PurposeTo investigate the safety and effectiveness of primary conservative therapy for patients with symptomatic isolated mesenteric artery dissection (IMAD) with a severely compressed true lumen and/or a large dissecting aneurysm.Materials and MethodsA total of 35 consecutive patients (all men; median age, 53 y) with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture who were treated with primary conservative therapy between November 2018 and February 2020 were assessed. A severely compressed true lumen was defined as luminal stenosis > 70%. A large dissecting aneurysm was defined as dissecting aneurysm diameter ≥ 1.5 times larger than the normal mesenteric artery diameter.ResultsThere was a strong positive relationship among abdominal pain, degree of luminal stenosis, and length of dissection (R = 0.811; P < .001). Conservative treatment was successful in all patients. Abdominal pain was eliminated within 4.7 d ± 4.8 (range, 2–31 d) in all patients, within 3.6 d ± 1.2 (range, 2–6) in the 31 patients with minor or moderate abdominal pain, and within 13.3 d ± 11.9 (range, 6–31 d) in the 4 patients with severe abdominal pain. Complete or partial remodeling of the mesenteric artery was achieved in 6 (17.1%) and 29 (82.9%) patients, respectively, during 8.6 mo ± 4.3 of follow-up.ConclusionsPrimary conservative therapy can be used safely and effectively in patients with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture. 相似文献
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which has spread worldwide since it was first identified in Wuhan, China, at the end of 2019. With the global transmission of the virus, a large number of SARS-CoV-2 variants have also appeared, especially, emerging strains that have recently been discovered in the United Kingdom (variant 20I/501Y.V1, lineage B.1.1.7), South Africa (variant 20H/501Y.V2, lineage B.1.351), and Brazil (variant 20 J/501Y.V3, and lineage P.1). The common feature of these variants is that they share the N501Y mutation involving the SARS-CoV-2 spike (S) protein, which is precisely the target of most COVID-19 vaccines. Furthermore, mutations such as N501Y, E484K, and K417N in the S protein may affect viral fitness and transmissibility. However, current research on the impact of these variants on COVID-19 vaccines is still lacking. Herein, we briefly explain why most COVID-19 vaccines target the S protein, update the progress of research regarding S protein-related COVID-19 vaccines, review the latest studies concerning the effects of S protein variants on COVID-19 vaccines, and finally, propose certain strategies to deal with SARS-CoV-2 variants. 相似文献
Introduction:Exercise has been believed to have positive effects on blood glucose control in patients with type 2 diabetes mellitus. However, few medical evidences have been found to ascertain which type of exercise has the best effect on blood glucose control in diabetes and which type of exercise is more acceptable. The purpose of this study is to compare the effects and acceptability of different exercise modes on glycemic control in type 2 diabetes patients by using systematic review and network meta-analysis.Methods and analysis:Relevant randomized controlled trial studies will be searched from PubMed, EMbase, CochraneCENTRAL, CNKI, VIP, and Chinese medical paper libraries. Primary outcome indicators: glycosylated hemoglobin and dropout rate of the research (number of dropouts/numbers of initially enrolled subjects). Secondary outcome measures: fasting blood glucose, body weight, total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol, triglycerides (TG), diastolic pressure, systolic pressure (SBP). Two reviewers are arranged to screen Title, Abstract, and then review full text to further extract data. Standard meta-analysis and network meta-analysis of the data are performed afterward. Methodological quality assessment is planned to be conducted using Cochrane risk of bias tool. The outcome will be analyzed statistically according to Bayesian analysis methods. After that, subgroup analysis is conducted on the duration of intervention, whether there is supervision of intervention, frequency of intervention per week, age, gender, and medication use.Trial registration number:PROSPERO CRD42020175181Discussion:The systematic review and network meta-analysis include evidence of the impact of different exercise modes on blood glucose control in type 2 diabetes mellitus. There are 2 innovative points in this study. One is to conduct a classified study on exercise in as much detail as possible, and the other is to study the acceptability of different exercise modes. The network meta-analysis will reduce the uncertainty of intervention and enable clinicians, sports practitioners, and patients to choose more effective and suitable exercise methods.Ethics and dissemination:The findings of the study will be disseminated through publications in peer-reviewed journals and scientific conferences and symposia. Further, no ethical approval is required in this study. 相似文献
Objective To explore the mechanism of Pi(Spleen)-deficiency-induced functional diarrhea(FD)model rats treated by Shenling Baizhu Powder(参苓白术散,SBP).Methods Thirty male Sprague-Dawley rats were randomly divided into 5 groups including control,model,low-,medium-,and high-dose SBP groups(SBPLDG,SBPMDG,SBPHDG),6 rats in each group,respectively.Pi-deficiency-induced FD rats model was developed through Radix et Rhizoma Rhei gavage for 7 days.After modeling,the rats were treated with 3 doses of SBP[0.93,1.86,and 3.72 g/(kg·d)],and the rats in the control and model groups were given pure water for 7 days.The diarrhea index was calculated.On the 7th and 14th days,the traveled distance of rat was measured by the open field test.Serum D-xylose content was determined by the phloroglucinol method and interleukin(IL)-10 and IL-17 levels were measured using an enzyme-linked immunosorbent assay kit.The content of Treg cells was determined by flow cytometry.Results Compared with the control group,the diarrhea index and IL-17 level in the model group were significantly higher and the total exercise distance and D-xylose content significantly decreased(P>0.05).The expression of IL-10 in the SBPHDG group was significantly up-regulated,and serum D-xylose level and Treg cells increased significantly compared with the model group(P>0.05).Conclusion High-dose SBP exhibited ameliorating effects against Pi-deficiency induced FD,which might be attributed to its modulations on intestinal absorption function as well as adaptive immunity in mesenteric lymph nodes of rat. 相似文献
Purpose: We previously developed a novel cryo-thermal therapy to treat malignant mammary carcinoma and melanoma in a mouse model; long-term survival and CD4+ T cell orchestrating anti-tumor immune memory response were achieved. Moreover, cryo-thermal-induced CD4+ T cell differentiation into Th1 and CD4+CTL sub-lineages, in which M1 macrophage polarization played a direct, important role. In particular, cryo-thermal therapy triggered M1 macrophage polarization with up-regulated expression of C–X–C motif ligand 10 (CXCL10) and Interleukin 6 (IL-6). But whether CXCL10 and IL-6 contribute to CD4+ T cell-mediated anti-tumor immunity remains unclear. In this study, the role of cryo-thermal-induced CXCL10 and IL-6 in anti-tumor immunity was determined.
Methods: The level of CXCL10 and IL-6 in spleen and serum was determined by RT-PCR and ELISA on day 14 after cryo-thermal therapy. Splenic dendritic cells (DCs) and macrophages were isolated from cryo-thermal-treated mice on day 5 and 14, and the level of CXCL10 and IL-6 in macrophages and DCs was determined by ELISA. The transwell migration assay was performed to study immune cell migration. In vivo neutralization of CXCL10 or IL-6 was performed to investigate the phenotypic changes of immune cells.
Results: Cryo-thermal therapy induced M1 macrophage polarization with up-regulation of CXCL10 and IL-6 expression in spleen. CXCL10 and IL-6 promoted DCs migration and maturation, and subsequently promoted CD4+ T cell migration and differentiation into Th1 and CD4+ CTL, moreover, reduced myeloid-derived suppressor cells (MDSCs) accumulation.
Conclusions: Cryo-thermal-induced CXCL10 and IL-6 created acute inflammatory environment to initiate a systemically cascading innate and adaptive anti-tumor immunity, which was more permissive for tumor eradication. 相似文献