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Objective To investigate the enteral nutrition(EN)complications in ICU critically ill patients and their risk factors.Methods The relevant information of 376 EN patients from three tertiary hospitals in Qingdao from September 2015 to April 2016 were retrospectively analyzed.The incidences of EN complications and their risk factors were analyzed.Results In these 376 patients,the complications included diarrhea(n=117,31.12％),constipation(n=89,23.67％),and reflux(n=102,27.13％).The incidence of diarrhea showed significant difference in terms of the application of antibiotics(OR=3.55),age(OR=1.03),fasting(OR=4.07),oral potassium preparations(OR=2.91),nasal feeding rate(OR=1.03),and nasal feeding volume(OR=1.002).The incidence of constipation showed significant difference in terms of nasal fluid type(OR=7.79),analgesics(OR=10.34),age(OR=1.06),nasal feeding rate(OR=0.95),and nasal feeding volume(OR=0.97).The incidence of reflux showed significant difference in terms of the use of analgesics(OR=2.143),mechanical ventilation(OR=2.071),nasal feeding pathway(OR=1.838),age(OR=1.025),nasal feeding rate(OR=1.042),and nasal feeding volume(OR=1.001).ConclusionApplication of antibiotics,increased age,fasting,oral potassium preparations,increased nasal feeding rate,and increased daily feeding volume are risk factors of EN-related diarrhea;short peptide EN solution,application of analgesics,and increased age are risk factors of EN-related constipation for enteral nutrition patients;and mechanical ventilation,application of nasogastric tube,increased age,increased nasal feeding rate,and increased nasal feeding are risk factors of EN-related relux in enteral nutrition patients.
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Objective To investigate the protective effects of Bcl-2 associated with athanogene-1 (BAG-1) gene on human neuroblastoma cells (SH-SY5Y) injury induced by hypoxia/reoxygenation,and its influence on heat shock protein 70 (HSP70) expression.Methods The SH-SYSY cells at logarithmic growth phase were collected.Lenti virus mediated RNA interference (RNAi) technology was used to suppress the BAG-1 expression.The cells screened out can be divided into four groups:the cell control group with no lentivirus infection,lentivirus control group (containing only fluorescein protein lentivirus infection),BAG-1 siRNA group (BAG-1 siRNA silencing group),including BAG-1 siRNA-α group and BAG-1 siRNA-β group with lentivirus containing fluorescein protein (GFP) but at different BAG-1 siRNA target sites of silencing.Western Blot was used to detect the protein expression of BAG-1 and HSP70 in target cells after infectious recombination lentivirus for 72 hours;the Cell Counting Kit-8 (CCK-8) was used to detect the activity of four different group cells after hypoxia;the flow cytometry was used to detect the cell apoptosis;the HSP70 mRNA transcription level were detected by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-qPCR) respectively in each group.Results After lentiviral infection for 72 hours,the Western Blot results showed that in the two BAG-1 siRNA silencing groups,the interference effect of BAG-1 siRNA-β group was superior to that of BAG-1 siRNA-α group.The cell viability of each group showed an increase followed by a decrease with the prolongation of hypoxia time,and reaching the peak at 8 hours.After hypoxia for 8 hours being given,the cell viability in BAG-1 siRNA-β group was significantly lower than that of the cell control group,lentivirus control group and BAG-1 siRNA-α group (A value:0.59 ±0.09 vs.0.94±0.12,0.90± 0.11,0.91± 0.14,P ＜ 0.01);the cell apoptosis rate was obviously higher in BAG-1 siRNA-β than that in the above three groups [(34.63 ± 3.46)％ vs.(14.83 ± 3.75)％,(19.93 ± 6.49)％,(16.40± 1.18)％,all P ＜ 0.01].There were no statistically significant differences in the HSP70 protein level and mRNA transcription level between BAG-1 siRNA-3 grroup,and the cell control group,lentivirus control group and BAG-1 siRNA-α group respectively (all P ＞ 0.05).Conclusion BAG-1 gene can play a role in protection of hypoxia nerve cells,reduce the apoptosis,and its protective effect can be independent of HSP70 gene.
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Objective To investigate the effects of lentivirus-mediated heat shock protein 70 (HSP70) gene on voltage-gated calcium channels on the cell membrane of pheochromocytoma cell 12 (PC 12 cells) induced by ischemic/hypoxia and its mechanisms.Methods PC12 cells at logarithmic phase were collected,which were challenged with hypoxia for 6 hours and reoxygenation for 12 hours to stimulate the nerve cells suffered ischemia/reperfusion pathological process in vitro.PC12 cells were divided into non-infection group,infected by lentivirus containing green fluorescent protein (GFP) without HSP70 gene lentivirus control group (GFP lentivirus control group),and infected by lentivirus containing HSP70 and GFP gene recombined lentiviral infection group (HSP70 recombined lentiviral infection group).Real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot were used to determine mRNA and protein expressions of L-type voltage-gated Ca2+ channel subunits cav1.2 and cav1.3,receptor gated channel subunits NR1 and NR2,and Na+/Ca2+ exchange (NCX) in PC12 cells.Results After being challenged with hypoxia/reoxygenation,the mRNA and protein expressions of cav1.2,NR1 and NR2 in the PC12 cells were significantly lower in HSP70 recombined lentiviral infection group than those of GFP lentivirus control group and non-infection group [cav1.2 mRNA (2-△△Ct):3.13 ± 0.46 vs.5.12 ± 0.52,5.13 ± 0.66;NR1 mRNA (2-△△△Ct):1.61 ± 0.44 vs.3.23 ±0.82,3.31 ±0.78;NR2 mRNA (2-△△Ct):2.09±0.41 vs.3.91 ±0.64,3.88±0.62;cav1.2 protein (gray value):2.82±0.39 vs.3.98±0.23,3.96±0.24;NR1 protein (gray value):1.84±0.35 vs.2.79±0.21,2.86±0.23;NR2 protein (gray value):0.87±0.24 vs.1.57±0.31,1.33±0.44;all P ＜ 0.01].But there were no statistical differences in the mRNA and protein expressions of cav1.2,NR1 and NR2 between GFP lentivirus control group and non-infection group (all P ＞ 0.01).There were no statistical differences in the mRNA and protein expressions of cav1.3 and NCX among non-infection group,GFP lentivirus control group and HSP70 recombined lentiviral infection group [cav1.3 mRNA (2-△△Ct):4.82 ± 0.32,4.72 ± 0.36,4.82 ± 0.29;NCX mRNA (2-△△Ct):3.49 ± 0.78,3.47 ± 0.71,3.56 ± 0.65;cav 1.3 protein (gray value):2.63±0.40,2.64±0.39,2.68±0.39;NCX protein (gray value):3.27±0.48,3.34±0.48,3.31 ±0.42;all P ＞ 0.01].Conclusion Exogenous HSP70 affects the expression of L-type voltage-gated Ca2+ channel subunit cav1.2 and receptor gated channel subunits NR1 and NR2,which may protect PC12 cells from the injury caused by ischemic/hypoxia.
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Objective To investigate effect of dicoumarol on the expression of serum tumor necrosis factor-α( TNF-α) in patients with acute cerebral infarction.Methods Eighty cases patients with acute cerebral infarction were admitted and randomly divided into two groups by digital draw:control group and observation group, 40 cases in each group.The control group were given conventional therapy for treatment of acute cerebral infarction, and observation group were given dicoumarol thrombolysis on the basis of control group.The serum TNF-αlevel and neurologic impairment score were compared between two groups pre-and post-treatment.Results After treatment of 6 h, the serum TNF-αlevel in observation group was significantly lower than that in control group (P<0.05).After treatment of 24 h, 48 h and 30 d, there were no significant differences of serum TNF-αlevels between two groups.After treatment of 5 d, 14 d and 28 d, the neurological deficit scores in observation group were significantly higher than those in control group (P<0.05).Conclusion Dicoumarol could effectively reduce TNF-αlevels in serum and extent of cerebral cell damage in patients.