Optimal evidence analysis for the nursing management of limb spasm in patients with spinal cord injury / 中华创伤杂志

Objective:To explore the optimal evidence for the nursing management of limb spasm in patients with spinal cord injury.Methods:Based on the "6S" evidence model, the databases including CNKI, Wanfang, PubMed and Cochrane Library, the guideline websites such as the National Guideline Clearinghouse, Guidelines International Network and Registered Nurses′ Association of Ontario, and the websites of professional associations such as the Royal College of Physicians, American Spinal Injury Association and Canadian Spine Association were systematically searched. Search period of each database was set from the year of inception until July 2022. Two investigators independently screened the literatures related to the management of limb spasm in patients with spinal cord injury, and conducted quality evaluation and evidence recommendation level evaluation.Results:Totally 17 literatures consisting of 6 guidelines, 3 expert consensuses, 5 systematic reviews, 2 evidence summaries, and 1 clinical decision were included. Moreover, 30 pieces of evidence were summarized from 3 aspects, including evaluation and identification, drug therapy (chemical denervation, and oral medication), rehabilitation training (hydrotherapy, electrical stimulation, magnetic stimulation, vibration therapy, heat and cold therapy, body position, and exercise therapy).Conclusion:Nursing staff can set up a multidisciplinary team according to the clinical environment and take into consideration of the characteristics of spinal cord injury patients to provide personalized interventions involving evaluation and identification, drug therapy, rehabilitation training, etc., so as to alleviate the degree of limb spasm.

Construction of a hypoglycemia prediction model for older adults with type 2 diabetes based on random forest algorithm / 中国实用护理杂志

Objective:To construct a hypoglycemia random forest prediction model for older adults with type 2 diabetes, and assess the model′s prognostication performance through internal and external verification.Methods:From August 2022 to January 2023, 300 older adults with type 2 diabetes in Beijing Hospital were selected. The demographic characteristics, medical history, laboratory tests, and other data of the patients were collected, and the data set was randomly divided into the training set and verification set in a ratio of 7∶3. The hypoglycemia prediction model for older adults with type 2 diabetes was constructed and optimized based on the random forest algorithm. The calibration curve was used to evaluate the model′s calibration, and the ROC was used to evaluate the model′s discrimination. The clinical applicability of the model was assessed by the decision curve analysis. The risk factors for hypoglycemia in the older adults were explored by prioritizing the contributions of variables in prediction. The Bootstrap method was used for internal validation, and the validation set was used for external validation.Results:Among the 300 older adults with type 2 diabetes, 128 cases (42.67%) experienced hypoglycemia within one week. The predictive contributions of risk factors in the model were ranked as follows: the number of episodes of hypoglycemia in one month, HDL-C, heart disease, diabetes knowledge and education, combination therapy, age, duration of diabetes, staple food restriction, glycosylated hemoglobin, and gender. The internal and external calibration curves of the hypoglycemia random forest model for the older adults with type 2 diabetes fluctuated around the diagonal, indicating that the calibration degree of the predictive model is good. The AUROC of internal verification was 0.823 (95% CI 0.752-0.894), the sensitivity and specificity were 0.867 and 0.698, respectively. The external verification was 0.859 (95% CI 0.817 - 0.902), and sensitivity and specificity were 0.789 and 0.804, respectively, showing that the overall discrimination of the prediction model was good. The DCA curves were far from the all-positive line and all-negative line, which indicated that the prediction model had good clinical applicability. Conclusions:The predictive effect of this model is good, and it is suitable for predicting the risk of hypoglycemia in older adults with type 2 diabetes, and it provides a reference for early hypoglycemia screening and predictive intervention for this kind of patients.

Clinical significance of phospholipase A2 receptor 1 in patients with idiopathic membranous nephropathy / 中华肾脏病杂志

Objective To explore the role of phospholipase A2 receptor 1 (PLA2R1) in the diagnosis,differential diagnosis and evaluation of idiopathic membranous nephropathy (IMN) in adult patients.Methods A total of 242 renal disease patients diagnosed by renal biopsy from March 2015 to January 2016 were enrolled,consisting of 90 IMN,20 secondary membranous nephropathy (SMN),82 IgA nephropathy (IgAN),30 minimal changed disease (MCD),16 focal segmental glomerulosclerosis (FSGS) and 4 membranoproliferative glomerulonephritis (MPGN).Their clinical data including age,sex,serum creatinine (Scr),serum albumin and 24 h urinary protein were collected.Serum PLA2R1 was measured by enzyme linked immunosorbent assay.PLA2R and IgG subclasses in glomeruli were detected by indirect immunofluorescence assay.The positive rate of serum PLA2R1 among those groups and its correlation with clinical-pathological parameters were analyzed.Results Compared with IMN patients,SMN,MCD and FSGS patients were younger (all P ＜ 0.01); IgAN patients were younger and had higher serum albumin and lower 24 h proteinuria (all P ＜ 0.001); MPGN patients had higher Scr (all P ＜ 0.01).The positive rate of serum PLA2R1 was 75.6％ in IMN patients,while it was 0.0％ in non-IMN patients.The distribution between serum PLA2R1 and pathological diagnosis had difference (P ＜ 0.001),their positive coincidence rate was 100％,negative coincidence rate was 87.4％,total coincidence rate was 90.9％ and their consistency was well (Kappa=0.795,P ＜ 0.001).Among IgG subtype comparisons between IMN patients and SMN patients in the glomeruli,only moderate or more positive IgG4 had statistical differences (82.2％ vs 5.0％,P ＜ 0.001); the positive rate of glomerular PLA2R1 was 41.1％ in IMN patients,higher than 10.0％ in SMN patients (P=0.009); positive PLA2R1 with moderate or more positive IgG4 in glomeruli in IMN patients was more than that in SMN patients (40.0％ vs 0.0％,P ＜ 0.001),which could improve the diagnostic specificity of IMN.In IMN patients serum PLA2R1 and glomerular PLA2R1 had statistical differences (P＜0.001).Spearman rank correlation analysis showed that serum PLA2R1 of IMN patients positively correlated with 24 h proteinuria (r=0.315,P=0.002),negatively correlated with serum albumin (r=-0.228,P=0.030) and didn't correlate with Scr (r=0.199,P=0.059).Conclusions Serum PLA2R can be used as the specific indicator for diagnosis,differential diagnosis of IMN and to reflect the severity of IMN in patients.

Association of A53T polymorphism with Parkinson's disease in Chinese patients / 中华行为医学与脑科学杂志

Objective To investigate the association of α-synaptophysin A53T gene polymorphism with parkinson's disease(PD) in Chinese people.Methods The conventional polymerase chain reaction was used to detect the α-synaptophysin A53T gene polymorphism in 224 sporadic PD patients(PD group)and 154 healthy individuals(control group).According to the Hoehn-Yahr(H-Y) classification standard, PD patients were divided into H-Y ≥ 3 group(n=172) and H-Y ≤ 2.5 group(n=52).Each genotype and alleles frequencies as well as the A53T gene expression and their relation to the severity of parkinson's disease were analyzed with Chi-square test of SPSS19.0.Results The frequency of the A53T genotype of A/A were 40(17.9％) and 10(6.5％) (x2 =10.267, P=0.001, OR=3.13,95％ CI =1.514-6.473) in the PD group and control group, respectively.The frequency of the allele A was 160(35.7％) and 70(22.7％) (x2 =14.543, P=0.000, OR=1.889,95％ CI =1.359-2.625) in the PD group and control group,respectively.The frequency of the A53T genotype of A/A was 30(17.4％) and l0 (19.2％) in the H-Y ≥ 3 group and H-Y ≤ 2.5 group, respectively, with significant difference (P=0.003,0.007) as compared to the control group.The frequency of the allele A was 122(35.5％) and 38(36.5％) in the the H-Y ≥ 3 group and H-Y ≤ 2.5 group,respectively, with significant difference (P=0.000,0.006) as compared to the control group.There was no statistically significant difference of the A53T genotype of A/A and the allele A between the H-Y≥3 group and H-Y≤2.5 group (P=0.768,0.841).Conclusion The A53T gene polymorphism is the risk factor of Parkinson's disease in Chinese people, but it isn't correlated to stage of sporadic parkinson' s disease.

Pulmonary expression levels of fibroblast growth factor receptors and lung fibrosis in mice at different ages / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the correlation of pulmonary expressions of fibroblast growth factor receptors (FGFR1-4) with lung fibrosis and aging.</p><p><b>METHODS</b>Real-time fluorescence quantitative PCR was used to detect the expression levels of FGFR1-4 in the lung tissues, and lung fibrosis was observed by HE and Masson staining in mice at different ages.</p><p><b>RESULTS</b>The 4 subtypes of FGFR showed different expression levels in the lung tissues of mice, and FGFR2 had the highest expressions. The expression levels of all the 4 FGFR subtypes in 8-month-old mice were significantly lower than those in 5-week-old mice. The 8-month-old mice tended to present with histological changes of lung fibrosis.</p><p><b>CONCLUSION</b>FGFR expressions is down-regulated with aging in mice. Among the FGFR subtypes, FGFR2 is expressed at the highest level. The occurrence of lung fibrosis with aging is probably associated with down-regulated FGFR expression. FGF/FGFR signaling may participate in the aging process and regulation of lung fibrosis.</p>

Evaluation of the biological properties of a highly efficient tissue cell preservative / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the performance of a new highly efficient and environment-friendly tissue cell fixatives for preserving the morphologies and properties of pleural and peritoneal effusions.</p><p><b>METHODS</b>Fifty-six specimens of tissue cells from pleural and peritoneal effusions were preserved using the new preservative or 95% ethanol. HE staining and Western blotting were employed to detect the morphologies and protein expression levels of CK, CEA and P53 of the cells after fixation.</p><p><b>RESULTS</b>The new preservative well preserved the morphologies of the cells from the pleural and peritoneal effusions, and the nuclei and cytoplasm were intact with little debris. The conventional preservative (95% ethanol) caused noticeable structural damage of the tissue cells, especially the cytoplasm where obvious debris were seen after fixation. CK, CEA and P53 protein expression levels in the cells were 91%, 86% and 88% after fixation with the new preservative, significantly higher than those (46%, 38% and 31%, respectively) in cells fixed with 95% ethanol (P<0.05).</p><p><b>CONCLUSION</b>The new preservative is efficient and environment-friendly for preserving the morphologies as well as the proteins of tissue cells from pleural and peritoneal effusions well, demonstrating its potential in tissue cell fixation and preservation.</p>

Hedgehog signaling pathway and lung cancer / 肿瘤研究与临床

Hedgehog (Hh) pathway plays a critical role in embryonic development period,which regulates cell proliferation and differentiation,and coordinates the key step of organs' development process such as skin,brain,neural tube,bowels,appendage and lung.In the adult stage,Hh signaling regulates proliferation of stem cells.At this time,Hh signaling is strictly controlled by time and space.In recent years,studies have shown aberrant activation of the Hh pathway is closely related to various types of malignancies,and would be a new therapeutic target of tumor treatment.This paper will review the characteristic of Hh signaling pathway and its research status in lung cancer.

Identification of the reference genes' accuracy for lung tissue specimens by real-time quantitative PCR / 肿瘤研究与临床

Objective To analyze the expression stability of the three widely used reference genes β-glueuronidase (GUSB), glycera]dehydes-3-phosphate dehydrogenase (GAPDH), β2-microglobulin (β2-M) in Chinese lung cancer tissue specimens and normal lung tissue specimens. Methods Gene expression wasmeasured by quantitative real time PCR and expression stability was analyzed with two widely used softwares genorm and normfinder. Results The intra-and inter-group difference of GAPDH is maximum (The intra and inter-group s is 1.07 and 0.93 respectively, |△ Ct|=2.01±1.06; P =0.000). The mean of these three genes' Ct value is the most stable one analyzed by the two softwares. But the t test showed that the mean of Ct value of GUSB and β2-M is the unique combination that had the minimum intra-and inter-group difference, with no statistically significant differences between normal and malignant samples (The intra-and inter-group s is 0.53 and 0.79 respective]y, |△Ct|= 0.73±0.53; P =0.053). Conclusion It is inappropriate to normalize data derived from lung tissue specimens using one of these three housekeeping genes alone. Among the different combinations of these three genes, the mean of the Ct values of GUSB and β2-M is the best choice as the internal control of lung tissue specimens.

Inhibitory effect of blocking both epidermal growth factor receptor and cycloox-ygenase-2 pathway on proliferation of lung cancer A549 cells / 中国肿瘤生物治疗杂志

Objective:To explore the inhibitory effects of gefitinib (epidermal growth factor receptor inhibitor) com-bined with celecoxib (cyclooxygenase-2 inhibitor) against human lung cancer A549 cells and the possible mechanism. Methods: A549 cells were cultured in RPMI 1640 medium and were divided into 4 groups: normal control group, 5 μmoL/L gefitinib group, 25 μmol/L celecoxib group, and 5 μ mol/L gefitinib + 25 μmol/L celecoxib group. The morpho-logical changes of A549 cells were observed under inverted microscope 48 h after treatment ; the effects of drugs on growth of A549 Cells were detected by MTT assay; the apoptosis and cell cycles of A549 cells were measured by Annexin V/PI and Hoechst 33258 staining, respectively; and the expression of EGFR protein, COX-2 protein, and EGFR mRNA were determined by immunofluorescenee and real-time PCR. Results: Compared with gefitinib and celecoxib groups, many granules and vacuoles were observed in the gefitinib and celecoxib combination group, and cells became round and there was defluxion. Both gefitinib and celecoxib inhibited the growth of A549 cells in a time- and dose-dependent manner. Af-ter treatment for 48 h, the inhibitory rate was (58.2±4.6) % in the combination group, which was significantly higher than those of the other two groups. Apoptosis rate in the combination group was also significantly higher than those in the other two groups (33.9% vs 6.0%, 8.8%), and the cell proportion in S phase significantly decreased and in G_0/G_1 phases significantly increased(P <0.01). EGFR protein, COX-2 protein, and EGFR mRNA expression in A549 cells was significantly decreased in the combination treatment group compared with those in the other two groups (P < 0.05). Conclusion : Gefitinib and celecoxib can synergistically inhibit the growth of A549 cells, possibly through promoting apop-tosis, G_0/G_1 arrest, and down-regulating activated EGFR and COX-2 expression.

Inhibitory effect of blocking both epidermal growth factor receptor and cyclooxygenase-2 pathway on proliferation of lung cancer A549 cells / 中国肿瘤生物治疗杂志

Objective:To explore the inhibitory effects of gefitinib(epidermal growth factor receptor inhibitor) combined with celecoxib(cyclooxygenase-2 inhibitor) against human lung cancer A549 cells and the possible mechanism.Methods: A549 cells were cultured in RPMI 1640 medium and were divided into 4 groups: normal control group,5 ?mol/L gefitinib group,25 ?mol/L celecoxib group,and 5 ?mol/L gefitinib+25 ?mol/L celecoxib group.The morphological changes of A549 cells were observed under inverted microscope 48 h after treatment;the effects of drugs on growth of A549 Cells were detected by MTT assay;the apoptosis and cell cycles of A549 cells were measured by Annexin V/PI and Hoechst 33258 staining,respectively;and the expression of EGFR protein,COX-2 protein,and EGFR mRNA were determined by immunofluorescence and real-time PCR.Results: Compared with gefitinib and celecoxib groups,many granules and vacuoles were observed in the gefitinib and celecoxib combination group,and cells became round and there was defluxion.Both gefitinib and celecoxib inhibited the growth of A549 cells in a time-and dose-dependent manner.After treatment for 48 h,the inhibitory rate was(58.2?4.6)% in the combination group,which was significantly higher than those of the other two groups.Apoptosis rate in the combination group was also significantly higher than those in the other two groups(33.9% vs 6.0%,8.8%),and the cell proportion in S phase significantly decreased and in G0/G1 phases significantly increased(P