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ABSTRACT BACKGROUND: For critically ill patients, physicians tend to administer sufficient or even excessive oxygen to maintain oxygen saturation at a high level. However, the credibility of the evidence for this practice is unclear. OBJECTIVE: To determine the effects of different oxygen therapy strategies on the outcomes of mechanically ventilated intensive care unit (ICU) patients. DESIGN AND SETTING: Systematic review of the literature and meta-analysis conducted at Jiangxi Provincial People's Hospital, Affiliated to Nanchang University, Nanchang, China. METHODS: We systematically searched electronic databases such as PubMed and Embase for relevant articles and performed meta-analyses on the effects of different oxygen therapy strategies on the outcomes of mechanically ventilated ICU patients. RESULTS: A total of 1802 patients from five studies were included. There were equal numbers of patients in the conservative and liberal groups (n = 910 in each group). There was no significant difference between the conservative and liberal groups with regard to 28-day mortality (risk ratio, RR = 0.88; 95% confidence interval, CI = 0.59-1.32; P = 0.55; I2 = 63%). Ninety-day mortality, infection rates, ICU length of stay, mechanical ventilation-free days up to day 28 and vasopressor-free days up to day 28 were comparable between the two strategies. CONCLUSIONS: It is not necessary to use liberal oxygen therapy strategies to pursue a higher level of peripheral oxygen saturation for mechanically ventilated ICU patients. Conservative oxygen therapy was not associated with any statistically significant reduction in mortality.
Subject(s)
Humans , Oxygen , Respiration, Artificial , Oxygen Inhalation Therapy , Prognosis , Critical Illness/therapy , Intensive Care Units , Length of StayABSTRACT
SUMMARY: Skeletal muscle injury is an acute inflammatory condition caused by an inflammatory response. To reduce inflammatory cell infiltration and relieve skeletal muscle injury, efficient treatment is urgently needed. Nitric oxide is a free radical molecule reported to have anti-inflammatory effects. In this study, we showed that NO could inhibit the inflammatory response of C2C12 cells in vitro and protect rat skeletal muscle injury from notexin in vivo. NO synthase inhibitor (L-NG-Nitroarginine Methyl Este?L-NAME) and NO donor (sodium nitroprusside dehydrate ?SNP) were used to explore the vital role of lipopolysaccharides (LPSs) in LPS-stimulated C2C12 myoblasts.The expression of IL-18 and IL-1b was upregulated by L-NAME and downregulated by SNP, as indicated by the ELISA results. NO can reduce ASC, Caspase-1, and NLRP3 mRNA and protein levels. Furthermore, NO was detected in the rat model. The results of immunohistochemical staining showed that the production of DMD decreased. We conducted qRT-PCR and western blotting to detect the expression of Jo-1, Mi-2, TLR2, and TLR4 on day 6 post injury following treatment with L-NAME and SNP. The expression of Jo-1, Mi-2, TLR2, and TLR4 was upregulated by L-NAME and significantly reversed by SNP. NO can alleviate C2C12 cell inflammatory responses and protect rat skeletal muscle injury from notexin.
RESUMEN: La lesión del músculo esquelético es una afección inflamatoria aguda causada por una respuesta inflamatoria. Para reducir la infiltración de células inflamatorias y aliviar la lesión del músculo esquelético es necesario un tratamiento eficaz. El óxido nítrico es una molécula de radicales libres que tiene efectos antiinflamatorios. En este estudio, demostramos que el ON podría inhibir la respuesta inflamatoria de las células C2C12 in vitro y proteger la lesión del músculo esquelético de rata de la notexina in vivo. El inhibidor de ON sintasa (L-NG-nitroarginina metil este, L-NAME) y el donante de ON (nitroprusiato de sodio deshidratado, SNP) se utilizaron para explorar el papel vital de los lipopolisacáridos (LPS) en los mioblastos C2C12 estimulados por LPS. La expresión de IL- 18 e IL-1b fue regulada positivamente por L-NAME y regulada negativamente por SNP, como indican los resultados de ELISA. El ON puede reducir los niveles de proteína y ARNm de ASC, Caspasa-1 y NLRP3. Además, se detectó ON en el modelo de rata. Los resultados de la tinción inmunohistoquímica mostraron que disminuyó la producción de DMD. Realizamos qRT-PCR y transferencia Western para detectar la expresión de Jo-1, Mi-2, TLR2 y TLR4 el día 6 después de la lesión después del tratamiento con L-NAME y SNP. La expresión de Jo-1, Mi-2, TLR2 y TLR4 fue regulada positivamente por L- NAME y significativamente revertida por SNP. El ON puede aliviar las respuestas inflamatorias de las células C2C12 en ratas, y proteger la lesión del músculo esquelético de la notexina.
Subject(s)
Animals , Male , Rats , Myoblasts/drug effects , Elapid Venoms/toxicity , Anti-Inflammatory Agents/pharmacology , Muscular Diseases/chemically induced , Nitric Oxide/pharmacology , In Vitro Techniques , Enzyme-Linked Immunosorbent Assay , Immunohistochemistry , Cell Survival , Rats, Sprague-Dawley , NG-Nitroarginine Methyl Ester , Caspases , Disease Models, Animal , Real-Time Polymerase Chain Reaction , InflammationABSTRACT
@#Abstract: Objective To follow up and evaluate the stability testing status of γ stereotactic radiotherapy system (hereinafter γ knife WS 582-2017 Specifications for Testing of Quality Control in X and γ referred to ) in medical institutions based on the RayStereotactic Radiotherapy System WS 582-2017 Methods (hereinafter referred to ). A total of 43 medical institutions using γ knife and 54 medical physics personnel were recruited as the research subjects by random sampling method. Based on the - - standard tracking evaluation method, we followed up the evaluation of γ knife stability testing based on WS 582 2017. Results - Only 66.7% of the 54 subjects preformed WS 582 2017 in their daily work. Only 30.2% (all were tertiary hospital) of 43 medical institutions were equipped with complete quality control and testing equipment. The implementation rate of γ knife stability test was 67.4%, and it was not carried out in strict accordance with the test events and test cycle requirements - specified in the WS 582 2017. There were incomplete test events, incomplete records or test cycles that did not meet the Conclusion standard requirements in γ knife stability test. Medical institutions did not carry out γ knife stability tests in strict - accordance with the projects and cycle required by the WS 582 2017. The reasons are related to medical institutions are not equipped with complete testing equipment, the personnel are lack of understanding of relevant national standards, the poor publicity and implementation of the standards, the lack of standardized training channels and inadequate health supervision.
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Objective@#To examine the effect of functional sports training on the development of spatial awareness in children aged 6-8 years old,to provide a reference to improve children s ability of spatial sense.@*Methods@#A class of 125 children aged 6-8 years from first, second, and third grades of an elementary school in Zhengzhou City were conveniently selected by stratified random sampling, who were divided into the experimental group ( n =62) and the control group ( n =63) by random number tables. The experimental group received functional sports intervention for 8 weeks,3 times a week,20 min each time, and the control group received traditional sports game program.@*Results@#After the intervention,the error values of depth perception, orientation perception, and space perception in the experimertal group of 6 and 7 year old children reduced by 1.98 cm, 2.88°, and 22.00 cm (6 year old children) and 1.61 cm, 2.34°, and 17.99 cm (7 year old children) compared with the control group, respectively. Compared with those in the control group of 8 year old after the intervention, and the differences were of statistical signifiance( t =-3.07, -2.94, -3.07 ; -3.25, -3.29, -3.15, P <0.01). There was no significant difference in the error values of depth perception, orientation perception and space perception between the experimental group and the control group after intervention ( P >0.05). In the experimental group, the error values of depth perception, orientation perception and space perception reduced by 2.30 cm, 3.88°, 28.05 cm (6 year old children), 2.16 cm, 2.15°, 17.45 cm (7 year old children) and 1.16 cm, 1.81°, 9.10 cm (8 year old children) in children aged 6-8 years after intervention, significant improvement were observed compared with before intervention ( t = 8.50 , 9.04, 7.35; 7.39, 10.30, 11.05; 4.67, 4.46, 14.14, P <0.01). Compared with before the intervention, children aged 6-8 in the control group only had significant differences in space perception( t =4.13, 6.71, 8.93, P <0.01).@*Conclusion@#Functional sports games can improve depth perception, orientation perception and spatial perception for children aged 6-8 years. It can be integrated into children s daily activities to play a positive role in promoting the healthy growth of children.
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Methods@#A retrospective review was conducted, involving all patients who underwent ultrasound-guided lumbar spine injection therapy at a single institution over 1 year. Patients were evaluated by two interventionists, who then performed standardized ultrasound-guided lumbar facet joint and pararadicular spinal injections. @*Results@#There were 42 patients treated at our Sports Medicine Centre; with 27 patients (64.3%) receiving facet joint injections and 18 patients (42.9%) receiving nerve root injections. The majority (90.5%) of patients experienced an improvement of >30% in pain intensity at 3 months post-injection, using the Numerical Rating Scale pain score (pp<0.001). No complications were reported. @*Conclusions@#Our initial experience confirms the safety, feasibility, and effectiveness of ultrasound-guided lumbar spinal injection for the treatment of axial and radicular pain in an Asian multiethnic cohort.
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Methods@#A retrospective review was conducted, involving all patients who underwent ultrasound-guided lumbar spine injection therapy at a single institution over 1 year. Patients were evaluated by two interventionists, who then performed standardized ultrasound-guided lumbar facet joint and pararadicular spinal injections. @*Results@#There were 42 patients treated at our Sports Medicine Centre; with 27 patients (64.3%) receiving facet joint injections and 18 patients (42.9%) receiving nerve root injections. The majority (90.5%) of patients experienced an improvement of >30% in pain intensity at 3 months post-injection, using the Numerical Rating Scale pain score (pp<0.001). No complications were reported. @*Conclusions@#Our initial experience confirms the safety, feasibility, and effectiveness of ultrasound-guided lumbar spinal injection for the treatment of axial and radicular pain in an Asian multiethnic cohort.
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Increasing studies have demonstrated that interferon gamma (IFN-γ),which serves as a critical inflammatory cytokine,is essential to induce the immunosuppressive effects of mesenchymal stem cells (MSCs).However,the mechanisms underlying the enhanced immunosuppressive effects of IFN-γ-stimulated MSCs (γMSCs) are not fully understood.MSC-derived rnicrovesicles (MSC-MVs) have been viewed as potential pivotal mediators of the immunosuppressive effects of MSCs.Moreover,microRNAs (miRNAs) are important regulators of immunological processes and can be shuttled from cell to cell by MVs.The aim of our study was to analyze the the miRNA expression signature of MVs derived from γMSCs (γMSC-MVs),which may provide better understanding of the immunosuppressive property of their parent cells.Through miRNA microarray and bioinformatics analysis,we found 62 significantly differentially expressed miRNAs (DEMs) in γMSC-MVs compared with MSC-MVs.And the potential target genes and signaling pathways regulated by DEMs were predicted and analyzed.Interestingly,many DEMs and predicted signaling pathways had been.demonstrated to be involved in immunoregulation.Furthermore,the network between immunoregulation-related pathways and relevant DEMs was constructed.Collectively,our research on the miRNA repertoires of γMSC-MVs not only provides new perspectives into the mechanisms underlying the enhanced immunosuppressive property of γMSCs,but also paves the way to clinical application of these potent organelles in the future.
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@#Traditional resin-based composites have been placed in cavities by incremental layering technique. The shrinkage stress may result in microleakage, post-operative sensitivity which lead to the failed restorations. In 2009, bulk-fill resin-based composites were reported to have the capability to be placed and cured in 4-5 mm increments, because of the improved resin matrix, modified nano-hybrid fillers and new photo initiators. This group of materials can simplify operation in clinical application in addition to decrease shrinkage stress and polymerization shrinkage. The aim of this review is to summarize the classification and properties of bulk-fill resin-based composites and to discuss the development of these new materials in the future.
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PURPOSE:To investigate the effect of metformin on renal tubular epithelial cell apoptosis and inflammation after kidney ischemia/ reperfusion in rats.METHODS:Eighteen SD rats were randomly divided into three groups: Sham (S), Ischemia/reperfusion (I/R), and Metformin (E). Before establishing the I/R model, group E was administered metformin for three days, while groups S and I/R were administered equal volumes of saline. After three days, a right nephrectomy was performed on all groups, after which the left kidneys of groups E and I/R rats were subjected to 45 min renal ischemia. Renal function, histology, and cell apoptosis were assessed. AMPK, pAMPK, COX-2, and Caspase 3 were also detected.RESULTS:Compared to I/R group, Caspase 3 and COX-2 levels were decreased in group E. COX-2, Caspase3 and pAMPK levels were higher in groups E and I/R than in group S. The pAMPK level of group E was higher than that of I/R group, while COX-2 and caspase 3 were lower in group E than they were in the other groups. There was no significant difference between E and I/R groups in AMPK levels.CONCLUSION:Metformin preconditioning attenuated the inflammation caused by ischemia/reperfusion and inhibited the apoptosis of renal tubular epithelial cells.
Subject(s)
Animals , Male , Apoptosis/drug effects , Epithelial Cells/drug effects , Ischemic Preconditioning/methods , Kidney/blood supply , Kidney/drug effects , Metformin/pharmacology , Reperfusion Injury/prevention & control , AMP-Activated Protein Kinases/analysis , Blood Urea Nitrogen , Blotting, Western , /analysis , Creatinine/blood , /analysis , Immunohistochemistry , Kidney/pathology , Random Allocation , Rats, Sprague-Dawley , Reproducibility of Results , Time FactorsABSTRACT
To explore the velocity difference between specifications and categories of liquid with the same pressure infusion bag in order to widen the specification range of the liquid for pressure infusion. Pressure infu-sion experiments were performed with three specifications of normal saline of 100, 250 and 500 ml to compare the veloci-ties of different specifications of liquid, and with 500 ml normal saline, (5%, 10% and 50%) glucose injection, 5% glu-cose and sodium chloride injection, 5% sodium bicarbonate injection, 10% fructose injection, 706 plasma substitute, 20%mannitol injection and etc to make clear the velocities of different categories of liquid. With the same pressure, there were no significant differences between the velocities of three specifications of liquid, and between those of cate-gories of liquid with the same specification and concentration; the difference was significant between the same category of liquid with different concentrations, and the velocity showed a negative correlation with the concentration. The pressure infusion bag is compatible with 100, 250 and 500 ml liquid, and the velocity may be constant in case some specification of liquid is replaced by another one. The velocity has to be regulated in case the concentration or category of the liquid changes, when the pressure infusion is performed.
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<p><b>OBJECTIVE</b>To establish an effective method for haploid spermatid enrichment by Hoechst 33342 staining and flow sorting.</p><p><b>METHODS</b>Mouse testicular monoplast suspension was prepared by two-step enzyme digestion, and the cells were incubated in the medium containing Hoechst 33342 and Verapamil. Haploid spermatids were separated and enriched according to their DNA content by flow sorting. The gene expressions in the spermatids of several histone-modified enzymes, including the histone acetylases (HAT) and histone deacetylases (HDAC), were examined by RT-PCR and compared with that in the HAT-inhibitor curcumin-treated counterparts.</p><p><b>RESULTS</b>We successfully enriched the haploid spermatids with high purity and further purified the round and elongated spermatids. RT-PCR results indicated the specificity of the expression of the HAT gene in the spermatids, and that it was influenced by curcumin.</p><p><b>CONCLUSION</b>Flow sorting can efficiently improve the purity of haploid spermatid enrichment, which helps a lot to elucidate the mechanisms of spermiogenesis.</p>
Subject(s)
Animals , Male , Mice , Cell Separation , Methods , Flow Cytometry , Methods , Haploidy , Mice, Inbred ICR , Spermatids , Cell BiologyABSTRACT
The pharmacokinetics (PK) of ordinary tablets and sustained release capsules of diltiazem hydrochloride in human clinical trials had been studied. The PK of diltiazem hydrochloride delay-onset sustained-release pellet capsules, a new dosage form, has not been reported, although it is very important to clinical use. In this paper, we investigated the PK of diltiazem hydrochloride delay-onset sustained-release pellet capsules and the food influence in Chinese healthy volunteers. The PK parameters indicated that the diltiazem hydrochloride delay-onset sustained-release pellet capsules appeared marked characteristics of delayed and controlled release. An opened-label, randomized and parallel clinical trial was conducted in 36 Chinese healthy volunteers with single oral dose (90 mg, 180 mg or 270 mg) and a multiple oral dose (90 mg d-1×6 d) administration. The effect of food on the PK of one single oral dose (360 mg) was investigated in 24 healthy Chinese volunteers. Plasma diltiazem concentration was determined by reversed-phase high-performance liquid chromatography (RP-HPLC) and the main pharmacokinetic parameters were analyzed by PKSolver (Ver 2.0). All clinical studies were conducted in the Clinical Pharmacological Center (No. JDX1999064) of Xiangya Hospital Affiliated Central South University, China. The PK parameters suggested that the new formulation had marked characteristics of delayed and controlled release of diltiazem, and food intake did not alter significantly diltiazem pharmacokinetic parameters.
Embora a farmacocinética (PK) do cloridrato de diltiazem nas formas de comprimidos de liberação imediata e cápsulas de liberação modificada em ensaios clínicos já tenha sido relatada, a pesquisa da PK do cloridrato de diltiazem na forma de cápsulas com peletes de liberação retardada e sustentada ainda é muito importante. Neste trabalho, propusemos avaliar a farmacocinética do cloridrato de diltiazem administrado através desta nova forma farmacêutica em voluntários chineses sadios, assim como a influência da ingestão de alimentos neste perfil farmacocinético. Foi realizado um ensaio clínico aberto, randomizado e paralelo em 36 voluntários, que receberam dose oral única de 90 mg, 180 mg ou 270 mg e dose múltiplas (90 mg/d × 6 d) pela mesma via de administração. Para avaliar o efeito da ingestão de alimentos sobre a PK do diltiazem foi realizada a administração de dose única (360 mg) em 24 voluntários chineses sadios. A concentração plasmática do diltiazem foi determinada por Cromatografia Liquida de Alta Eficiência em fase reversa (CLAE-FR) e os principais parâmetros farmacocinéticos foram analisados através do emprego do software PKSolver (Ver 2.0). O ensaio de farmacocinética clínica foi conduzido na clínica Pharmacological Center (No.JDX1999064) do Hospital de Xiangya, Central South University, China. Os parâmetros PK obtidos indicaram que a nova formulação de cápsulas de liberação retardada e sustentada de cloridrato de diltiazem possue marcantes características de liberação retardada e controlada do fármaco.
Subject(s)
Humans , Capsules/analysis , Pharmacokinetics , Diltiazem/analysis , Healthy Volunteers/classification , Chromatography, High Pressure Liquid/methods , Collateral Ligament, UlnarABSTRACT
By summarizing the literature and clinical experiences, the author analyzed the pathogenesis of gastrointestinal functions and the diagnosis and treatment progress of Chinese medicine and Western medicine. The author addressed the main reason for gastrointestinal dysfunction was enteroparalysis (lack of motive power). Its pathogenesis was mainly due to deficiency syndrome, or to dominant deficiency syndrome with mingled deficiency and excess. According to the principle of treating different diseases by the same method, syndrome typing based strategies for treating postoperative gastrointestinal dysfunction in the perioperative phase should strengthen body resistance and supplement deficiency, or strengthen body resistance and dispel evil pathogens as the main principal method. Although purgations such as Dachengqi Decoction played a role in promoting gastrointestinal motive power, they were not suitable for major patients with selective surgeries induced gastrointestinal dysfunction. They were mainly suitable for acute abdomen patients with heat accumulation in Fu-organs as main symptoms, or for individual patients with interior heat induced excess syndrome.
Subject(s)
Humans , Gastrointestinal Diseases , Therapeutics , Medicine, Chinese Traditional , Methods , Postoperative PeriodABSTRACT
Aims: This paper evaluates the interactions between forest area, CO2 emissions, rainfall and arable production at a national scale in Cameroon. Methodology: The data used for this analysis was essentially time series data for all the variables spanning the period 1961-2000. It uses regression analysis to determine the most important of these variables that affects CO2 emissions and uses correlation analysis and coefficient of determination to verify the nature of the interactions between the variables. Results: The results show that as forest area reduces there is an increase in CO2 emissions concentration in the air in Cameroon. On the other hand, as forest area and rainfall reduce arable production also reduces but forest area is seen to be more responsible for changes in arable production than rainfall. Conclusion: The study concludes that the interactions between CO2 and forest area, arable production and forest area seem to be the most significant while rainfall is denoted as very variable from year to year.
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The aim of this study is to investigate the influence of different posts on the fracture mechanics of endodontically-treated teeth with open apex.Forty-eight human maxillary anterior teeth were collected,and the root was transversely sectioned 12 mm under the cementoenamal junction (CEJ).These samples were then randomly divided into two groups,i.e.,minor diameter open apex root (group A) and major diameter open apex root (group B),with mineral trioxide aggregate (MTA) placed into the apical 4 mm in the root canals.Subsequently,both groups were respectively further divided into three subgroups as follows:fiber-post (subgroup 1),metal post (subgroup 2) and non-post (subgroup 3) group.Teeth were restored with a composite resin crown and tested by using a universal testing machine at the rate of 1 mm/min cross-head.Values of the maximum fracture resistance and failure patterns were recorded and compared among all subgroups.In addition,the changes of MTA properties were carefully examined via X-ray photography.Our results indicate that (1) In group A,the mean value of fracture resistance for teeth restored with fiber posts were statistically higher than that with either metal post or non-post; (2) In group B,there was no statistically significant difference in the mean value of fracture resistance among three subgroups; (3) No statistical significance in the mean value of fracture resistance was found between group A and group B; (4) The failure modes of most samples (58％) were irreparable; (5) MTA in two teeth developed cracks after loading tests.In conclusion,endodontically-treated teeth restored with fiber posts are more resistant to fracture than those restored with either metal posts or non-post,and most of the fracture modes are catastrophic in nature.
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The author raised that the orientation of peri-operative integrative medicine studies as: Correct surgical decision-making is the prerequisite for successful surgery, the skilled surgical technique is the key for successful operation. At the same time, considerate and appropriate peri-operative management is the guarantee for the success of surgery. Consequently, quick recovery is the core concept of peri-operative integrative medicine studies. Its academic value and practical significance lie in that it can accelerate the improvement of surgical skills, optimize various effective measures to improve the overall efficacy, promote discipline construction and personnel training to improve academic levels, promote the development of Chinese medicine and accelerate its internationalization.
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Humans , Integrative Medicine , Perioperative Care , Methods , Rehabilitation , MethodsABSTRACT
<p><b>OBJECTIVE</b>To identify the exosomes-like vesicles from the plasma and study their biologic characteristics and regulatory effect.</p><p><b>METHODS</b>The exosomes-like vesicles were purified from healthy donors plasma with a series of high-speed centrifugations and ultrafiltration. Morphology was identified by transmission electron microscopy and biologic characteristics by Western blot and flow cytometry. CD4(+)T cells and CD4(+)CD25(+)CD127low Treg cells were purified from peripheral blood mononuclear cells (PBMCs) by Magnetic cell sorting. After exosomes-like vesicles cultured with CD4(+)T cells or CD4(+)CD25(+)CD127low Treg cells, cell proliferation and apoptosis were assayed. Phosphorylated β-catenin level in Wnt signaling by phosflow.</p><p><b>RESULTS</b>Exosomes-like vesicles from plasma were similar to previously described exosomes in shapes and size and expressed exosome marker proteins CD63 and CD81 as well as the MHC-II molecule, costimulatory molecules CD86 etc. After co-cultured with CD4(+) T cells, exosomes-like vesicles inhibited the proliferation of the T cells in a dose-dependent manner. After Treg cells cultured with exosomes-like vesicles for 14 days, the survival rate of the Treg cells was 57.07%, while that of the control Treg was 30.91%. Frizzled receptors 2, 3, 4and LRP6 gene mRNA expressed (the relative gray value was 48.50, 34.84, 23.85, 49.73) in the Treg cells by RT-PCR, and Wnt molecular expressed in exosomes-like vesicles. After Treg cells co-cultured with exosomes-like vesicles, the MFI of phosphorylated β-catenin decreased (from 20.06 ± 2.99 to 12.41 ± 2.08), and the expression of Bcl-2 mRNA was upregulated significantly (the relative gray value from 0.45 to 84.97).</p><p><b>CONCLUSIONS</b>Exosomes-like vesicles existed in human plasma and express immune regulatory molecules. They can suppress the proliferation of activated CD4(+) T cells induce their apoptosis and pro-long the survival of natural Treg cells via Wnt signaling pathway.</p>