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Objective:To investigate the correlation of PELP1/MNAR expression with expressions of estrogen receptor (ER), Ki-67, human epidermal growth factor receptor 2 (HER2) and PIK3CA gene mutation.Methods:A total of 80 paraffin-embedded tissue specimens of primary invasive breast cancer patients in the Fifth People's Hospital of Datong in Shanxi Province from January 2008 to December 2018 were collected. The expression of PELP1/MNAR was examined by immunohistochemistry EliVision tow-step method. The polymerase chain reaction (PCR)-Sanger sequencing method was used to detect the mutation of PIK3CA gene. The expressions of PELP1/MNAR among patients with different expression status of ER, Ki-67, HER2 and with or without PIK3CA gene mutation were compared, and the correlations between each index and the expression of PELP1/MNAR were analyzed.Results:The high expression rates of PELP1/MNAR protein in patients with ER-positive [86.1% (31/36) vs. 59.1% (26/44)], Ki-67 high expression [100.0% (13/13) vs. 65.7% (44/67)], HER2-positive [81.0% (34/42) vs. 60.5% (23/38)] were high, and the differences were statistically significant (all P<0.05). There was no significant difference in the high expression rate of PELP1/MNAR protein between patients with mutant and wild-type PIK3CA [60.0% (12/20) vs. 75.0% (45/60), P = 0.199]. The expression of PELP1/MNAR was negatively correlated with the expression level of ER ( r = -0.195, P < 0.05), positively correlated with the expression level of Ki-67 ( r = 0.198, P < 0.05), positively correlated with the expression level of HER2 ( r = 0.225, P < 0.05), and negatively correlated with lymph node metastasis ( r = -0.269, P < 0.05). Conclusions:The expression of PELP1/MNAR in invasive breast cancer is negatively correlated with the expression level of ER, and positively correlated with the expression level of Ki-67 and HER2. There is no correlation between PELP1/MNAR expression and PIK3CA gene mutation, and the two may play their own role in the PI3K-AKT-mTOR regulatory pathway of breast cancer.
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Objective:To investigate the clinical manifestations of hospitalized patients with spinal muscular atrophy (SMA) combined with pneumonia and compare outcomes of different plans based on the manifestations, so as to improve the diagnosis and treatment of this disease.Methods:The clinical data of 13 SMA children with pneumonia hospitalized in the Department of Respiratory in Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2015 to June 2019 were retrospectively analyzed.General information including the age of patients, the classification of their diseases, the type of respiratory failure and complications was collected.For the pneumonia, the pathogens, complications, related respiratory failure type, and the treatments for SMA children during hospitalization were documented.The pathogen of pulmonary infection and treatment were described.The mode, duration, and outcome of mechanical ventilation for the SMA children during hospitalization and after discharge from the hospital were also analyzed.Results:There were 8 SMA patients with type 1 suffering from more severe conditions, most of whom had type Ⅱ respiratory failure and pneumonia complications.The average duration of hospitalization for type 1 patients [(39.8±30.3) d] was longer than that of type 2 patients [(7.8±2.2) d]( t=2.318, P=0.041). Six SMA children underwent tracheal intubation and tracheotomy, who had multiple drug-resistant bacterial infections and needed long-term treatments with rotated multiple antibiotics.The average duration of hospitalization of these 6 children [(51.3±25.3) d] was longer than that of other 4 children with non-invasive ventilation [(7.5±2.4) d]( t=3.391, P=0.009). In contrast, 3 patients who underwent tracheal intubation achieved a stable condition (normal body temperature; percutaneous oxygen saturation condition >94% under air condition; chest radiography without inflammation; sputum suction frequency less than 4 hours) after active application of airway clearance technique.They were successfully extubated and shifted to non-invasive ventilation.Three children who got rid of mechanical ventilation in daytime still took long-term application of nighttime non-invasive ventilation after discharge since their polysomnography indicated sleeping disorders.None of those 3 patients were hospitalized again due to severe pneumonia. Conclusions:In order to avoid infection of multi-resistant bacteria, SMA children with pneumonia receiving tracheal intubation should be extubated and shift to non-invasive ventilation as soon as their condition is stable.Children who get rid of non-invasive ventilation should take polysomnography before being discharged from hospital.Long-term application of nighttime non-invasive ventilation should be taken at home if the polysomnography suggests sleeping disorders, so as to reduce the risk of re-hospitalization due to recurrent pneumonia.
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Objective@#To study the short-term and long-term efficacy of the non-invasive ventilation treatment in children with spinal muscular atrophy (SMA) and sleep-disordered breathing.@*Methods@#This was a prospective research to study the effect of night-time non-invasive ventilation in children with SMA and moderate to severe sleep-disordered breathing during March 2016 to January 2018, from the Pulmonary Department of Capital Institute of Pediatrics Affiliated Children's Hospital. Patients were divided into the treated group (with night-time non-invasive ventilation) and the control group (without ventilator). Sleep breathing pressure titration was suggested to the patients who were prepared to receive non-invasive ventilation. All cases were followed up for one year. Parameters′changes in polysomnography were assessed (paired t-test) in titration patients. Frequency of respiratory tract infection during the next year in the patients with and without ventilation was collected and compared (Mann-Whitney U-test).@*Results@#Seventeen cases were recruited. The average age was (5.1±2.9) years, 10 cases were boys and 7 cases were girls. In the titration group (8 patients), after non-invasive ventilation, the average apnea hypopnea index was (3.8±2.5) times/h (t=4.086, P=0.005), hypopnea index was (2.4±1.2) times/h (t=2.779, P=0.027), average oxygen saturation during total sleep time was 0.966±0.007 (t=-5.292, P=0.001), and the minimum oxygen saturation was 0.906±0.023 (t=-3.938, P=0.006). All the above parameters were significantly improved after treatment. Than before, which was (16.6±9.7) times/h, (7.2±4.7) times/h, 0.946±0.015, 0.786±0.092 respectively. Ventilator mode for the 9 children with long time non-invasive ventilation at home was Bi-level positive airway pressure S/T. The positive airway pressure was set at 8-14 cmH2O (1 cmH2O=0.098 kPa) in inspiratory phase and 4-6 cmH2O in expiratory phase. In the treated group (9 patients), the average frequency of upper respiratory tract infection was 1.0 (0, 3.0) times/year (Z=-2.245, P=0.023), the lower respiratory tract infection was 0 (0, 0) times/year (Z=-3.189, P=0.001), hospitalization was 0 (0, 0) times/year (Z=-3.420, P<0.01), and admission to intensive care unit was 0 (0, 0) times/year (Z=-3.353, P=0.029). All the above indexes were significantly decreased compared with the control group (8 patients), which was 3.0 (2.3, 7.0) times/year, 2.0 (1.3, 4.5) times/year, 1.0 (1.0, 4.3) times/year, 0.5 (0, 1.0) times/year respectively.@*Conclusion@#Non-invasive ventilation is efficient to SMA children with sleep-disordered breathing, and also can reduce the incidence of respiratory tract infections for children with SMA.
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Objective To evaluate the present development and status of quality control for intensive care unit (ICU) in Sichuan Provincial traditional Chinese medicine (TCM) hospitals including integrated traditional Chinese and western medicine hospitals and ethnic hospitals, and to provide practical references for improving the service quality of ICU. Methods Supervisory Group of Sichuan Provincial Critical Care Medicine Quality Control Center of TCM was established in September 2018. From September 8th to 17th, 2018, according to the Scoring Criteria of Quality Control and Supervision Project of TCM for Critical Care Medicine, a 10-day quality control professional guidance was hand out to TCM hospitals with independent ICU in Sichuan Province. The service level of different aspects of hospital quality control was evaluated and ranked from equipment and resource support, medical team, service capacity and level, ward quality, completion of critical care core indicators, completion of quality control of TCM, development of new technologies, diagnosis and treatment schemes for dominant diseases. Results There were 52 TCM hospitals across the province that had an ICU. Thirty-three hospitals were third-class (63.5%), while the rest 19 hospitals were second-class (36.5%). Province-level, city-level and county-level hospitals were accounted for 9.6% (5/52), 38.5% (20/52), and 51.9% (27/52), respectively. Average bed ratio of ICU was 1.8%. Doctor-bed and guard-bed ratios were 0.71∶1 and 2.0∶1, respectively. The average annual admission rate of patients and the average daily admission rate of beds were higher, which were basically 1%. Ward quality was high; the incidence of nosocomial infection was controlled below 10%. Compliance rate of septic shock bundle treatment was high. The incidences of ventilator-associated pneumonia (VAP), catheter-related bloodstream infection (CRBSI) and catheter-associated urinary tract infection (CAUTI) were 0.45%, 0.22%, and 0.30%, respectively. Participation rate of TCM was about 83.4%. Average number of new technologies was about 4.4. Average number of disease schemes was about 2.62. Conclusions ICU of Sichuan Provincial TCM hospitals reaches the standard level in service capacity and level, ward quality, critical medicine quality control, and participation rate of TCM treatment. Improvements are required for other prospects, including department scale, medical personnel allocation, new technical development, diagnosis and treatment schemes of dominant diseases.
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Objective To learn about polysomnography (PSG) of the patients with spinal muscular atrophy (SMA),and the improvement of the moderate-severe sleep disordered breathing(SDB) patients after non-invasive ventilation (NIV) treatment.Methods The PSG examination of 11 SMA patients in Children′s Hospital Affiliated to Capital Institute of Pediatrics was performed.The PSG results and the levels of breathing disorder of these patients were collected.These patients were divided into 2 groups as follows.The mild group:apnea hypopnea index(AHI) was between 5 to 10 times/h,or average pulse oxygen saturation(SpO2)>95%;the moderate-severe group:AHI>10 times/h,and average SpO2≤95%.The moderate-severe levels of the patients were treated with NIV.Then the improvement of PSG after the treatment was evaluated.Results Within the 2 cases of type 1 SMA,1 was moderate-severe,the other 1 was mild.There were 2 cases moderate-severer and 6 cases mild SDB cases of type 2 SMA.The only 1 case of type 3 was categorized as mild disorder.The average hypopnea index(6.3 times/h) was higher than apnea index(4.9 times/h).The indicators to distinguish the moderate-severe and mild groups were as follows:AHI,average SpO2,hypopnea index,and arousal index associated with respiratory case,and there were statistically significant differences(all P<0.05).Significant improvement in PSG of the 3 NIV-treated patients was observed and it remained in normal range.The following indicators also remarkably improved after NIV treatment were hypopnea index [(1.5±0.1) times/h vs.(11.5±4.6) times/h,t=3.741,P<0.05],AHI [(2.4±1.1) times/h vs.(17.4±8.1) times/h,t=3.196,P<0.05],and average SpO2 [(96.7±0.6)% vs.(94.3±1.2)%,t=-3.130,P<0.05].Conclusions There are different levels of SDB within SMA patients.The major characteristic of SMA patients is hypopnea.There are more moderate-severer SDB in type 1 than those in type 2.The average SpO2,arousal index associated with respiratory incidents,AHI,and hypopnea index can reflect the levels of SDB of SMA patients.Besides,the results indicate NIV treatment can significantly improve SDB of SMA patients.
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Objective To test the hypothesis that perceived organizational support(POS) plays a moderate role in the process of personality' s effect on emotional exhaustion.Methods Using POS,Revised NEO Personality Inventory and Emotional Exhaustion Inventory,376 special combat soldiers were tested from the Chinese Armed Police Force.Then SPSS 16.0 was used to conduct descriptive analysis,correlational analysis and hierarchical regression analysis.Results The interaction of neuroticism and POS as well as the interaction of conscientiousness and POS were significant or marginally significant,respectively.POS significantly moderated the relationship between neuroticism and emotional exhaustion(β=-0.19,t=-2.82,P＜0.01)as well as the relationship between conscientiousness and emotional exhaustion(β=-0.12,t=-1.95,P=0.052).Conclusion Neuroticism and conscientiousness are more strongly related with emotional exhaustion among individuals with low POS than high POS.