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Objective:To evaluate the effect of high concentration hydrogen on myocardial injury and expression of mammalian STE20-like protein kinases 1 (Mst1) in septic mice.Methods:One hundred and five clean-grade healthy male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 3 groups ( n=35 each) using a random number table method: sham operation group (group Sham), sepsis group (group SEP), and sepsis+ high concentration hydrogen group (group SEP+ HCH). The model of sepsis-induced myocardial injury was developed by cecal ligation and perforation in anesthetized mice. In SEP+ HCH group, high concentration hydrogen (66.7%) was inhaled for 1 h starting from 1 and 6 h after the successful preparation of the model. Twenty mice were taken from each group to observe the survival rate at day 7 after operation. Blood samples from the medial canthus were collected after deep anesthesia at 24 h after surgery for determination of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) concentrations (by enzyme-linked immunosorbent assay). Then the animals were sacrificed, and the heart tissues were taken for examination of the pathological results (with a light microscope) which were scored and for determination of apoptosis in myocardial cells (by TUNEL) and expression of Mst1, dynamic-related protein 1 (Drp1) and mitofusin 2 (Mfn2) in myocardium (by Western blot). Results:Compared with group Sham, the survival rate at 7 days after operation, pathological score, apoptosis index and concentrations of TNF-α and IL-6 were significantly increased, Mst1 and Drp1 expression was up-regulated, and Mfn2 expression was down-regulated in group SEP ( P<0.05). Compared with group SEP, the survival rate at 7 days after operation, pathological score, apoptosis index and concentrations of TNF-α and IL-6 were significantly decreased, Mst1 and Drp1 expression was down-regulated, and Mfn2 expression was up-regulated in group SEP+ HCH ( P<0.05). Conclusions:Inhalation of high-concentration hydrogen can attenuate the myocardial injury in septic mice, and the mechanism may be related to down-regulation of Mst1 expression, improvement in mitochondrial dynamics, and inhibition of apoptosis in myocardial cells.
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Objective:To understand the practice of humanistic care and social worker voluntary service in public hospitals in China.Methods:From January to March 2021, 38 typical cases concerning " medical social worker and volunteer system" and " building a harmonious doctor-patient relationship through humanistic service" were collected by relying on the evaluation of China Healthcare Improvement Initiative. By means of statistics on the frequency of the subject words in the cases, hotspots of these hospitals in " paying attention to medical humanistic care and promoting social work voluntary service" were identified.Results:By classifying the keywords of the 38 cases, the hotspots mainly focused on strengthening the construction and management of social work volunteer platform and team, providing convenient and high-quality services, integrating humanistic care into diagnosis and treatment services, and building characteristic brand projects.Conclusions:The concept of humanistic care should be integrated into the hospital culture construction, the standardized and institutionalized development of humanistic care and volunteer work in the hospital should be promoted. Supporting measures should be introduced to promote the professional and stable development of talent team, and the routine service system should be established based on the needs assessment of both doctors and patients.
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Objective:To summarize the progress and achievement of inpatient experience improvement in public hospitals in China from 2016 to 2021, so as to provide basis for further improving hospitalization experience and raising inpatient satisfaction.Methods:Based on the five Third-party Evaluations of China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on inpatient process, cost and inpatient satisfaction, and the inpatient satisfaction in different regions and different types of institutions was compared.Results:The overall satisfaction of hospitalized patients in the fifth evaluation in 2021(98.5%)was higher than that in the first evaluation in 2016(96.2%). The western region and maternal and child institutions had the most obvious improvement in the comparison of regional and institutional types. The improvement of inpatients′ satisfaction with diet was not obvious. Inpatients were most dissatisfied with " high medical expenses" , " cumbersome procedures" and " long waiting time for bed" .Conclusions:From 2016 to 2021, the satisfaction of hospitalized patients has been consistently improved, but there is still room for improvement in non-medical services. Hospital meals for inpatient and relief of inpatient healthcare financial burden are the priorities for healthcare improvement and raising hospitalization satisfaction in the next stage.
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Objective:To summarize the progress and achievement of outpatient experience improvement in tertiary public hospitals from 2016 to 2021, so as to provide basis for further improving outpatient experience and raising outpatient satisfaction.Methods:Based on 5 round third-party evaluations of the China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on the outpatient process and outpatient satisfaction, and stratified analysis was conducted on patient satisfaction in different regions and different types of institutions.Results:One hundred and thirty-six core sample hospitals were included in the 5 round evaluation, and 30 153 valid questionnaires were collected in the fifth evaluation in 2021.From 2016 to 2021, the overall satisfaction of outpatients in the 5 round evaluations was 91.4%, 87.3%, 90.1%, 91.1% and 95.4%, respectively. The satisfaction of outpatients to the medical services continued to improve. Outpatient treatment process has been continuously optimized, appointment registration has become the most commonly used way of outpatient registration. The satisfaction of outpatients to the process and environment of treatment in the western region was significantly improved.Conclusions:From 2016 to 2021, the overall satisfaction of outpatients has been consistently improved. Informatization helps to optimize the treatment process, but it is recommended that hospitals should provide special support for elderly outpatients.
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Objective:To explore the change trend of patients′ recognition of the medical reform effect and medical staff′s occupation and its relationship with medical experience, since the implementation of the China Healthcare Improvement Initiative(CHII), so as to provide reference for exploring the breakthrough point of consolidating the reform effect.Methods:Four indicators of the third-party assessment of patients were selected, which were " I think the medical reform has benefited patients" , " I think the doctor-patient relationship is improving in the past three years" , " I think medical personnel deserve social respect and recognition" , and " I am willing to let my children join the medical profession" . Descriptive and trend analysis were carried out on the survey results, and correlation analysis was carried out between the survey results and patients′ medical experience.Results:Compared with the baseline evaluation results(76.9% and 69.9%for outpatients, 87.3% and 85.6%for inpatients), the patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship in the fifth evaluation(86.2% and 89.1%for outpatients, 91.4% and 92.6%for inpatients)were significantly improved. The proportion of patients who thought the medical staff was worthy of respect and willing to let their children work in the hospital in the fifth evaluation(97.4%, 79.1%for outpatients, 98.7%, 85.1%for inpatients)were higher than the baseline evaluation results(92.3%, 71.0%for outpatients, 98.1%, 81.6%for inpatients). The above indicators were positively correlated with the patient′s medical experience.Conclusions:Since the implementation of CHII, patients′ recognition of the sense of medical reform and the improvement of doctor-patient relationship has been continuously improved, and patients′ respect and recognition of professional identity of medical personnel is at a high level and continues to improve. Improving medical experience has a positive effect on the improvement of patients′ sense of medical reform.
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Objective To evaluate the effect of iron metabolism of preoperation on the length of intensive care unit (ICU) stay in liver transplant recipients.Methods A retrospective study was conducted. 120 adult liver transplant recipients admitted to Tianjin First Central Hospital from September 2015 to September 2017 were enrolled. The basic data, model of end-stage liver disease (MELD) evaluation system score at admission; iron metabolism index, routine blood test, blood biochemistry, coagulation time and C-reactive protein (CRP) level within 24 hours after admission; intraoperative clinical indicators such as operation time, operation bleeding volume, red blood cells and fresh frozen plasma input volume, hot ischemia time, cold ischemia time, urine volume; and the length of ICU stay were collected. All patients were divided into iron deficiency group (ID group; serum ferritin < 100μg/L, or serum ferritin 100-300μg/L and transferrin saturation < 0.20) and non-iron deficiency group (non-ID group; serum ferritin > 300μg/L, or serum ferritin 100-300μg/L and transferrin saturation > 0.20) according iron deficiency standard. The indexes of iron metabolism, basic data and clinical indicators of two groups were compared. The correlation between serum ferritin level and the length of ICU stay was analyzed by Pearson correlation.Results Compared with non-ID group, the levels of serum iron concentration and serum ferritin were significantly decreased in ID group [serum iron concentration (μmol/L): 3.50±1.62 vs. 14.50±2.31, serum ferritin (μg/L): 67.00±31.54 vs. 315.00±36.73, bothP < 0.01], infusion volume of intraoperative red blood cells and fresh frozen plasma were significantly increased, and the length of ICU stay was significantly prolonged (days: 6.5±2.4 vs. 3.3±0.5,P < 0.01). There was no significant difference in transferrin saturation, CRP and other clinical indicators between the two groups. Correlation analysis showed that serum ferritin level was negative correlated with the length of ICU stay (r = -0.768,P < 0.001).Conclusion Preoperative iron deficiency in liver transplant recipients will lead to increased blood transfusion and prolonged length of ICU stays.
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Objective To explore the effects ofPolygonum multiflorum Thunb. by different processed temperature on acute liver injury induced by CCl4 in mice. MethodsA total of 140 KM mice were randomly divided into the control group, the positive drug group, the model group, the 100℃, 110℃, and 120℃ processed group and crude drug group, all the groups above were in sequence given the equal normal saline, silymarin (10 mg/kg), 100℃ extract (100 mg/kg), 110℃ extract (100 mg/kg), 120℃ extract (100 mg/kg) and crude drug extract (100 mg/kg) each day, respectively. After 7 days, apart of the control group, the other groups were established the acute liver injury model by the carbon tetrachloride. The blood and liver of mice were taken after 24 h post-model made. The levels of AST, ALT, Alb, TP, IL-6, TNF-a, IL-1, SOD, MDA and GSH-Px were detected, and liver pathological features of each group were observed.Results Compared with the model group, the levels of ALT (132.14 ± 19.66 U/L, 81.55 ± 12.67 U/L, 169.37 ± 24.18 U/Lvs. 261.84 ± 31.61 U/L), AST (231.57 ± 38.38 U/L, 181.73 ± 36.52 U/L, 318.36 ± 39.68 U/Lvs. 624.79 ± 49.98 U/L), IL-6 (10.35 ± 1.62 pg/ml, 6.26 ± 1.36 pg/ml, 12.57 ± 1.88 pg/mlvs. 18.73 ± 5.54 pg/ml), TNF-α (243.74 ± 13.02 pg/ml, 189.36 ± 9.85 pg/ml, 273.13 ± 14.64 pg/mlvs. 314.36 ± 29.67 pg/ml), IL-1 (235.36 ± 30.14 pg/ml, 208.07 ± 9.33 pg/ml, 48.21 ± 33.15 pg/mlvs.264.76 ± 32.55 pg/ml) in the 100℃, 110℃, 120℃ group significantly decreased (P<0.05). The levels of TP (69.16 ± 2.96 g/L, 74.14 ± 3.17 g/L, 65.73 ± 2.22 g/Lvs. 62.06 ± 2.65 g/L), Alb (35.86 ± 2.64 g/L, 36.67 ± 2.81 g/L, 34.06 ± 2.64 g/Lvs. 32.16 ± 2.05 g/L) in the 100℃, 110℃, and 120℃ group significantly increased (P<0.05). The levels of SOD (82.94 ± 6.21 U/mg, 101.33 ± 9.16 U/mg, 71.32 ± 5.15 U/mg vs. 66.22 ± 1.13 U/mg), GSH-Px (153.39 ± 15.23 U, 199.25 ± 12.04 U, 159.26 ± 17.18 Uvs. 64.79 ± 32.56 U) in the 100℃, 110℃, and 120℃ group significantly increased (P<0.05), while the level of MDA (0.96 ± 0.22 nmol/mg, 0.69 ± 0.13 nmol/mg, 1.29 ± 0.13 nmol/mgvs.1.71 ± 0.33 nmol/mg) in the 100℃, 110℃, and 120℃ group significantly decreased (P<0.05). Conclusions Different processed temperature ofPolygonum Multiflorum Thunb. water extract on liver injury in mice caused by carbon tetrachloride is not the same. The 110℃ processed temperature showd the best liver protection.
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Objective To evaluate the efficacy of CHOP (cyclophosphamide,doxorubicin,vincristine,and prednisone)chemotherapy on peripheral T cell lymphomas-unspecified (PTCL-U)in patients aged 80 years and over,and investigate the chemotherapy adverse effects and its prognostic factors.Methods Clinical data of 57 patients with PTCL-U confirmed by pathology and immunohistochemistry in Guangzhou First People's Hospital from January 2008 to January 2015 were retrospectively analyzed.The efficacy and adverse effects of CHOP chemotherapy,and its prognostic factors were evaluated.Results Of 57 patients,11 (19.3％) achieved complete remission,23(40.4％)had partial remission,14(24.6％)had stable disease,and 9(15.8％)had progressive disease after CHOP chemotherapy,with a total effective rate of 59.6％ (34 cases).The expected 1-year,2-year and 3-year overall survival(OS)rate was 70.2％ (40 cases),36.8％ (21 cases) and 17.5％ (10 cases),respectively.The median survival time was 18.2 months.Among the 57 patients,40(70.2％) had hypoplasia of bone marrow at degree Ⅰ-Ⅱ,17 (29.8％) at degree Ⅲ-Ⅳ,49 (86.0％) had mild nausea and vomiting(degree Ⅰ-Ⅱ),8(14.0％)had severe nausea and vomiting(degree Ⅲ-Ⅳ),7 had liver dysfunction,2 had cardiac toxicity and 7 had disturbance of blood coagulation.Univariate analysis showed that the alkaline phosphatase,Ki-67 percentage,lymphoma international prognostic index(IPI)score,extranodal involved sites(＞1),as well as the efficacy and course of chemotherapy were the prognostic factors for survival time in very elderly patients.Multivariate analysis indicated that IPI score＞2(95％CI:1.12～6.35,x2 ＝5.45,P＜0.01),extranodal involved sites(＞1)(95％ CI:2.58-15.32,x2 ＝ 16.42,P＜0.01),disease progression(95％CI:1.82～12.15,x2 ＝ 10.23,P＜0.01),chemotherapy courses(＞4) (5％CI:0.18～0.79,x2 ＝7.28,P＜0.01)were the independent prognostic factors for the median survival time in very elderly patients.Conclusions PTCL U patients aged 80 years and over have poor prognosis.CHOP chemotherapy has a certain effect on PTCL-U in very elderly patients,and chemotherapy side effects can be tolerated.IPI score＞2 and extranodal involved sites(＞ 1)are the important prognostic factors in very elderly PTCL-U patients.The completion of full course of chemotherapy with remission occurrence is important to prolong survival time in very elderly PTCL-U patients.
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Objective To detect the expressions of c-myc,Bmi-1,serum insulin-like growth factor-Ⅰ (IGF-Ⅰ) and insulin-like growth factor binding protein-3 (IGFBP-3) in diffuse large B-cell lymphoma (DLBCL),and to analyze their relations with clinical stages,efficacy and prognosis.Methods 102 cases of incipient patients with DLBCL and 60 patients or health examination volunteers were chosen as DLBCL group and control group,respectively.Immunohistochemical method was used to detect expressions of c-myc and Bmi-1 in DLBCL wax samples.Chemiluminescence immunoassay method was used to determine the levels of serum IGF-Ⅰ and serum IGFBP-3.The expression differences of these factors between DLBCL group and control group and their relations with pathological types,clinical stage,IPI and chemotherapy were analyzed.Results The positive rates of c-myc and Bmi-1 were 71.6 ％ (73/102) and 61.8 ％(64/102) in the tissues of DLBCL,respectively.The positive rates of c-myc and Bmi-1 in non-GCB group were higher than those in GCB group [c-myc:80.0 ％ (48/60) vs 59.5 ％ (25/42);Bmi-1:71.7 ％ (43/60) vs 50.0 ％ (21/42)].With the increase of IPI score,the expressions of c-myc and Bmi-1 were enhanced,but there were no statistical differences between Ⅲ-Ⅳ group and Ⅰ-Ⅱ group (P ＞ 0.01).The differences of 3-year progression free survival (PFS) rate and 3-year overall survival (OS) rate between c-myc gene or Bmi-1 gene normal and abnormal had statistical significance,and 3-year PFS rate and 3-year OS rate of double-hit of c-myc gene and Bmi-1 were lower.C-myc gene and Bmi-1 gene aberrant were the independent prognosis factors.The levels of serum IGF-Ⅰ and serum IGFBP-3 in DLBCL group were significantly lower than those in the control group (P ＜ 0.01),however,the levels were increased after chemotherapy (P ＜ 0.01).Serum IGF-Ⅰ and serum IGFBP-3 levels had no significant differences between non-GCB group and GCB group (P ＞ 0.01).Their levels in stage Ⅳ group or high risk group were significantly lower than those in other groups.Serum IGF-Ⅰ level and serum IGFBP-3 level had no significant differences between the c-myc gene or Bmi-1 gene abnormal group and normal group (P ＞ 0.01),but their levels were lower in both c-myc gene and Bmi-1 gene abnormal group than those in normal group.Conclusions C-myc and Bmi-1 are related with the biological characteristics and prognosis of DLBCL.Serum IGF-Ⅰ level and serum IGFBP-3 level reflect clinical stages of DLBCL and the efficacy in a certain degree.The expressions of c-myc and Bmi-1 have some correlation with the levels of serum IGF-Ⅰ and IGFBP-3 in DLBCL.
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Objective To construct a prokaryotic expression vector pET-22b+with Middle East respiratory syndrome ( MERS) coronavirus nuclocapsid protein( NP) gene and to express and purify N protein.Methods N gene amplified by PCR was inserted into the prokaryotic expression vector pET-22b+.Recombinant plasmid was confirmed using DNA elec-trophoresis and sequencing.NP was expressed in E.coli BL21(DE3) by IPTG induced and purified by cation exchange chromatography using the AKTA purification system.Results The NP gene sequence was proved to be correct by sequen-cing and the protein was expressed in both soluble and insoluble forms in E.coli BL21 ( DE3 ) after IPTG induction.The purity and concentration of recombinant protein was improved obviously by cation exchange chromatography and enrich-ment.Conclusion Recombiant NP of high purity and concentration is purified and will facilitate NP functional research.
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Objective To detect the impact of reactive oxygen species ( ROS) on mitochondrial morphology and distri-bution during mitosis.Methods A viral vector in which the fluorescence gene was specifically under the control of mito-chondrial promoter was constructed and confirmed through DNA sequencing and Western blotting.After transfecting HeLa s3 cell with packaged virus, the HeLa s3-COX4tp-EGFP cell line stably expressing the mitochondrial fluorescence signal was obtained.With immunofluorescent staining, the impact of ROS on the morphology and distribution of mitochondria dur-ing mitosis was inspected.Result The cell line constantly expressing mitochondrial fluorescence signals was successfully constructed.Meanwhile,it was found that H2 O2 treatment could significantly change the morphology and distribution of mi-tochondria during mitosis by confocal microscopy.Conclusion Our study demonstrates that ROS can affect the morphology and distribution of mitochondria during mitosis.This research help study the relationship between the mitochondrial function and the regulation of mitosis in the future.
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Objective To investigate the role and possible mechanism of ultrasound-targeted microbubble destruction for accelerating neovascularisation in ischemic skeletal muscle. Methods Unilateral hind limb ischaemia was surgically induced in thirty wister rats. On postoperative day 7 , the rats were randomly divided into three groups: ultrasound-targeted microbubble destruction group (group A), ultrasound group (group B), and control group. After the end of the experiment , parafin sections for the skeletal muscle from one rat in each group were made to observe the changes in microstructure. The remaining rats were sacrificed at 24 h and on day 7. VEGF expression, inflammatory factor E-selectin, and monocyte chemotactic factor-1 (MCP-1) were detected in the rats. Results As compared with the other two goups, expressions of VEGF, neovascularization, E-selectin, and MCP-1 in the skeletal muscle were significantly increased in group A. Conclusions Microvascular rupture caused by ultrasound-targeted microbubble destruction can promote angiogenesis by stimulating secretion of endogenous VEGF in skeletal muscle; meanwhile, an increase in expression level of inflammatory factors may be one of the mechanisms.