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Secretory Phenotype in Peripheral Blood Mononuclear Cells of Elderly Patients with Rheumatoid Arthritis. 类风湿性关节炎老年患者 PBMC 的分泌表型。
Pub Date : 2024-08-01 Epub Date: 2024-06-26 DOI: 10.1089/rej.2024.0008
Wenlong Wang, Yanjuan Chen, Yidi Shen, Jian Chen, Xiaoyang Yao, Yongjun Cheng, Jinzhong Xu, Lisha Ma, Yong Chen, Chuanfu Zhang

This study aims to investigate the expression differences of peripheral blood mononuclear cells (PBMCs) in patients with elderly rheumatoid arthritis (ERA). Differentially expressed genes (DEGs) of PBMCs between young patients with RA (RA_Y) and elderly patients with RA (RA_A) were identified by RNA sequencing using the DESeq2 package, followed by bioinformatics analysis. The overlapped targets of the current DEGs and proteomic differentially expressed proteins (another set of unpublished data) were identified and further validated. The bioinformatics analysis revealed significant transcriptomic heterogeneity between RA_A and RA_Y. A total of 348 upregulated and 363 downregulated DEGs were identified. Gene functional enrichment analysis indicated that the DEGs, which represented senescence phenotype for patients with ERA, were enriched in pathways such as Phosphatidylinositol3 kinase/AKT serine-threonine protein kinase (PI3K/Akt) signaling, Mitogen-activated protein kinases (MAPK) signaling, toll-like receptor family, neutrophil degranulation, and immune-related pathways. Gene set enrichment analysis further confirmed the activation of humoral immune response pathways in RA_A. Quantitative polymerase chain reaction validated the expression of five representative DEGs such as SPTA1, SPTB, VNN1, TNXB, and KRT1 in PBMCs of patients with ERA. Patients with ERA have significant senescence phenotype differences versus the young patients. The DEGs identified may facilitate exploring the biomarkers of senescence in RA.

简介:目的:研究老年类风湿关节炎(ERA)患者外周血单核细胞(PBMC)的表达差异:研究老年类风湿性关节炎(ERA)患者外周血单核细胞(PBMCs)的表达差异:方法:使用 DESeq2 软件包通过 RNA-seq 鉴定年轻类风湿关节炎患者(RA_Y)和老年类风湿关节炎患者(RA_A)外周血单核细胞的差异表达基因(DEGs),然后进行生物信息学分析。对当前 DEGs 和蛋白质组差异表达蛋白(另一组未发表数据)的重叠靶标进行了鉴定和进一步验证:生物信息学分析显示 RA_A 和 RA_Y 之间存在显著的转录组异质性。共鉴定出 348 个上调 DEGs 和 363 个下调 DEGs。基因功能富集分析表明,代表ERA患者衰老表型的DEGs富集在PI3K-Akt信号、MAPK信号、toll样受体家族、中性粒细胞脱颗粒和免疫相关通路中。GSEA分析进一步证实了RA_A中体液免疫反应通路的激活。qPCR验证了ERA患者PBMCs中SPTA1、SPTB、VNN1、TNXB和KRT1等5个代表性DEGs的表达:结论:ERA 患者的衰老表型与年轻患者有明显差异。结论:ERA 患者的衰老表型与年轻患者存在明显差异,所发现的 DEGs 有助于探索 RA 中衰老的生物标志物。
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引用次数: 0
Effects of Dexmedetomidine Added to Ropivacaine in Ultrasound-Guided Continuous Pericapsular Nerve Group Block Among Elderly Patients Undergoing Total Hip Arthroplasty. 在接受全髋关节置换术的老年患者中,超声引导下连续性囊周神经组阻滞中加入右美托咪定的效果。
Pub Date : 2024-08-01 Epub Date: 2024-05-13 DOI: 10.1089/rej.2024.0014
Xia Li, Liang Chen, Yunyun Sun, Yuanhai Li

Total hip arthroplasty (THA) is a highly effective intervention for addressing hip joint issues, yet managing perioperative pain remains a significant challenge. In this study, we aimed to investigate the impact of supplementing ropivacaine with dexmedetomidine in ultrasound-guided continuous pericapsular nerve group block (PENGB) among elderly patients undergoing THA. We conducted a retrospective analysis involving 112 elderly patients who underwent THA. These patients were divided into two groups: the Control group, receiving ropivacaine alone, and the DEX group, receiving ropivacaine combined with dexmedetomidine. We evaluated various parameters including hemodynamic data, postoperative pain levels assessed using the Visual Analog Scale, cognitive status measured with the Montreal Cognitive Assessment, and serum markers (S100β and GFAP). Our findings revealed that the DEX group exhibited improved stability in blood pressure and oxygen saturation following surgery. Moreover, patients in the DEX group reported significantly lower levels of pain at 6 and 12 hours postsurgery, with a prolonged duration of pain relief. Furthermore, dexmedetomidine administration was associated with preserved cognitive function during the early postoperative period. Analysis of serum markers suggested potential cognitive protection conferred by the addition of dexmedetomidine. Overall, our study underscores the multifaceted benefits of incorporating dexmedetomidine into ropivacaine-based PENGB for elderly THA patients.

全髋关节置换术(THA)是解决髋关节问题的一种非常有效的干预措施,但围术期疼痛的管理仍然是一项重大挑战。在这项研究中,我们旨在调查在超声引导下连续性囊周神经组阻滞(PENGB)中使用右美托咪定辅助罗哌卡因对接受全髋关节置换术的老年患者的影响。我们对 112 名接受 THA 手术的老年患者进行了回顾性分析。这些患者被分为两组:对照组(仅接受罗哌卡因)和 DEX 组(接受罗哌卡因联合右美托咪定)。我们评估了各种参数,包括血液动力学数据、使用视觉模拟量表(VAS)评估的术后疼痛程度、使用蒙特利尔认知评估(MoCA)测量的认知状态以及血清标记物(S100β 和 GFAP)。我们的研究结果显示,DEX 组患者术后血压和血氧饱和度的稳定性有所改善。此外,右美托咪定组患者在术后 6 小时和 12 小时的疼痛程度明显降低,疼痛缓解时间延长。此外,右美托咪定与术后早期认知功能的保护有关。对血清标志物的分析表明,加入右美托咪定可保护认知功能。总之,我们的研究强调了在基于罗哌卡因的 PENGB 中加入右美托咪定对老年 THA 患者的多方面益处。
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引用次数: 0
Differential Responses of Young and Old Erythrocytes Stored with Vitamin C and Vitamin E in Additive Solution-7. 用维生素 C 和维生素 E 在 AS-7 中储存的新老红细胞的不同反应
Pub Date : 2024-07-05 DOI: 10.1089/rej.2024.0033
Masannagari Pallavi, Vani Rajashekaraiah

Oxidative stress (OS) causes biochemical and morphological alterations in erythrocytes. The primary factors contributing to OS are aging and storage. Antioxidants significantly alleviate OS. Therefore, this study aimed to investigate the response of young and old erythrocytes to vitamin C and vitamin E during storage. Erythrocytes were separated into young and old by the Percoll method. Each erythrocyte subpopulation was categorized into the i) Control (additive solution-7 [AS-7]) and ii) vitamin C and vitamin E in AS-7 (VC+VE) groups and stored for 21 days at 4°C. OS, antioxidant, and aging markers were analyzed on days 1, 14, and 21. The activity of antioxidant enzymes was similar throughout storage in young cells. However, superoxide dismutase activity elevated in old cells (Control and VC+VE) on days 1 and 21. Catalase (CAT) activity increased on days 14 and 21, whereas glutathione peroxidase (GPX) increased on days 1 and 14 in old Controls. However, in old VC+VE, CAT increased on day 21 and GPX increased on day 1. Advanced oxidation protein products, superoxides, glutathione, and uric acid increased in old cells throughout storage. Malondialdehyde decreased in old VC+VE compared with old Control on days 14 and 21. Sialic acids and glutamate oxaloacetate transaminase activity were higher in young cells compared to old cells. Young cells exhibited lower oxidative changes throughout storage. Vitamin C and vitamin E were effective in maintaining the redox balance in old cells. These findings emphasize the need for specific approaches for different subpopulations during erythrocyte banking.

氧化应激会导致红细胞的生化和形态发生改变。导致氧化应激的主要因素是衰老和储存。抗氧化剂能明显缓解氧化应激。因此,本研究旨在调查年轻和年老红细胞在储存过程中对维生素 C 和维生素 E 的反应。采用 Percoll 法将红细胞分为年轻红细胞和年老红细胞。每个红细胞亚群被分为 i) 对照组[添加剂溶液-7(AS-7)]和 ii) VC+VE 组[AS-7 中的维生素 C 和维生素 E],并在 4˚C 下储存 21 天。在第 1、14 和 21 天分析氧化应激、抗氧化和衰老指标。在整个储存过程中,Young 细胞中抗氧化酶的活性相似。然而,老细胞(对照组和 VC+VE)的超氧化物歧化酶活性在第 1 天和第 21 天升高。过氧化氢酶的活性在第 14 天和第 21 天升高,而谷胱甘肽过氧化物酶在第 1 天和第 14 天升高。然而,在旧 VC+VE 中,过氧化氢酶在第 21 天增加,谷胱甘肽过氧化物酶在第 1 天增加。在整个储存过程中,老细胞中的高级氧化蛋白产物、超氧化物、谷胱甘肽和尿酸都有所增加。与老对照组相比,老 VC+VE 中的丙二醛分别在第 14 天和第 21 天减少。与老细胞相比,年轻细胞中的唾液酸和谷氨酸草酰乙酸转氨酶活性更高。在整个储存过程中,年轻细胞的氧化变化较小。维生素 C 和维生素 E 能有效维持老细胞的氧化还原平衡。这些发现强调了在红细胞储藏过程中针对不同亚群采取特定方法的必要性。
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引用次数: 0
Clinical Relevance of Plasma Lactic Acid in the Onset and Prognosis of Sudden Deafness. 血浆乳酸在突发性耳聋发病和预后中的临床意义。
Pub Date : 2024-06-01 Epub Date: 2024-04-09 DOI: 10.1089/rej.2023.0071
Ling Wang

Sudden deafness poses a significant threat to patients' quality of life, yet effective indicators for evaluating its onset and prognosis remain elusive. The inner ear is primarily supplied by the labyrinthine artery, which lacks collateral circulation. Changes in coagulation function and hemorheology can cause spasm or thrombosis of the labyrinthine artery, leading to ischemia, hypoxia, and microcirculation disorders in the inner ear, ultimately resulting in sudden deafness. This retrospective study examined 196 patients with sudden deafness, utilizing the 2015 Chinese guideline for diagnosis and treatment classification. Coagulation system analysis used the STA-R Evolution automatic coagulation analyzer, measuring activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIB). Plasma lactate concentration was determined using a Johnson and Johnson Fusion 5.1 model plasma lactate detector. Results of the study revealed a correlation between the degree of hearing loss and disease prognosis. Patients with higher grade hearing loss exhibited elevated plasma lactate levels upon admission compared with those with lower grade hearing loss. Importantly, elevated plasma lactate levels at admission served as predictive indicators for treatment outcomes. In addition, patients with ineffective treatment demonstrated a more coagulable blood state, as evidenced by the lower APTT (ineffective treatment: 31.47 ± 4.55 seconds, effective treatment: 35.17 ± 5.38 seconds) and PT on admission, but higher plasma FIB. In conclusion, plasma lactate levels upon admission hold promise as prognostic markers for sudden deafness treatment outcomes, providing valuable insights for clinical management.

突发性耳聋对患者的生活质量构成重大威胁,但评估其发病和预后的有效指标却仍然难以确定。内耳主要由缺乏侧支循环的迷走神经动脉供血。凝血功能和血液流变学的变化可引起迷走神经动脉痉挛或血栓形成,导致内耳缺血、缺氧和微循环障碍,最终导致突发性耳聋。这项回顾性研究采用《2015 年中国突发性耳聋诊断与治疗分类指南》,对 196 名突发性耳聋患者进行了检查。凝血系统分析采用 STA-R Evolution 自动凝血分析仪,测量活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和纤维蛋白原(FIB)。使用强生 Fusion 5.1 型血浆乳酸检测仪测定血浆乳酸浓度。研究结果显示,听力损失程度与疾病预后之间存在相关性。与听力损失程度较轻的患者相比,听力损失程度较高的患者入院时血浆乳酸水平较高。重要的是,入院时血浆乳酸水平升高是治疗结果的预测指标。此外,治疗无效的患者表现出更易凝血的状态,入院时较低的 APTT(治疗无效:31.47±4.55 秒,治疗有效:35.17±5.38 秒)和 PT 以及较高的血浆 FIB 都证明了这一点。总之,入院时的血浆乳酸水平有望成为突发性耳聋治疗效果的预后指标,为临床管理提供有价值的见解。
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引用次数: 0
Corydalis ternata Nakai Alleviates Cognitive Decline in Alzheimer's Disease by Reducing β-Amyloid and Neuroinflammation. Corydalis ternata Nakai通过减少β-淀粉样蛋白和神经炎症缓解阿尔茨海默病的认知能力下降。
Pub Date : 2024-06-01 Epub Date: 2024-04-24 DOI: 10.1089/rej.2023.0069
Bomi Lee, Myeong-Sang Yu, Jae Gwang Song, Hyang-Mi Lee, Hyung Wook Kim, Dokyun Na

Recently, natural herbs have gained increasing attention owing to their comparatively low toxicity levels and the abundance of historical medical documentation regarding their use. Nevertheless, owing to a lack of knowledge regarding these herbs and their compounds, attempts to find those that could be beneficial for treating diseases have often been ad hoc; thus, there is now a growing demand for an in silico method to identify beneficial herbs. In this study, we present a computational approach for identifying natural herbs specifically effective in treating cognitive decline in Alzheimer's disease (AD) sufferers, which analyzes the similarities between herbal compounds and known drugs targeting AD-related proteins. Our in silico method suggests that Corydalis ternata can improve cognitive decline in AD sufferers. Behavioral tests with an AD mouse model for the confirmation of the in silico prediction reveals that C. ternata significantly alleviated the cognitive decline (memory and motor functions) caused by neurodegeneration. Further pathology analyses reveal that C. ternata decreases the level of Aβ plaques, reduces neuroinflammation, and promotes autophagy flux, and thus C. ternata can be clinically effective for preventing mild cognitive impairment during the early stages of AD. These findings highlight the potential utility of our in silico method and the potential clinical application of the identified natural herb in treating and preventing AD.

近来,天然草药因其相对较低的毒性水平和大量有关其用途的历史医学文献而受到越来越多的关注。然而,由于缺乏对这些草药及其化合物的了解,寻找有益于治疗疾病的草药的尝试往往是临时性的;因此,现在人们越来越需要一种硅学方法来识别有益的草药。在这项研究中,我们提出了一种计算方法,通过分析草药化合物与已知的针对注意力缺失症相关蛋白的药物之间的相似性,来确定对治疗注意力缺失症患者认知能力下降特别有效的天然草药。我们的硅学方法表明,C. ternata能改善AD患者的认知能力衰退。为了证实我们的硅学预测,我们用一种注意力缺失症小鼠模型进行了行为测试,结果表明 C. ternata 能明显缓解神经变性引起的认知能力下降(记忆和运动功能)。进一步的病理分析表明,蛇床子素能降低Aβ斑块的水平,减少神经炎症,促进自噬通量,因此蛇床子素在临床上可有效预防AD早期阶段的轻度认知障碍。这些发现凸显了我们的硅学方法的潜在效用,以及所发现的天然草药在治疗和预防AD方面的潜在临床应用。
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引用次数: 0
Aprepitant alleviates post-stroke pneumonia in a mouse model of middle cerebral artery occlusion. 阿瑞匹坦可减轻大脑中动脉闭塞小鼠模型卒中后肺炎。
Pub Date : 2024-04-26 DOI: 10.1089/rej.2024.0011
Zhihui Xie, Minghui Xin, Fatao Yu, Xiaolin Zhu
Elevated substance P can be utilized to predict early mortality during the first week of cerebral infarction. Whether Aprepitant, a substance P receptor blocker, could be utilized to alleviate post-stroke pneumonia is investigated in this study. Intraluminal monofilament model of middle cerebral artery occlusion (MCAO) was constructed in C57BL/6J male mice, and the relative expression of substance P was detected in collected bronchoalveolar lavage fluid (BALF) and lung tissue homogenate at 24 h, 48 h, and 72 h post-stroke. On the other hand, different concentrations of aprepitant (0.5, 1, 2 mg/kg) were atomized and inhaled into MCAO mice. Inflammation cytokines and bacterial load were detected in collected BALF and lung tissue homogenate at 72-h post-stroke, and lung injury was revealed by histological examination. Aprepitant administration decreased total proteins, total cells, neutrophils, and macrophages in BALF. The concentrations of interleukin (IL)-6, IL-1β, tumor necrosis factor-α, interferon γ, monocyte chemoattractant protein-1, and IL-10 in lung tissue homogenates were also diminished by the administration of aprepitant. In conclusion, aprepitant could attenuate post-stroke pneumonia in mice suggesting its potential therapeutic use in the clinic.
物质 P 升高可用于预测脑梗塞第一周的早期死亡率。本研究探讨了是否可以利用物质 P 受体阻断剂阿普瑞坦来缓解卒中后肺炎。本研究以 C57BL/6J 雄性小鼠为对象,构建了大脑中动脉闭塞(MCAO)的腔内单丝模型,并检测了卒中后 24 h、48 h 和 72 h 采集的支气管肺泡灌洗液(BALF)和肺组织匀浆中 P 物质的相对表达。另一方面,将不同浓度的阿普瑞坦(0.5、1、2 毫克/千克)雾化并吸入 MCAO 小鼠体内。中风后72小时,在收集的BALF和肺组织匀浆中检测到炎症细胞因子和细菌负荷,组织学检查显示肺损伤。服用阿瑞匹坦可减少 BALF 中的总蛋白、总细胞、中性粒细胞和巨噬细胞。阿瑞匹坦还能降低肺组织匀浆中白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α、干扰素γ、单核细胞趋化蛋白-1和IL-10的浓度。总之,阿瑞匹坦可减轻小鼠卒中后肺炎,这表明它有可能用于临床治疗。
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引用次数: 0
Platelet Factor 4 and longevity of patients with essential thromobocythaemia: an example of Antagonistic Pathogenic Pleiotropy (APaP). 血小板因子 4 与重症血栓闭塞性脉管炎患者的寿命:拮抗致病性多态性 (APaP) 的一个实例。
Pub Date : 2024-04-06 DOI: 10.1089/rej.2023.0066
William Bains
This paper presents the concept of Antagonistic Pathogenic Pleiotropy (APaP), in which an abnormality that causes a specific pathology can simultaneously reduce other morbidities through unrelated mechanisms, resulting in the pathology causing less morbidity or mortality than expected. The concept is illustrated by the case of Essential Thrombocythaemia (ET). ET patients have substantially elevated platelets, and are therefore expected to have increased thrombotic events leading to reduced life expectancy. However ET patients do not have reduced life expectancy. A possible explanation is that elevated platelets produce higher levels of Platelet Factor 4 (PF4), which has been found to reduce age-associated decline in immune and cognitive function in mice, and has been suggested as a treatment for age-associated illness. The benefit of elevated PF4 is hypothesised to balance the increased morbidity from hematological causes. Searches for other indications where a well-defined pathology is not associated with concomitant reduction in overall mortality may be a route to identifying factors that could protect against, prevent or treat chronic disease.
本文提出了拮抗致病多效性(APaP)的概念,即导致特定病理的异常现象可同时通过不相关的机制降低其他发病率,从而使病理导致的发病率或死亡率低于预期。基本血栓性血小板增多症(ET)的病例说明了这一概念。ET 患者的血小板大幅升高,因此预计血栓事件会增加,导致预期寿命缩短。然而,ET 患者的预期寿命并没有缩短。一种可能的解释是,升高的血小板会产生更高水平的血小板因子 4(PF4),研究发现,PF4 可减少小鼠因年龄增长而导致的免疫和认知功能下降,并被建议用于治疗与年龄相关的疾病。据推测,PF4 升高所带来的益处可以平衡因血液病而增加的发病率。在其他适应症中,明确定义的病理学与总死亡率的降低并不相关,寻找这些适应症可能是确定可防止、预防或治疗慢性疾病的因素的一条途径。
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引用次数: 0
Pharmacodynamics and Mechanism of Astragali Radix and Anemarrhenae Rhizoma in Treating Chronic Heart Failure by Inhibiting Complement Activation. 黄芪和知母通过抑制补体激活治疗慢性心力衰竭的药效学和机制
Pub Date : 2024-04-01 DOI: 10.1089/rej.2023.0068
Qi Dai, Shi Zhao, Weihong Li, Kedi Liu, Xingru Tao, Chengzhao Liu, Hong Yao, Fei Mu, Sha Chen, Jing Li, Peifeng Wei, Feng Gao, Miaomiao Xi

Astragali radix (AR) and anemarrhenae rhizoma (AAR) are used clinically in Chinese medicine for the treatment of chronic heart failure (CHF), but the exact therapeutic mechanism is unclear. In this study, a total of 60 male C57BL/6 mice were divided into 5 groups, namely sham, model, AR, AAR, and AR-AAR. In the sham group, the chest was opened without ligation. In the other groups, the chest was opened and the transverse aorta was ligated to construct the transverse aortic constriction model. After 8 weeks of feeding, mice were given medicines by gavage for 4 weeks. Left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were detected by echocardiography. Heart weight index (HWI) and wheat germ agglutinin staining were used to evaluate cardiac hypertrophy. Hematoxylin-eosin staining was used to observe the pathological morphology of myocardial tissue. Masson staining was used to evaluate myocardial fibrosis. The content of serum brain natriuretic peptide (BNP) was detected by enzyme-linked immunosorbent assay kit. The content of serum immunoglobulin G (IgG) was detected by immunoturbidimetry. The mechanism of AR-AAR in the treatment of CHF was explored by proteomics. Western blot was used to detect the protein expressions of complement component 1s (C1s), complement component 9 (C9), and terminal complement complex 5b-9 (C5b-9). The results show that AR-AAR inhibits the expression of complement proteins C1s, C9, and C5b-9 by inhibiting the production of IgG antibodies from B cell activation, which further inhibits the complement activation, attenuates myocardial fibrosis, reduces HWI and cardiomyocyte cross-sectional area, improves cardiomyocyte injury, reduces serum BNP release, elevates LVEF and LVFS, improves cardiac function, and exerts myocardial protection.

黄芪(AR)和知母(AAR)在中医临床上被用于治疗慢性心力衰竭(CHF),但确切的治疗机制尚不清楚。本研究将 60 只雄性 C57BL/6 小鼠分为 6 组,分别为 Sham 组、Model 组、AR 组、AAR 组和 AR-AAR 组。Sham 组小鼠只开胸、不结扎。其他组小鼠开胸并结扎横向主动脉,构建横向主动脉收缩(TAC)模型。小鼠饲养八周后,灌胃给药四周。通过超声心动图检测左室射血分数(LVEF)和左室缩短分数(LVFS)。心脏重量指数(HWI)和小麦胚芽凝集素(WGA)染色用于评估心脏肥大。苏木精-伊红(HE)染色用于观察心肌组织的病理形态。马森染色用于评估心肌纤维化。用酶联免疫吸附试剂盒检测血清中脑钠肽(BNP)的含量。用免疫比浊法检测血清免疫球蛋白 G(IgG)的含量。通过蛋白质组学探讨了 AR-AAR 治疗 CHF 的机制。采用 Western 印迹法检测补体成分 1s(C1s)、补体成分 9(C9)和末端补体复合物 5b-9(C5b-9)的蛋白表达。结果表明,AR-AAR通过抑制B细胞活化产生的IgG抗体来抑制补体蛋白C1s、C9和C5b-9的表达,从而进一步抑制补体活化,减轻心肌纤维化,降低HWI和心肌细胞横截面积,改善心肌细胞损伤,减少血清BNP释放,提高LVEF和LVFS,改善心功能,发挥心肌保护作用。
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引用次数: 0
Rejuvenation Research Is 20 Years Old! 年轻化研究已有 20 年历史!
Pub Date : 2024-04-01 DOI: 10.1089/rej.2024.29011.editorial
Aubrey de Grey, Irina Conboy
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引用次数: 0
The Association Between Multidimensional Frailty and Poor Venous Accesses in a Geriatric Population: A Retrospective Study. 老年群体多维度虚弱与静脉通路不畅之间的关联:一项回顾性研究。
Pub Date : 2024-04-01 DOI: 10.1089/rej.2023.0054
Davide Mariani, Francesco Saverio Ragusa, Martina Alongi, Elisabetta Gugliuzza, Giorgia Petta, Alessandra Luca, Giuseppe Bianco, Anna Maria Marfisi, Diego Lalicata, Antonio Cambiano, Alessandro D'Aleo, Francesca Tantillo, Elisabetta Vaccaro, Nicola Veronese, Mario Barbagallo

Since the association between frailty and difficulty in finding venous access (VA) is largely unexplored and unclear in geriatrics, the aim of this study is to demonstrate how multidimensional frailty is associated with bad VA in a population of older hospitalized people. Multidimensional Prognostic Index (MPI), based on eight different domains usually assessed in comprehensive geriatric assessment, was used for identifying multidimensional frailty; VA heritage was investigated using a questionnaire prepared by a trained nurse, based on clinical experience. Overall, 145 patients were included (mean age 78.6 ± 7.6; males 51.0%). Frailer people, identified as an MPI >0.66 (MPI 3), had a significantly higher presence of bad VA (49.0% vs. 27.3% in MPI 3 and MPI 1 groups, p = 0.045), no success at first attempt (49.0% vs. 22.7% in MPI 3 and MPI 1 groups, p = 0.03), reported more frequently pain during VA attempts (63.3% in MPI 3 vs. 27.3 in MPI 1, p = 0.002), and significantly higher scores in the Numeric Rating Scale compared to their robust counterparts. Taking robust participants in MPI 1 as reference, after adjusting for potential confounders, frailer people (MPI 3) were at increased odds of bad VA (odds ratio [OR] = 2.72; 95% confidence interval [CI]: 1.16-6.41; p = 0.02), not success at first attempt (OR = 3.67; 95% CI: 1.09-12.57; p = 0.04), and presence of pain during VA attempt (OR = 4.26; 95% CI: 1.30-13.92; p = 0.02). In conclusion, our study demonstrated an association between multidimensional frailty and bad VA in a population of older hospitalized people.

在老年病学领域,身体虚弱与寻找静脉通路(AV)困难之间的关系大多尚未得到探讨,也不明确,因此本研究旨在证明在老年住院患者中,身体虚弱与寻找静脉通路(AV)困难之间的关系。研究采用多维预后指数(MPI)来确定多维虚弱程度;由一名训练有素的护士根据临床经验编制问卷,对 AV 遗产进行调查。总共纳入了 145 名患者(平均年龄 78.6(±7.6)岁,男性占 51.0%)。与体格健壮的人相比,体格较弱的人存在不良反流的比例明显较高,首次尝试反流不成功,在尝试反流过程中更频繁地报告疼痛,NRS(数字评分量表)得分也明显较高,即使在调整了一些潜在的混杂因素后也是如此。总之,我们的研究表明,在住院老年人群中,多维度虚弱与不良房室术之间存在关联。
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Rejuvenation research
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