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Objective To explore the effects of nasogastric tube nutrition and jejunal nutrition on the complications and mortality in severe neurological diseases during hospitalization.Methods The clinical data of patients with severe neurological diseases admitted to Department of Intensive Care Unit,Wuhan Fourth Hospital from June 2020 to June 2022 were analyzed retrospectively.Patients were di-vided into nasogastric tube nutrition group and jejunal nutrition group according to enteral nutrition methods.The propensity score matc-hing(PSM)was used to equalize the baseline data of the two groups,and the differences in complications,mortality,hospitalization costs,and mean length of stay between two groups were compared.Results There were no significant differences in baseline data be-tween the two groups after PSM(P>0.05).There were also no significant differences in complication rate and mortality between the na-sogastric tube nutrition group and the jejunal nutrition group(P>0.05).Further univariate and multivariate regression Logistic analysis showed that age(OR =1.135,P =0.001),acute physiology and chronic health evaluation Ⅱscore(APACHEⅡ score,OR =1.147,P<0.001)and blood urea nitrogen level(OR = 1.135,P = 0.001)might be the key factors affecting the prognosis of patients with severe neurological diseases.Conclusion Enteral nutrition had no significant effect on the incidence of complications and mortality during hos-pitalization in patients with severe neurocritical diseases,elderly patients,higher levels of APACHE Ⅱ score and blood urea nitrogen were independent risk factors for mortality patients with severe neurological diseases.
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Objective:To study the inhibitory effect of overexpression of mitofusion 2 (Mfn2) protein on acute respiratory distress syndrome (ARDS) pulmonary fibrosis and its mechanism.Methods:Human embryo lung fibroblasts (HELF) were cultured in vitro, and digested and passaged when the adherent rate of HELF reached 80%, and then the cells in good condition were selected for experiment. The ARDS cell model was reproduced by 5 mg/L of lipopolysaccharide (LPS, LPS group); 75 mol/L adenovirus vector carrying mitofusion 2 (Adv-Mfn2) was transfected into HELF (Adv-Mfn2+LPS group); at the same time, blank control group (complete medium culture) and Adv-vector+LPS group were set as controls. The cell proliferation was observed by sulforhodamine B (SRB) method at 0, 12, 24, 36 and 48 hours. After Hoechst 33342 staining, the morphological changes were observed under confocal microscope. Western blotting was used to detect the protein expressions of Bcl-2 and caspase-3. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to detect the gene expressions of Bcl-2 and caspase-3. Results:After LPS stimulation for 12-48 hours, the cell proliferation rates in the LPS group increased gradually, which were significantly higher than those in the blank control group [12 hours: (10.75±1.51)% vs. (0.73±1.22)%, 24 hours: (20.09±1.71)% vs. (1.15±1.12)%, 36 hours: (20.58±1.55)% vs. (1.20±1.12)%, 48 hours: (21.30±1.51)% vs. (1.23±1.10)%, all P < 0.01]. There was no statistically significant difference in the cell proliferation rate between the LPS group and the Adv-vector+LPS group. After overexpression of Mfn2, the cell proliferation rates at 12, 24, 36, 48 hours in the Adv-Mfn2+LPS group were (8.93±1.14)%, (10.52±1.24)%, (10.72±1.30)%, and (10.91±1.20)%, which were significantly lower than those in the LPS group (all P < 0.05). Confocal microscopy showed that some cells in the blank control group had nuclei of different sizes, and some nuclei fragmented or shrank to form apoptotic bodies. The nuclei of the cells in the LPS and Adv-vector+LPS groups were round or oval in size, and only a few apoptotic cells appeared. When Mfn2 was overexpressed, there were more apoptotic cells in the visual field in the Adv-Mfn2+LPS group than LPS group. Western blotting and RT-qPCR results showed that Bcl-2 expressions increased significantly after LPS stimulation in the LPS group as compared with the blank control group [Bcl-2 protein (Bcl-2/GAPDH): 0.68±0.01 vs. 0.29±0.01, Bcl-2 mRNA (2 -ΔΔCT): 2.23±0.34 vs. 1.00±0.00, both P < 0.01], and caspase-3 expressions decreased significantly [caspase-3 protein (caspase-3/GAPDH): 0.37±0.02 vs. 0.66±0.02, caspase-3 mRNA (2 -ΔΔCT): 0.31±0.05 vs. 1.00±0.00, both P < 0.01]. Compared with LPS group, the expressions of Bcl-2 after overexpression of Mfn2 in the Adv-Mfn2+LPS group were down-regulated [Bcl-2 protein (Bcl-2/GAPDH): 0.46±0.01 vs. 0.68±0.01, Bcl-2 mRNA (2 -ΔΔCT): 1.45±0.14 vs. 2.23±0.34, both P < 0.01], and the expressions of caspase-3 were up-regulated [caspase-3 protein (caspase-3/GAPDH): 0.54±0.02 vs. 0.37±0.02, caspase-3 mRNA (2 -ΔΔCT): 0.88±0.10 vs. 0.31±0.05, both P < 0.01]. Conclusion:Mfn2 protein is involved in ARDS pulmonary fibrosis, which may be related to mitochondrial mediated inhibition of cell proliferation.
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Objective@#To explore the relationship between depression and life events among junior middle school students in Shanghai, and to provide the scientific reference for the construction of psychology in the schools.@*Methods@#A total of 3 648 junior middle school students were investigated by the Chinese version of the Kutcher Adolescent Depression Scale and Adolescent Self-Rating Life Events Check List(ASLEC) , to measure their depression and life events. χ2 test and multiple stepwise regression analysis were used to analyze the influencing factors of depression.@*Results@#Among 3 648 junior middle school students, 846 were positive for depression, and the detection rate of depression was 23.2%. There was a statistically significant difference in the detection rate of depression among junior middle school students in different grades(χ2=143.24，P<0.01). Study pressure(r=0.54), interpersonal relationship(r=0.54), other(r=0.51), health adaptation(r=0.41), being punished(r=0.40), and loss(r=0.26) in the Adolescent Life Events Scale were positively correlated with depression (P<0.05). Multiple stepwise regression analysis showed that being punished and loss scores had negative association with depression scores(β=-0.10, -0.08). Interpersonal relationships, study pressure, health adaptation and other scores had positive predictive effects on depression scores(β=0.29, 0.26, 0.04, 0.22)(P<0.05).@*Conclusion@#There was a wide positive correlation between depression and life events in junior middle school students. Some factors of life events had certain predictive effects on depression of junior middle school students in Shanghai.