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Objective:To analyze the risk factors of lower extremities deep vein thrombosis after thoracoscopic surgery in elderly patients with lung cancer, establish a nomogram prediction model and conduct internal verification.Methods:A total of 183 elderly patients with lung cancer who underwent thoracoscopic radical resection in Nanchong Central Hospital from February 2018 to February 2022 were selected as the study subjects. According to the presence or absence of deep venous thrombosis of the lower extremities within one month after operation, the patients were divided into lower extremities deep venous thrombosis group ( n=61) and non-deep lower extremities venous thrombosis group ( n=122) . Univariate and multivariate analyses of deep venous thrombosis of lower extremities after thoracoscopic surgery for lung cancer in the elderly were performed, and a nomogram prediction model was constructed according to the multivariate analysis results, and the model was verified. Results:There were statistically significant differences in smoking history ( χ2=13.40, P<0.001) , preoperative chemotherapy ( χ2=8.79, P=0.003) , surgical method ( χ2=7.97, P=0.005) , operation time ( t=7.23, P<0.001) , postoperative bed rest time ( t=10.40, P<0.001) , combined with diabetes ( χ2=6.37, P=0.012) , combined with hyperlipidemia ( χ2=9.58, P=0.002) , preoperative D-dimer ( t=13.08, P<0.001) , preoperative fibrinogen ( t=5.84, P<0.001) and preoperative platelet count ( t=7.01, P<0.001) between the lower extremity deep venous thrombosis group and the non-lower extremity deep venous thrombosis group. The results of multivariate logistic regression analysis showed that preoperative chemotherapy ( OR=2.45, 95% CI: 1.05-5.71, P=0.038) , surgical method ( OR=2.55, 95% CI: 1.14-5.73, P=0.023) , postoperative bed rest time ( OR=1.50, 95% CI: 1.24-1.81, P<0.001) , combined with diabetes ( OR=3.60, 95% CI: 1.05-12.33, P=0.042) , and preoperative D-dimer ( OR=1.01, 95% CI: 1.01-1.01, P<0.001) were all independent risk factors for lower extremity deep vein thrombosis in elderly patients with lung cancer after thoracoscopic surgery. The C-index of nomogram for predicting lower extremity deep vein thrombosis-related factors was 0.86 (95% CI: 0.81-0.93) . The calibration curve showed that the model had a good correlation in predicting lower extremities deep venous thrombosis. Conclusion:Preoperative chemotherapy, surgical method, postoperative bed rest time, combined with diabetes, and postoperative D-dimer level are influence factors for lower extremity deep vein thrombosis in elderly patients with lung cancer after thoracoscopic surgery. The nomogram prediction model established in this study has high accuracy and discrimination for the prediction of lower extremity deep vein thrombosis in elderly patients with lung cancer after thoracoscopic surgery.
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Objetive： To investigate the mechanism of antidepressant effect of verbascoside based on high-throughput sequencing technology （RNA-Seq），and to explore the possible targets and signaling pathways. MethodsForty C57BL/6 mice were randomly divided into control group，model group，fluoxetine group and verbascoside group，10 mice in each group. Except for the control group，all the other three groups were constructed with chronic unpredictable mild stimulation （CUMS） combined with solitary feeding for four weeks. Control group，fluoxetine group and verbascoside group were administered by gavage once daily for three weeks during the second week of modeling. The mice were assessed by sugar-water preference test，forced swimming test，open field test，elevated cross maze test，and water maze test. Enzyme linked immunosorbent assay（ELISA） was performed to detect the levels of major neurotransmitters and inflammatory factors in mice serum，and mRNA high-throughput sequencing was performed in the nucleus accumben and colon to screen differentially expressed genes and perform pathway enrichment analysis. Real-time polymerase chain reaction（Real-time PCR） was used to detect the mRNA expression of Gad，Slc32a1（VGAT） and brain-derived neurotrophic factor (BDNF） in nucleus accumbens. ResultCompared with the control group，the anxiety and depression-like behaviors in the model group increased，while the learning and memory ability decreased significantly. The content of neurotransmitter in serum decreased significantly. The content of pro-inflammatory factors increased significantly. The mRNA expression of Gad and Slc32a1（VGAT） in nucleus accumbens decreased significantly，while that of BDNF increased significantly. Compared with the model group，the anxiety and depression-like behavior of mice in verbascoside group was significantly relieved. The neurotransmitter content increased significantly，and the pro-inflammatory factors decreased significantly. The mRNA expression of Gad and Slc32a1（VGAT） in nucleus accumbens increased significantly，while that of BDNF decreased significantly.A total of 48 differentially expressed genes in nucleus accumbens and 43 differentially expressed genes in colon were screened by high-throughput sequencing. Differential genes in nucleus accumbens mainly focus on neuroactive ligand-receptor interaction， γ-aminobutyric acid（GABA）ergic synapse，synaptic vesicle cycle and other pathways. Colonic differential genes are mainly concentrated in GABAergic synapses，synaptic vesicle circulation，cyclic adenosine monophosphate（cAMP） signal pathway and other signal pathways. Compared with the control group，the mRNA expression of Gad and Slc32a1（VGAT） in nucleus accumbens of model group decreased significantly，while the mRNA expression of BDNF increased significantly. ConclusionVerbascoside has significant antidepressant effects. Its antidepressant effect may be related to the increase of monoamine neurotransmitters，the decrease of pro-inflammatory factors and the restoration of neurotransmitter homeostasis by increasing GABA，and it mainly acts through the signaling pathways such as neuroactive ligand-receptor interaction，GABAergic synapses，synaptic vesicle cycle and cAMP signaling pathway.
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Objective To investigate the relationship between muscle mass reduction and quality of life in elderly lung cancer patients at the initial visit.Methods Totally 221 patients with non-small cell lung cancer undergoing chest and abdominal CT examination were included in this study at Fenyang Hospital in Shanxi Province.The Pearson's correlations of skeletal muscle index(SMI) and skeletal muscle radiodensity(SMD)with the disease stage,physical function,role of physical function,global quality of life,fatigue and dyspnea were analyzed.Results The average age of 221 patients was(70.2t9.0)years.The mean SMI for men and women was(46.7± 7.8)cm2/m2 and(39.4 ±6.4) cm2/m2 respectively.Multivariate linear regression analysis showed that SMI affected the body function,role of physical function,global quality of life,and fatigue dimension(all P ＜ 0.05),and SMD affected the physical function of life quality and dyspnea dimension(P ＜0.05).SMI was related to the physical function and role of physical function(men:r =0.287 and 0.245,P =0.001 and 0.006;women:r=0.296 and 0.395,P =0.004 and 0.000).In male patients,SMO was also associated with low global quality of life and fatigue(r=0.191 and-0.198,P =0.032 and 0.026).The above relationships did not change even after adjusting for the effect of age and disease stages.Low SMD was associated with low physical function and dyspnea in both men and women(men:r =0.287 and 0.245,P=0.037 and 0.049;women.:r=0.281 and-0.262,P=0.006 and 0.010),and SMD was associated with dyspnea only in women even after adjusting for age and disease stages.A correlation between SMI and the disease stage was found in both men and women(male:r =-0.266,P=0.003;female:r=-0.223,P=0.005).Conclusions Changes in muscle mass may affect the physical function,role of physical function and global quality of life in elderly patients with non-small cell lung cancer.
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Objective To explore the training mode of tutorial system for undergraduates majoring in pharmacy based on CDIO (conceive,design,implement and operate).Methods 72 undergraduates majoring in pharmacy from the Fourth Military Medical University were randomly divided into two groups,and they were taught by CDIO based tutorial system and general tutorial system,respectively.By using the Graphpad prism 5.0 software and adopting the method of independent sample unpaired t test,we made a comparative analysis of two groups in the project's scoring.In addition,the questionnaire survey was conducted to evaluate the teaching effectiveness,whose data was expressed by a percentage.Results The average score of the experimental group was (116.8 ± 7.73),which was 43.3％ higher than that of the control group (81.51 ± 6.08),and the difference was statistically significant (P=0.001).The questionnaire survey showed that the average satisfaction rate of the experimental group was above 90％.Conclusion Excellent teaching effect was obtained based on CDIO training mode,and the ability of students in practice,team cooperation,problem-solving and innovative thinking,professional ethics and a serious attitude on scienceare promptly enhanced.
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AIM: To investigate the effect of zacopride, an inward rectifier potassium channel agonist, on ouabain-induced arrhythmias in adult rats, and to explore the underlying electrophysiological mechanism.METHODS: Using ouabain to establish in vitro and in vivo arrhythmic rat models, the effects of zacopride on ouabain-induced arrhythmias were observed.The technique of whole-cell patch clamp was used to observe the effects of zacopride on inward rectifier potassium current (IK1), resting membrane potential (RMP) and delayed afterdepolarizations (DADs) in single rat ventricular myocyte.RESULTS: Zacopride at 1 μmol/L significantly reduced total number of premature ventricular beats, and the duration and incidence of ventricular tachycardia and ventricular fibrillation induced by ouabain in rat hearts in vitro (P<0.05).In anesthetized rats, zacopride at 15 μg/kg significantly reduced total number of premature ventricular beats, and the duration and incidence of ventricular tachycardia and ventricular fibrillation induced by ouabain (P<0.05).IK1 was significantly inhibited by ouabain (P<0.05), which was partially and even completely reversed by zacopride at 0.1~10 μmol/L.RMP value was significantly reduced by ouabain (P<0.05), and then increased to different levels after treatment with zacopride (0.1~10 μmol/L).Zacopride at 1 μmol/L showed its maximal effect and RMP was restored to normal level.Moreover, zacopride at 1 μmol/L markedly suppressed ouabain-induced DADs in single rat ventricular myocyte.The incidence of DADs decreased from 91.67% to 12.50% after zacopride was applied (P<0.05), and this effect was abolished by 1 μmol/L BaCl2.CONCLUSION: Inward rectifier potassium channel agonist zacopride significantly inhibits ouabain-induced ventricular arrhythmias in adult rats.The mechanism is related to increased RMP level and inhibition of DADs by activation of IK1 channel.
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Aim To observe the effect of antibody NCX-3F10 on the main ion current of rat ventricular myocytes and its effect on arrhythmias induced by ischemia/reperfusion(I/R).Methods ① The whole-cell patch clamp technique was employed to record the Na+/Ca2+ exchange current(INa/Ca) and other major ion currents in rat ventricular myocytes.② The rat models of arrhythmia induced by ischemia/reperfusion were established by ligating the left coronary artery to in vivo and in vitro.Then the effects of antibody on the arrhythmia were observed.③ The IonOptix ion imaging system was used to observe the effect of antibody on calcium transients in single ventricular myocytes.Results ① The antibody NCX-3F10 dose-dependently inhibited INa/Ca from 5 to 40 mg·L-1.The IC50 for outward and inward currents was 11.15 and 11.69 mg·L-1, and the maximum inhibitory rates were 61% and 62%, respectively.The antibody also had an inhibitory effect on calcium current(ICa-L), and had no significant effect on inward rectifier potassium current(IK1), transient outward potassium current(Ito) and sodium current(INa).② In the isolated rat heart group I/R, 100% rats showed ventricular tachycardia, and 88.89% rats had ventricular fibrillation.After administration of antibody NCX-3F10(10 mg·L-1) 5 min before reperfusion, the incidence of ventricular tachycardia decreased to 44.43%(P<0.05), and the duration of ventricular tachycardia and ventricular fibrillation was also shortened remarkably(P<0.05).③ In the anesthetized rats after administration of antibody NCX-3F10(50 μg·kg-1) 5 min before reperfusion, the incidence and duration of ventricular tachycardia,the incidence and duration of ventricular fibrillation, and total number of ventricular premature beats were significantly decreased(P<0.05).④ From 5 to 40 mg·L-1, NCX-3F10 antibody decreased calcium transient amplitude in rat single ventricular myocytes dose-dependently(P<0.05).Conclusions The NCX-3F10 antibody shows significant arrhythmic effects on ischemia-reperfusion induced arrhythmia in rats both in vitro and in vivo, the underlying mechanism of which is related to NCX and L-type calcium current inhibition and calcium overload reduction by the NCX antibody.
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Cationic lipid nanoparticles possessing favorable biocompatibility and controllable particle size has at-tracted increasing attention in the field of non-viral vectors for delivering nucleic acids in vitro and in vivo.1,2-Dilinoleyloxy-3-dimethylaminopropane(DLinDMA)and its derivatives,one of the most important cationic lipid materials,have been widely studied as the mainly composition of cationic lipid nanoparticels.This paper summa-rized the structure,characteristics and clinical application of DLinDMA nanoparticles.
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The pathogenesis of cancer-related sarcopenia is complicated,involving all aspects of tumor and the body's metabolism,mainly related to accelerated proteolysis and insufficient protein synthesis.Cancerrelated sarcopenia can predict antineoplastic-induced dose-limiting toxicities,increase complications,and reduce survival rate.The interventions of cancer-related sarcopenia includes nutrition,exercise,hormone therapy and other interventions.A single treatment can not reverse clinical outcome.Various interventions are still in the investigation stage,in which more evidence-based studies are needed.
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Objective To explore the correlation between the levels of nitrite/nitrate(NO2/NO3) in exhaled breath condensate (EBC) and pulmonary infection in mechanically ventilated patients.Methods The clinical data from ventilated patients in critical care units of Peking University People' s Hospital from November 2006 to August 2007 were collected and analyzed.The patients' clinical pulmonary index score (CPIS) were calculated.EBC of those patients were collected via endotracheal tube or tracheostomy cannula, and the concentrations of NO2/NO3 were assayed.The level of NO2/NO3 in different CPIS patients in 24 hours' ventilation,weaning proportion in 3 days and mortality in different NO2/NO3 level patients were compared.The correlation of the CPIS and level of NO2/NO3 were explored between survival and non-survival patients.Results A total of 76 patients were enroled.The NO2/NO3 levels in patients of CPIS≤3 ,CPIS 3-6 and CPIS >6 in 24 hours of ventilation were (23.31±5.79), (28.72±9.10) and (35.42±12.10) μmoL/L respectively, with significantly differences between each other (P < 0.01).The lower the patients' concentration of NO2/NO3 was, the earlier the weaning and the lower the mortality were.The NO2/NO3 levels on 4th and 7th day were detected in 24 survival patients and 23 non-survival patients.The difference of NO2/ NO3 levels between the survival patients and non-survival patients became significant on 7th day [(29.32±9.52) μmol/L vs.(37.22±12.03) μmol/L, P < 0.01].Linear correlation analysis showed that the NO2/ NO3 level was positively correlated with CPIS (r = 0.76, P < 0.01).Condusions The NO2/NO3 level of EBC in ventilated patients is positively correlated to the severity of pulmonary infection, thus may be used as a new predictor for weaning and prognosis.
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Objective To observe the efficacy of invasive ventilation (Ⅳ) in treatment of acute pulmonary edema (APE), and to explore the factors associated with prognosis. Method From March 2005 to December 2007, 23 APE patients, who were hospitalized in the EICU of People' s Hospital of Peking University and the con-ventional treatment and noninvasive ventilation were not effective, were treated by Ⅳ (PEEP 5～18 cmH2O). Blood pressure, heart rate, respiratory rate, and arterial blood gas values were recorded accurately before and after ventilation and compared with each other. Regression analysis was used to analyze the factors associated with prog-nosis. Resets Three hours after Ⅳ, the blood pressure, heart rate, respiratory rate, arterial blood gas were sig-nificanfly improved (P <0.01). Among the 23 patients, 11 survived, and the other 12 patients died. Nine pa-tients died of MOF. Among 16 patients with cardiac function Ⅲ-Ⅳ, 10 died. Among 15 patients with acute my-ocardial infarction, 9 died. Among 11 patients with renal insufficiency, 9 died. The multivariate logistic regression analysis showed that the reduced left ventricular ejection fraction, the lower mean arterial pressure, and the in-creased creatinine were the independent predictor of prognosis. Conclusions Invasive ventilation is an effective method of treating patients with acute pulmonary edema. Proper ventilation may improve the cardiac function and clinical symptoms, but it's not the fundamental measure for increasing cure rate. 1he renal insufficiency and heart failure are the independent predictor of prognosis.
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OBJECTIVE:To screen formulation of Insulin cream and to investigate the effects of insulin cream on wound healing in rabbits.METHODS:The best formulation of insulin cream was selected from 8 kinds of formulations with appearance and stability as index.Rabbit trauma model were induced and divided into matrix group,blank group,Insulin cream groups(high-dose,medium-dose and low-dose).Wound healing rate and healing time were compared among those groups.RESULTS:The fifth formulation possessed good appearance and stability,which included albolene,cetanol,glycerin monostearate,glycerol,etc.Compared with matrix group,the wound healing rates were obviously increased at different time points in Insulin cream groups(P
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65yrs, diabetes mellitus, chronic renal failure, etc; of which 7 were independent risk factors associated with death (P
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<p><b>OBJECTIVE</b>To explore the clinical and radiological features of severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Analysis of the clinical presentation, chest radiographs, course of disease and features of severe pneumonia in 45 SARS patients diagnosed at our hospital in Beijing between April 5 - 20, 2003. Also included is a summation of the clinical features of SARS.</p><p><b>RESULTS</b>(1) SARS appears to have high infectivity; (2) the most common symptom is fever; (3) the count of leukocyte is normal or decreased; (4) most patients (35/45, 77.8%) had experienced a 24-hour fever prior to the abnormal chest X-ray changes which showed progression of pulmonary infiltrates within 48 hours in 71.1% (32/45) of the patients and, (5) the percentage of patients who developed severe pneumonia (24.4%) is higher than those who developed typical pneumonia.</p><p><b>CONCLUSION</b>SARS is a disease with high infectivity and has its own clinical and radiological features. Early recognition, prompt isolation, and appropriate therapy are the key to combat this infection.</p>