFloridaUSA Division of Cardiology University of Florida College of Medicine-JacksonvilleJacksonvilleFloridaUSA

Acute decompensated heart failure(HF)is the most common cause of hospital ad-mission in patients older than 65 years.Mean length of hospital stay is about 5-6 days and with a frequent number of hospital readmission rates of 25%to 50%at 30 days and 6-12 months,respect-ively.[1]Treatment options are vast and depend on certain patient characteristics,including hemody-namics,which drive the acute management.A pop-ular modality to assess hemodynamics in acute HF is the right heart catheterization(RHC).While in-vasive,the use of RHC gives providers the oppor-tunity to evaluate values that directly contribute to the management of the patient.These numbers can calculate the cardiac output as well as help establish the underlying etiology of the patient’s symptoms and guide therapy.

关键词： patients acute Acute

Diffusion tensor tractography characteristics of axonal injury in concussion/mild traumatic brain injury

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Neural Regeneration Research 2022年第5期17卷 978-982页

作者： Sung Ho Jang You Sung Seo Department of Physical medicine and Rehabilitation College of MedicineYeungnam UniversityDaeguRepublic of Korea

The main advantage of diffusion tensor tractography is that it allows the entire neural tract to be evaluated.In addition,configurational analysis of reconstructed neural tracts can indicate abnormalities such as tearing,narrowing,or discontinuations,which have been used to identify axonal injury of neural tracts in concussion patients.This review focuses on the characteristic features of axonal injury in concussion or mild traumatic brain injury(m TBI)patients through the use of diffusion tensor tractography.Axonal injury in concussion(m TBI)patients is characterized by their occurrence in long neural tracts and multiple injuries,and these characteristics are common in patients with diffuse axonal injury and in concussion(m TBI)patients with axonal injury.However,the discontinuation of the corticospinal tract is mostly observed in diffuse axonal injury,and partial tearing and narrowing in the subcortical white matter are frequently observed in concussion(m TBI)patients with axonal injury.This difference appears to be attributed to the observation that axonal injury in concussion(m TBI)patients is the result of weaker forces than those producing diffuse axonal injuries.In addition,regarding the fornix,in diffuse axonal injury,discontinuation of the fornical crus has been frequently reported,but in concussion(m TBI)patients,many collateral branches form in the fornix in addition to these findings in many case studies.It is presumed that the impact on the brain in TBI is relatively weaker than that in diffuse axonal injury,and that the formation of collateral branches occurs during the fornix recovery process.Although the occurrence of axonal injury in multiple areas of the brain is an important feature of diffuse axonal injury,case studies in concussion(m TBI)have shown that axonal injury occurs in multiple neural tracts.Because axonal injury lesions in m TBI patients may persist for approximately 10 years after injury onset,the characteristics of axonal injury in concussion(m TBI)patients,which are reviewed and c

关键词： axonal injury brain injury concussion diffusion tensor imaging diffusion tensor tractography mild traumatic brain injury neural tract