ABSTRACT
Objective:To evaluate the effect of neuromuscular electrical stimulation (NMES) on muscle strength and duration of mechanical ventilation through cumulative Meta-analysis and sequential trial analysis (TSA).Methods:Randomized controlled trial (RCT) of NMES intervention in intensive care unit (ICU) patients with mechanical ventilation were searched from PubMed database of US National Library of Medicine, EMbase database of Netherlands Medical Abstract, Web of Science, SinoMed database of China, CNKI, Wanfang data, VIP and other Chinese and English databases from database construction to July 15, 2021. The control group received ICU routine nursing or rehabilitation exercise; the experimental group received NMES (low frequency electric current through electrode stimulation to make muscle groups twitch or contract) based on routine care in ICU. Relevant data were screened, evaluated and extracted by two researchers independently. After extracting data, STATA 15.0 and TSA software were used to analyze the data and evaluate the research results. Results:A total of 9 studies were enrolled, including 619 subjects. Among the 9 articles included, 2 were grade A and 7 were grade B, indicating good overall quality. Cumulative Meta-analysis showed that compared with ICU routine care, NMES improved muscle strength of patients undergoing mechanical ventilation [standardized mean difference ( SMD) = 0.64, 95% confidence interval (95% CI) was 0.07 to 1.21] and shortened the duration of mechanical ventilation ( SMD = -1.84, 95% CI was -2.58 to -1.10). TSA analysis of the two outcomes showed that the sample size of muscle strength outcome index ( n = 518) and mechanical ventilation outcome index ( n = 419) did not meet the expected information (RIS; n values of 618 and 685); the cumulative Z-value line of the muscle strength outcome index crossed the traditional boundary line and TSA boundary line, indicating that more tests were not needed to verify this result. In the outcome index of mechanical ventilation duration, it was found that the cumulative Z-value line only crossed the traditional boundary line, but did not cross the TSA boundary line, indicating that further studies in this area should be carried out in the future to demonstrate this result. Conclusion:NMES can improve ICU patients' muscle strength and reduce the duration of mechanical ventilation.
ABSTRACT
Objective To systematically evaluate the effect of early mobilization on the physical function of patients in intensive care unit (ICU). Methods The randomized controlled trials (RCT) about early intervention in ICU patients were retrieved from the Cochrane Library, PubMed, Wed of Science, Medline, CBM, CNKI, VIP, and Wanfang database, all of which were published literatures from the establishment to October 2018. Early activities were carried out in the intervention group, while only routine nursing was carried out in the control group. Outcome measures included the medical research council score (MRC-Score), physical function ICU test (PFIT), independent walking ability, score of quality of life health survey short form (SF-36), incidence of ICU-acquired weakness (ICU-AW) and hospital mortality. Two researchers independently screened the literature, evaluated the quality of the literature and extracted the data. After literature selection, literature quality evaluation and date extraction was performed, and RevMan 5.3 software was used for Meta-analysis. The publication bias was analyzed by funnel plot. Results A total of 13 literatures were included, 10 in English and 3 in Chinese; of the 1 347 patients, 695 in intervention group and 652 in control group. Compared with the control group, the MRC-Score was increased in intervention group [mean difference (MD) = 4.74, 95% confidence interval (95%CI) = 2.30-7.19, P = 0.000 1], independent walking ability was improved [odds ratio (OR) = 2.04, 95%CI =1.39-2.99, P = 0.000 3], the incidence of ICU-AW was decreased (OR = 0.22, 95%CI = 0.14-0.35, P < 0.000 01), and there was no significant difference in PFIT (MD = -0.19, 95%CI = -0.69-0.31, P = 0.46), physical health (PCS) after 6 months (MD = -1.39, 95%CI = -4.18-1.39, P = 0.33) and inpatient mortality (OR = 0.77, 95%CI = 0.53-1.12, P = 0.17) between two groups. It was shown by funnel plot that the publication bias of each literature was relatively small in terms of MRC-Score, PFIT, independent walking ability and SF-36. Conclusion Early mobilization are beneficial for the physical function recovery of ICU patients, which can improve the muscle strength, improve the ability of patients to walk independently, reduce the occurrence of ICU-AW, and do not increase the mortality rate in hospital.
ABSTRACT
Objective@#To study the relationship between the expressions of tuftelin 1 (TUFT1) and the clinicopathological features of hepatocellular carcinoma and its effect on proliferation and apoptosis, and to explore the relationship between TUFT1 with the development of hepatocellular carcinoma.@*Methods@#Immunohistochemistry was used to detect the expression of TUFT1 in 98 cases of hepatocellular carcinoma and 30 cases of adjacent normal tissues. Quantitative real-time PCR (qRT-PCR) was used to detect the expression of TUFT1 in HCC cell line. The expression of TUFT1 in SMMC-7221 cell lines was down-regulated by lentiviral vector. Cell proliferation assay, clonogenic assay, cell apoptosis assay and cell cycle assay were used to detect proliferation, apoptosis, and cell cycle changes of hepatocarcinoma cells after TUFT1-down-regulation. Statistics were performed using the χ2 test and the t-test.@*Results@#Among the 98 cases of hepatocellular carcinoma, 65 cases (66.33%) were positive for TUFT1, and in 30 cases of adjacent normal tissues, 6 cases (16.67%) were positive for TUFT1, and the difference was statistically significant (χ 2 = 19.956, P < 0.05). The expression of TUFT1 in HCC tissues was related to tumor size, tumor stage, recurrence and metastasis (χ2 = 6.214, 8.066, 14.400, P < 0.05). After lentiviral vector mediated downregulation of TUFT1 expression in SMMC -7221 cells, the cell proliferation rate [(18.62% ± 0.15%) vs. (67.91% ± 0.62%), P < 0.05], clonality [(8.10% ± 0.80%) vs. (50.80% ± 1.60%), P < 0.05] and G1 phase cells [(36.71% ± 0.69%) vs. (44.65% ± 0.73%), P < 0.05] were significantly decreased, whereas the G2 phase cells [ (15.44% ± 0.53%) vs. (22.31% ± 0.20%), P < 0.05] and the rate of apoptosis [(3.45% ± 0.18%) vs. (5.45% ± 0.06%), P < 0.05] was significantly increased compared with the control group of HCC cells, and the differences were statistically significant.@*Conclusion@#The expression of TUFT1 is highly expressed in hepatocellular carcinoma tissues. Furthermore, the expression of TUFT1 promotes HCC cell proliferation, inhibits the apoptosis, and is poor prognostic factor of hepatocellular carcinoma.
ABSTRACT
Objective@#To screen, diagnose and follow up the abnormal mutation in the gene screening of neonatal deafness.@*Methods@#A total of 24161 newborns born in Zhuhai Maternal and Child Health Hospital from February 1, 2015 to January 31, 2008 were screened for hearing and deafness genes, and audiological screening, diagnosis and 1-3 years follow-up were carried out for the newborns with positive gene screening.@*Results@#There were 991 cases of deafness gene mutation (533 males and 458 females), and the rate of abnormal mutation was 4.10%(991/24 161). Among them, 921 cases were single heterozygous mutation, 130 cases were failed in primary hearing screening, 11 cases were failed in secondary hearing screening, 8 cases were abnormal in audiological diagnosis finally. In these 8 cases, 3 were diagnosed as otitis media and passed audiological follow-up after cure, 2 cases of single ear sensorineural injury caused by high-risk factors, passed after close audiological follow-up, and the other 3 cases were closely audiological follow-up while none of them were successfully sequenced. All of them were moderate to severe sensorineural deafness, 1 case was heterozygous mutation at 3 loci of GJB2(c.235delC,c.408C>A,c.134G>A), 1 case was heterozygous mutation at 2 loci of GJB2(c.235delC, c.109G>A), and 1 case was single heterozygous mutation of GJB2(c.235delC). The remaining 913 cases who passed the primary screening, secondary screening or hearing diagnosis were followed up for 1 to 3 years. Three cases of multiple heterozygous mutation were found in gene screening(2 cases were SLC26A4 2168A>G, IVS7-2A>G, 1 case was GJB2 c.176_191del 16bp, c.299_300del AT), all of them passed both primary and secondary hearing screening. In these 3 cases, the final audiological diagnosis was moderate sensorineural deafness in both ears, with no improvement in the follow-up of 1-3 years. There were 9 monogenic homozygous mutations, 7 failed in primary hearing screening, 3 failed in secondary hearing screening and also failed in audiological diagnosis and 1-3 years′ audiological follow-up, all of whom were GJB2 c.235 del C homozygous mutations, and one of whom had a definite family history of deafness. The remaining 6 cases of homozygous mutation diagnosed by primary screening, secondary screening or hearing diagnosis were GJB2 c109G>A homozygous mutation, and passed the 1-3 years′ hearing follow-up. 58 children with mtDNA mutations, including 2 with 12S rRNA 1494C>T homozygous mutation, 47 with 1555A>G homozygous mutation, and 9 with 1555A>G heterozygous mutation, all passed the primary or secondary hearing screening, and were instructed to ban ototoxic drugs for the whole life, and passed the 1-3 years′ hearing follow-up.@*Conclusions@#The audiological follow-up of children with monogenic heterozygous mutations in deafness gene screening is generally normal. In case of abnormality, the influencing factors such as otitis media should be excluded at first. In case of unexplained moderate to severe sensorineural deafness, the whole-gene sequencing should be performed to find possible pathogenic factors. The children with homozygous mutation or compound heterozygous mutation in gene screening, most of whom show different degrees of hearing loss, should be followed up for a long time, and provide parents with scientific and reasonable genetic counseling according to the mutation genes and loci,. The hearing of drug-induced deafness gene carriers is normal after birth. Parents should be advised to strengthen prevention and follow-up is generally enough.
ABSTRACT
Objective To analyze the effects of different doses of naloxone on resuscitation of patients with quality of dezocine anesthesia.Methods 84 patients with dezocine anesthesia surgery were selected and divided into three groups in accordance with the use of naloxone plus volume,28 cases in each group.All patients were treated with vein injection of propofol,fentanyl and Shun type atracurium for induction of anesthesia,endotracheal intubation and mechanical ventilation were given dezocine infusion to maintain anesthesia.After the operation,the high dose group was given 14μg/kg naloxone,the low dose group was given 7μg/kg naloxone,and the control group only received intravenous infusion of the corresponding measurement.Mean arterial pressure (map),heart rate (HR)before anes-thesia,recovery,extubation and intubation after 10min of three groups were observed.Pain and sedation situation score of the patients regained consciousness after 1min,1h,2h were received by visual analogue scale (VAS),sedation/restlessness score (SAS).At the same time,the incidence of complications and adverse reactions of the three groups were recorded.Results There were no significant differences in MAP and HR indexes among the three groups before anesthesia.At resuscitation and extubation there were no differences in MAP and HR between the low dose group and the control group (all P >0.05).However,resuscitation,extubation,MAP and HR were significantly lower in the low dose group than those in the high dose group (all P <0.05).The difference of VAS,SAS score had no statistical sig-nificance between the low dose group waken up each time and control group,but the VAS,SAS score in the high dose group waken up each time were significantly higher than those in the control group and low dose group(all P <0.05). The respiratory inhibition in the high dose group and low dose group were significantly lower than those of the control group(0,3.57% and 10.71%;χ2 =4.169,1.077,all P <0.05),but nausea and vomiting in the high dose group were higher than those in the control group and low dose group(all P <0.05).Conclusion Different doses of nalox-one could be used for patients using dezocine anesthesia according to patients after operation,to reduce respiratory inhibi-tion,and help patients relieve pain and agitation,and the recommend dose of naloxone is 7μg/kg.
ABSTRACT
Objective:This study investigates the expression of long non-coding RNA termed amine oxidase, copper containing 4, pseudo-gene (AOC4P) in hepatocellular carcinoma (HCC) and its relationship with clinicopathological factors and patient prognosis. Methods:The expression of AOC4P in 106 HCC tissues and adjacent non-tumor tissues were detected using qRT-PCR. The relationship between AOC4P expression and clinicopathological factors, as well as patient prognosis, in HCC was analyzed. Results:The relative expression of AOC4P in the cancer tissues was 0.66±0.34, which was significantly lower than the relative expression in adjacent non-tumor tissues, i. e., 1.45±0.63 (P<0.05). Univariate analysis showed that low AOC4P expression was correlated with tumor size, lymph node metastasis, and TNM stage (P<0.05). The group with high AOC4P expression levels has longer survival time compared with the group with low AOC4P expression levels. Cox multivariate regression analysis showed that AOC4P expression, lymph node metastasis, and vascular in-vasion were all independent factors that affect prognosis of patients. Conclusion:AOC4P expression was reduced in HCC tissues, and AOC4P may play crucial roles in the occurrence and development of HCC. For patients with poor prognosis, low AOC4P expression is an independent risk factor for patients with HCC. Thus, AOC4P expression may be used as a molecular marker for HCC.
ABSTRACT
<p><b>OBJECTIVE</b>To establish a quality evaluation method, quantitative analysis of multi-component with a single-marker (QAMS) to determine the contents of four rhubarb anthraquinones in Sanhuang tablets.</p><p><b>METHOD</b>Emodin was used as the internal reference substance, the relative correlation factors (RCF) of rhein, chrysophanol and physcion to emodin were calculated and evaluated. The contents of these four anthraquinones were determined by the external standard method and QAMS, respectively. Rationality, feasibility and repeatability of the QAMS method was verified by comparing the results obtained from the two different methods.</p><p><b>RESULT</b>RCFs of rhein, chrysophanol and physcion to emodin against Sanhuang tablets were 1.13, 1.46 and 1.01, respectively, indicating good reproducibilities. The two methods did not show significant difference in results.</p><p><b>CONCLUSION</b>The QAMS method can be used a new quality assessment model for quantity of anthraquinones in Sanhuang tablets.</p>
Subject(s)
Anthraquinones , Chromatography, High Pressure Liquid , Methods , Drugs, Chinese Herbal , Chemistry , Emodin , Reproducibility of Results , Rheum , Chemistry , Tablets , Technology, Pharmaceutical , MethodsABSTRACT
Three hundred and thirty eight patients with type 2 diabetes mellitus( DM) admitted from January 2006 to June 2009 and 50 healthy subjects (control group) were enrolled in the study. Platelet glycoprotein PAC-1 and CD62P levels were measured in both groups. Compared with control group, plasma PAC-1 and CD62P levels of DM patients increased significantly (P ＜0.01). Patients were divided into three groups according to their urinary albumin excretion rate ( UAER) . PAC-1 and CD62P levels in macroalbuminuria group (UAER≥200μg/min) were significantly higher than those in normoalbuminuria group( UAER <20μg/min) and microalbuminuria group (20μg/min≤UAER ＜ 200μg/min) (both P＜ 0.05). The results indicate that plasma levels of PAC-1 and CD62P, which reflect platelet activation, are the independent risk factors for diabetic nephropathy.