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Objective@#To explore the related factors of death from severe heat stroke in Shanghai from 2013 to 2017.@*Methods@#The data of 1 152 patients with severe heat stroke who were divided into survival (n=1 037) and death (n=115) groups including gender, age and heat stroke type (heat cramp, heat exhaustion, heat apoplexy and the mixed type) were collected from meteorological bureau and case report system for high temperature heat stroke in Shanghai from 2013 to 2017. Meanwhile, the meteorological data of the onset date of severe heat stroke cases were collected, including maximum temperature, minimum temperature, daily temperature, relative humidity, air pressure, precipitation and wind speed. The differences of individual and meteorological factors between the two groups were compared, and multivariate logistic regression model was used to analyze the related factors of death from severe heat stroke.@*Results@#Among 1 152 cases, the mean±SD of age was (56.29±18.95) years old, 843 (73.18%)were male, 962 (83.51%) were in the heat wave period; 322 cases (27.95%) were heat cramp, 170 cases (14.76%) were heat exhaustion, 533 cases (46.27%) were heat apoplexy and 114 cases (9.90%) were the mixed type. Daily average temperature ((32.81±1.99) ℃), daily maximum and minimum temperatures ((38.20±2.24) ℃ and (29.22±1.94) ℃) in survival group were lower than those in death group (all P values<0.001), which were (33.76±1.17) ℃, (39.19±1.31) ℃ and (29.72±1.66) ℃. Daily average relative humidity ((60.36±9.75)%) and daily minimum relative humidity ((41.26±9.71)%) in survival group were higher than those in death group(allP values <0.05), which were (54.59±6.89)% and (35.60±7.24)%. The results of logistic regression analysis suggested that compared with the cases with daily average humidity <60% and a mixed type heat stroke, the death OR (95%CI) values of cases with daily average humidity >60%, heat cramp, heat exhaustion and heat apoplexy were 0.31 (0.18,0.54), 0.13 (0.05,0.34), 0.68 (0.58,2.30) and 0.87 (0.48,1.58).@*Conclusion@#The temperature, relative humidity and the type of heat stroke were the main related factors affecting the prognosis of severe heat stroke.
ABSTRACT
Since all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3) have become front-line drugs in treatment of acute promyelocytic leukemia (APL), cure rates of APL patients have improved dramatically. However, resistance to ATRA and/or As2O3has been a critical problem which has hampered the effect of treatment. In this review, some emerging mechanisms of resistance to ATRA and/or As2O3in recent years, such as genetic mutations, disorders of cellular signal transduction, disorders of chromatin remodeling complex, abnormal regulation of cell apoptosis, and micro-environment mediated drug resistance are summarized.
ABSTRACT
Since all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3) have become front-line drugs in treatment of acute promyelocytic leukemia (APL), cure rates of APL patients have improved dramatically. However, resistance to ATRA and/or As2O3has been a critical problem which has hampered the effect of treatment. In this review, some emerging mechanisms of resistance to ATRA and/or As2O3in recent years, such as genetic mutations, disorders of cellular signal transduction, disorders of chromatin remodeling complex, abnormal regulation of cell apoptosis, and micro-environment mediated drug resistance are summarized.
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Objective To investigate the effects of radiofrequency thermocoagulation (RFT) on pathological features and the expressions of choline acetyltransferase (ChAT), vasoactive intestinal peptide (VIP) and nitric oxide synthase (NOS) at lower esophageal sphincter (LES) in family dogs. Methods A total of 15 dogs were randomly divided into three groups. Sham group underwent gastroscopy and was fed for 3 months (n=5). Dogs were given RFT and were fed for 24 h after RFT (n=5, RFT+24 h group). Dogs were given RFT and were fed for 3 months after RFT (n=5, RFT+3m group). The pathological changes of LES were observed after HE staining in three groups. The expressions of ChAT, VIP and NOS were detected by immunohistochemical method in three groups. Results Results of HE staining showed nearly the same tissues in Sham group and control group. There were active inflammatory reaction and structural damage in RFT+24 h group. The chronic in-flammatory reaction and structural remodeling were found in RFT+3m group. Immunohistochemistry showed that ChAT was significantly increased in RFT+3m group compare than that of Sham group. Values of VIP and NOS were significantly de-creased in RFT+3m group compare than that of Sham group (P<0.01). Conclusion The thickness and increased pressure of LES were found after RFT,which also caused changes in neurotransmitters of local tissues in dogs.
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Objective To observe the clinical efficacy of coupled plasma filtration adsorption (CPFA) combined with high volume hemofiltration (HVHF) for severe acute pancreatitis (SAP) and explore the practicality, the safety and the therapeutic mechanism. Methods This was a prospective, randomized clinical trail. A total of 29 patients with SAP were di-vided into two groups:treatment group (n=15, CPFA and HVHF) and control group (n=14, HVHF). The APACHEⅡscore, se-rum triglyceride, liver and kidney function, white blood cell (WBC), heart rate (HR), respiration, mean arterial pressure (MAP) and oxygenation index were compared before and after treatment between two groups. The organ function was as-sessed, and the adverse reactions and prognosis were observed in two groups. Results After treatment, there were signifi-cant decreases in APACHEⅡscore and WBC, and significant increase in PaO2/FiO2 in two groups, especially significant in treatment group. There was a significant decrease in the level of triglycerides in 7-d treatment group than that of 3-d treat-ment group (P＜0.05). There were no thrombocytopenia, bleeding, allergies, blood clotting and other adverse reactions in two groups of patients. There were significant decreases in the blood purification time and the length of hospital stay in treatment group than those of control group (P＜0.05). There was no significant difference in mortality between two groups. Conclu-sion CPFA combined with HVHF can effectively control inflammation, reduce the serum level of triglyceride and improve the prognosis in patients with SAP.