Sarcoidosis is a multi-organ inflammatory disorder characterized by the presence of non-caseating granulomas primarily affecting the lungs. The pathogenesis of sarcoidosis has not been fully clarified. In recent years, studies have suggested that a variety of pathogen infections, including Mycobacterium tuberculosis, Propionibacterium acnes, fungi, viruses, may be related to the occurrence and progression of sarcoidosis. This article reviews the researches on sarcoidosis and pathogen infection, aiming to explore the potential role of pathogen infection in the pathogenesis of sarcoidosis and provide another direction for the treatment of sarcoidosis.
Objective To investigate the efficacy and prognostic risk factors of high flow nasal cannula (HFNC) in elderly patients with respiratory failure. Methods Clinical data of 172 elderly patients with respiratory failure admitted to 363 Hospital from April 2020 to August 2022 were retrospectively collected. The patients were divided into an observation group (n=86) and a control group (n=86) according to treatment method. The observation group (54 males, 32 females), mean 68.67±2.36 years old, received HFNC oxygen therapy. The control group (52 males, 34 females), mean 68.12±2.14 years old, received conventional oxygen therapy. According to the prognosis after HFNC treatment, the observation group was subdivided into a poor prognosis group (n=21) and a good prognosis group (n=65). The clinical effects of different treatment methods in the two groups were analyzed, and the risk factors affecting prognosis of elderly patients with respiratory failure treated by HFNC were analyzed by multivariate logistic regression. A line graph model was constructed, and the model was verified by receiver operator characteristic curve and cumulative gain graph. Results Repeated measures ANOVA was conducted on the oxygen therapy indicators of the two groups of patients. The results showed that pH, PaO2, PaCO2, and respiratory rate all have statistical significance in terms of time effect (F=423.25, P<0.001; F=326.25, P<0.001; F=128.79, P<0.001; F=323.16, P<0.001), inter-group effect (F=128.79, P<0.001; F=205.46, P<0.001; F=310.52, P<0.001; F=123.15, P<0.001), and interactive effect (F=111.06, P<0.001; F=198.76, P<0.001; F=134.28, P<0.001; F=112.47, P<0.001). This indicated that the impact of time on pH, PaO2, PaCO2, and respiratory rate differs depending on the treatment method. The scores of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), the level of brain natriuretic peptide (BNP), the heart rate before treatment, the posterior root of tongue fall, the initial HFNC flow and the duration of HFNC in the poor prognosis group were significantly higher than those in the good prognosis group. Initial PaO2/FiO2 was significantly lower than that in the good prognosis group (P<0.05). Multiple factor analysis showed that APACHEⅡ score>17 points, BNP level>150 ng/L before treatment, heart rate >105 times/min before treatment, posterior root of tongue drop, initial HFNC flow>55 L/min, initial PaO2/FiO2<150 mmHg were independent influencing factors for poor prognosis of elderly patients with respiratory failure treated by HFNC. The histogram model showed that the total score of the above 6 indicators is 284, corresponding to a probability of poor prognosis of 71.6%, which proved that the prediction ability of this model is good. Conclusions The application of HFNC in elderly patients with respiratory failure has a significant effect. APACHEⅡ score, BNP level before treatment, heart rate before treatment, posterior root of tongue fall, initial HFNC flow, initial PaO2/FiO2 are all risk factors affecting the prognosis, which should be paid attention to in clinic to improve the therapeutic effect.
Abstract： Objective To investigate the cerebral protective effects of hyperoxia management during deep hypothermia circulatory arrest（DHCA） rabbit by the blood gas indexes, superoxide dismutase（ SOD） activity and malondialdehyde （MDA） levels of brain, and ratio of water to brain. Methods A DHCA and antegrade selective cerebral perfusion （ASCP） rabbit model was established. Twenty-four 11-13 week-old male New Zealand rabbits（ weighing 2.7 to 3.4 kg） were assigned to three groups with a random number table: a sham operation group （Sham group）, an ASCP group （S group）, and an ASCP ＋ hyperoxia management group （SH group）. There were eight rabbits in each group. We recorded the intraoperative values for arterial oxygen pressure （PaO2）, arterial oxygen saturation （SaO2）, jugular venous oxygen pressure（PjvO2）, jugular venous oxygen saturation（ SjvO2） and blood lactate level. The brain SOD activity, MDA levels, and ratio of water to brain were measured after the operation. Results Before initiating circulatory arrest, before initiating reperfusion and five minutes of reperfusion, levels of PaO2 , PjvO2 , and SjvO2 in the SH group were significantly higher than those of the S group and Sham group. SOD activity in the SH group was not significantly different from that of the S group[（213.53±33.52） U/mg. prot vs. （193.02±27.67） U/mg. prot] and Sham group[（213.53±33.52） U/mg. prot vs.（244.38±35.02）U/mg. prot], but the SOD activity in the S group was lower than that in the Sham group（ P ＜ 0.05）. MDA levels in the SH group were lower than that in the S group[（1.42±0.30） nmol/mg. prot vs. （2.37±0.55） nmol/mg. prot, P ＜ 0.05]. Conclusion Our data show that hyperoxia management during DHCA＋ASCP improves rabbits’PjvO2 and SjvO2, maintains brain SOD activity, and decreases brain MDA levels, demonstrating the neuroprotective effects of hyperoxia mangagement.
Objective To review the research progress of promoting the bone formation at early stage by components of the extracellular matrix (ECM). Methods Recent literature concerning the influence of these components on new bone formation and bone/implant contact was extensively reviewed and summarized. Results Coating of titanium or hydroxyapatite implants with organic components of the ECM (such as collagen type I, chondroitin sulfate, and Arg-Gly-Asp peptide) offers great potential to improve new bone formation and enhance bone/implant contact, which in turn will shorten recovery time and improve implant stability. Conclusion The increasing knowledge about the role of the ECM for recruitment, proliferation, differentiation of cells, and regeneration of tissue will eventually deal to the creating of an artificial ECM on the implant that could allow a defined adjustment of the required properties to support the healing process.
ObjectiveTo observe the morphological characteristic by implanting domestic porous tantalum in rabbit patellar tendon and to evaluate biocompatibility features so as to provide experimental basis for porous tantalum used as interface fixation between tendon and bone. MethodsA total of 48 adult New Zealand white rabbits, male or female, weighing 2.5-3.0 kg, were selected. Porous tantalum flake (5 mm×5 mm×2 mm) was implanted in the left patellar tendon (experimental group) and the same size porous titanium flake in the right patellar tendon (control group). The animals were sacrificed at 2, 4, 8, and 12 weeks after implantation, then the specimens were harvested for gross observation, HE staining, scanning electron microscope (SEM) observation, and hard slices observation. ResultsNo animal died after operation. Porous tantalum was bonded closely with host tendon and no inflammatory reaction was found. Loose and thick fibrous capsule was observed at the beginning and became density and thinner in the end by microscope, showing significant difference between different time points in 2 groups (P<0.05), but no significant difference was found between 2 groups at different time points (P>0.05). The SEM observation showed that fibrous tissue attached to the surface and inner walls of porous tantalum at early stage, and extended on the material to reach confluence at late period, but the experimental group was more than the control group. Hard slices observation showed that the collagen fibrils were seen on porous tantalum interface with host tendon, and blood vessels grew into the pores. The control group and the experimental group showed no significant difference. ConclusionThe domestic porous tantalum has good biocompatibility. Connection and integration can be established between tendon and porous tantalum, and therefore it could be used in reconstruction of tendon-bone fixation device.
ObjectiveThe antibacterial properties of porous medical implant materials were reviewed to provide guidance for further improvement of new medical implant materials.MethodsThe literature related to the antibacterial properties of porous medical implant materials in recent years was consulted, and the classification, characteristics and applications, and antibacterial methods of porous medical implant materials were reviewed.ResultsPorous medical implant materials can be classified according to surface pore size, preparation process, degree of degradation in vivo, and material source. It is widely used in the medical field due to its good biocompatibility and biomechanical properties. Nevertheless, the antibacterial properties of porous medical implant materials themselves are not obvious, and their antibacterial properties need to be improved through structural modification, overall modification, and coating modification.ConclusionAt present, coating modification as the mainstream modification method for improving the antibacterial properties of porous medical materials is still a research hotspot. The introduction of new antibacterial substances provides a new perspective for the development of new coated porous medical implant materials, so that the porous medical implant materials have a more reliable antibacterial effect while taking into account biocompatibility.
Objective To investigate the correlation between glycosylated hemoglobin A1c (HbA1c) and severity of coronary artery lesions in young men with acute myocardial infarction (AMI). Methods Total 278 young men with AMI less than 45 years old were retrospectively studied, and all of them were admitted to hospital from January 2009 to December 2011, and had undergone coronary angiography. According to the results of coronary angiography, the patients were divided into three groups based on the number of artery lesions: the single group (156 cases), the double group (64 cases) and the triple group (58 cases). The relationship between the severity of coronary artery lesions and the following factors were observed: HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum uric acid (UA), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), smoking history, drinking history and family history of early coronary artery disease. Results a) HbA1c levels were gradually raised in all the three groups, but the single group (6.39±1.67%) was significantly lower than the double group (6.91±1.63%) and the triple group (7.41±2.12%), with significant differences (Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in both the ST-segment elevation AMI (6.42±1.68% vs. 7.17±1.86%, Plt;0.05) and the non-ST-segment AMI (5.57±0.37% vs. 8.56±2.83%, Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in patients with diabetes millitus (8.31±1.83% vs. 8.59±2.02%, Plt;0.05) and in patients without diabetes millitus (5.56±0.33% vs. 5.74±0.37%, Plt;0.05); b) There were significant differences in SBP, TC, HDL-C, LDL-C and drinking history between the single group and the other two groups (all Plt;0.05), and there were significant differences in DBP and TG between the single group and the double group (all Plt;0.05); and c) The results of logistic regression analysis showed that, LDL-C (OR=1.790), HbA1c (OR=1.287) and SBP (OR=1.042) were the independent risk factors (all Plt;0.05) for multiple lesions in coronary arteries of young men with AMI. Conclusion Glycosylated hemoglobin A1c is an independent risk factor for multiple lesions in coronary arteries of young men with AMI.