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Objective:To investigate the current sedation level of patients with mechanical ventilation in ICU, and to explore the influence of early different sedation levels on clinical outcomes, so as to provide theoretical basis for better guidance of clinical sedation evaluation and implementation of sedation strategy management.Methods:This study was a retrospective longitudinal study. The 201 patients with invasive mechanical ventilation who underwent sedation in the Department of Intensive Care Medicine of the First Affiliated Hospital of Guangxi Medical University from January to December 2021 were selected by convenience sampling method. According to the results of Richmond Agitation-Sedation Scale(RASS), the patients were divided into deep sedation group (98 cases) and shallow sedation group (103 cases). The influencing factors of endotracheal intubation retention time and outcome were investigated by Cox multifactor analysis.Results:In the early sedation ≤48 h after the start of mechanical ventilation, 63.2%(2 143/3 389) of patients with invasive mechanical ventilation had a RASS score of shallow sedation, 35.2%(1 194/3 389) of patients with deep sedation, and 1.5%(52/3 389) of patients with insufficient sedation. Cox multivariate regression analysis showed that age, sedation level, duration of invasive mechanical ventilation and continuous renal replacement therapy were the factors influencing the indentation time of tracheal insertion ( χ2 values were 4.73 to 74.31, all P<0.05); early deep sedation was a risk factor for delayed extubation ( HR=0.499, 95% CI 0.276-0.903, P<0.05); gender, sedation level, invasive mechanical ventilation duration, acute physiology and chronic health evaluation Ⅱ scores, admission mode, continuous renal replacement therapywere the influencing factors of patient outcomes ( χ2 values were 4.41 to 26.20, all P<0.05). The deeper the sedation, the worse the patient outcomes ( HR=0.568, 95% CI 0.335-0.963 all P<0.05) . Conclusions:The early sedation level is related to the retention time and outcome of tracheal intubation in ICU patients with mechanical ventilation, and different sedation levels affect the clinical outcome of patients. The retention time of tracheal intubation in patients with shallow sedation was shortened, which was beneficial to the outcome of patients.Therefore, sedation evaluation should be strengthened in clinical work, and sedation methods should be selected according to the needs of patients. In the absence of contraindications, the shallow sedation strategy should be implemented as soon as possible. This study provides some reference and theoretical basis for the formulation and management of clinical sedation strategies.
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Object:To explore the role of personalized nutritional intervention based on nutritional assessment in long-term continuous nursing of elderly postoperative colorectal cancer patients.Methods:Elderly patients with colorectal cancer who received radical surgery in a tertiary hospital in Beijing were screened from January 2021 to January 2022 and a total of 100 patients at nutritional risk (defined as with a Nutritional Risk Screening 2002 [NRS 2002] score ≥ 3) were included in the study. Patients were stratified by age and then divided into control and intervention groups with 50 cases in each. The control group received regular health guidance and follow-up visits at postoperative outpatient clinics while the intervention group received personalized nutritional intervention based on nutritional assessment additionally. The intervention period was 12 months. Nutritional indicators including body mass index (BMI), upper arm circumference, grip strength and hemoglobin, as well as albumin and quality of life (QoL), are compared between the two groups.Results:Compared with the control group, the intervention group showed significantly better results of BMI [(18.46±0.53) vs (16.9±0.77)], upper arm circumference [(25.09±1.41)cm vs (23.49±1.45)cm], grip strength [(28.34±8.00)kg vs (23.97±7.19)kg], HGB [(135.10±9.27)g/L vs (106.40±8.73)g/L] and ALB [(41.62±3.41)g/L vs (28.62±2.38)g/L, all P < 0.01]. The intervention group also had significantly higher scores in physical [(20.96±2.03) vs (15.66±0.82)], emotional [(21.48±1.64) vs (15.76±1.00)], social [(23.44±1.67) vs (15.96±0.99)], and functional [(20.74±1.74) vs (5.46±0.97)] domains of QoL (all P<0.01). Conclusion:In elderly patients with colorectal cancer after radical resection, personalized nutritional intervention based on nutritional assessment can effectively control nutritional indicators, help reduce the incidence of malnutrition, improve postoperative quality of life, and inform the establishment of standardized process in nutrition management.
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Objective:To systematically evaluate the dose-response relationships of resistance exercise intensity in frail elderly.Methods:A comprehensive search of randomized controlled trials on the dose-response relationships of resistance exercise for frail elderly in PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database. The documents that met the conditions were screened out, and after the data were extracted and the quality of the documents were evaluated, the RevMan 5.3 software was used for Meta analysis.Results:A total of 10 eligible randomized controlled trials were included in this study. The subjects of the study were 454 cases of frail and pre-frail elderly. After Meta analysis, there was a dose-response relationships between the training intensity of resistance exercise and the muscle strength, muscle endurance, and physical function of frail elderly. Both low-intensity and high-intensity resistance exercises can significantly increase the leg muscle strength of frail elderly people ( MD=4.58, 95% CI 3.34-5.82, P<0.05) and muscle endurance ( MD=12.27, 95% CI 6.54-17.99, P<0.05). Compared with low-intensity resistance exercise, high-intensity resistance exercise increased leg muscle strength of frail elderly people ( MD=7.97, 95% CI 0.85-15.09, P<0.05) and muscle endurance ( MD=6.94, 95% CI 5.21-8.66, P<0.05) showed more obvious advantages. The analysis of the results of the chair sitting test and the stairs climbing test shows that low-intensity resistance exercise has no obvious advantage in improving the physical function of frail elderly people, while high-intensity resistance exercise can significantly improve the physical function of frail elderly people ( MD=-5.8, 95% CI -7.3--4.29, P<0.05; MD=-1.20, 95% CI-2.17--0.23, P<0.05). Conclusions:Resistance exercise can significantly improve the muscle strength, muscle endurance and physical function of the frail elderly. High-intensity resistance exercise is more effective than low-intensity resistance exercise.
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Background@#Arctic-like (AL) lineages of rabies viruses (RABVs) remains endemic in some Arctic and Asia countries. However, their evolutionary dynamics are largely unappreciated. @*Objectives@#We attempted to estimate the evolutionary history, geographic origin and spread of the Arctic-related RABVs. @*Methods@#Full length or partial sequences of the N and G genes were used to infer the evolutionary aspects of AL RABVs by Bayesian evolutionary analysis. @*Results@#The most recent common ancestor (tMRCA) of the current Arctic and AL RABVs emerged in the 1830s and evolved independently after diversification. Population demographic analysis indicated that the viruses experienced gradual growth followed by a sudden decrease in its population size from the mid-1980s to approximately 2000.Genetic flow patterns among the regions reveal a high geographic correlation in AL RABVs transmission. Discrete phylogeography suggests that the geographic origin of the AL RABVs was in east Russia in approximately the 1830s. The ancestral AL RABV then diversified and immigrated to the countries in Northeast Asia, while the viruses in South Asia were dispersed to the neighboring regions from India. The N and G genes of RABVs in both clades sustained high levels of purifying selection, and the positive selection sites were mainly found on the C-terminus of the G gene. @*Conclusions@#The current AL RABVs circulating in South and North Asia evolved and dispersed independently.
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Background@#High concentrations of particulate matter less than 2.5 μm in diameter (PM2.5) in poultry houses is an important cause of respiratory disease in animals and humans. Pseudomonas aeruginosa is an opportunistic pathogen that can induce severe respiratory disease in animals under stress or with abnormal immune functions. When excessively high concentrations of PM2.5 in poultry houses damage the respiratory system and impair host immunity, secondary infections with P. aeruginosa can occur and produce a more intense inflammatory response, resulting in more severe lung injury. @*Objectives@#In this study, we focused on the synergistic induction of inflammatory injury in the respiratory system and the related molecular mechanisms induced by PM2.5 and P. aeruginosa in poultry houses. @*Methods@#High-throughput 16S rDNA sequence analysis was used for characterizing the bacterial diversity and relative abundance of the PM2.5 samples, and the effects of PM2.5 and P. aeruginosa stimulation on inflammation were detected by in vitro and in vivo. @*Results@#Sequencing results indicated that the PM2.5 in poultry houses contained a high abundance of potentially pathogenic genera, such as Pseudomonas (2.94%). The lung tissues of mice had more significant pathological damage when co-stimulated by PM2.5 and P. aeruginosa, and it can increase the expression levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α through nuclear factor (NF)-κB pathway in vivo and in vitro. @*Conclusions@#The results confirmed that poultry house PM2.5 in combination with P. aeruginosa could aggravate the inflammatory response and cause more severe respiratory system injuries through a process closely related to the activation of the NF-κB pathway.
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Salmonella enterica serovar Enteritidis (SE) is one of the most important zoonotic pathogens that cause enteritis and systemic infection in animals and human. Understanding invasive capacities of SE isolates is of vital importance to elucidate pathogenesis of Salmonella infection. To improve the throughput capacity and repeatability of classical gentamicin protection assay (GPA), a modified PGA was developed by taking high-throughput advantage of 96-well cell plates and multichannel pipettes. In addition, drop plate technique rather than spread plate method was applied in the modified GPA protocol for bacterial enumeration. The modified GPA protocol was evaluated by phenotyping intracellular replication of a high virulent and a low virulent SE isolates, JL228 and LN248, in a phagocytic cell line RAW264.7. The protocol was then applied in invasive phenotype determination of 16 SE strains to non-phagocytes (HT-29) and the intracellular replication of 43 SE strains to phagocytes (RAW264.7). Significant lower intra-group and inter-group coefficient of variations of the modified GPA was observed, implying good repeatability and reproducibility over traditional protocol. Further, replication phenotypes were also correlated with those from direct observation by confocal microscopy. Collectively, the improved GPA protocol had advantages of high throughput capacity, good repeatability and reliability, it was also noticed that the protocol also represented a fast and labor-saving alternative scheme for the invasive phenotype determination of Salmonella Enteritidis, and providing reliable phenotype profiles for Salmonella-host interplay interpretation.
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Animals , Humans , Gentamicins/pharmacology , Phenotype , Reproducibility of Results , Salmonella Infections, Animal , Salmonella enteritidisABSTRACT
Objective@#To understand the confidence-related factors of refusing unprotected sex behavior among college students in Zhejiang province.@*Methods@#Stratified cluster random sampling method was conducted among college students from 13 colleges and universities in Zhejiang province, from October to November, 2018. A total of 3 718 students who self-reported "ever having had sexual contacts" were enrolled. Chi-square test was used to compare the confidence of rejecting unprotected sex under different demographic characteristics, sexual attitude/behaviors and different intervention approaches. Multivariate logistic regression model was used to analyze the related factors.@*Results@#A total of 3 718 college students were involved in this study with average age as (20.17±1.38) years old and 70.5% (2 620/3 718) were male. The proportions of having confidence to refuse unprotected sex behavior were 74.9% (1 963/2 620) of male and 77.9% (896/1 098) of female students, respectively. According to the results from multivariate logistic regression analysis, factors that related to the confidence of refusing unprotected sex behavior in male students would include, did not accept casual sex behavior (compared with accepted students, OR=2.247, 95%CI: 1.828-2.762), did not accept homosexual behavior (compared with accepted students, OR=1.810, 95%CI: 1.302- 2.516), having casual sex behavior in the past one year (compared with having no sex behavior, OR=1.345, 95%CI: 1.051-1.721), aware of the availability of HIV self-test reagents service in college (compared with did not knew, OR=1.381, 95%CI: 1.011-1.887), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.707, 95%CI: 1.374-2.121). In female students, the factors would include: being urban resident (compared with rural residence, OR=1.816, 95%CI: 1.225-2.693), 21 years old or above (compared with 20 years old or below, OR=1.469, 95%CI: 1.075-2.007), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.597, 95%CI: 1.093-2.333), etc.@*Conclusions@#Both male and female college students had higher confidence in refusing unprotected sex behavior. For male students, refusing casual or homosexual contacts, having casual sex in the recent year, knowing HIV self-test reagents service and having had HIV-related risk self-assessment in college as related factors. However, for female students; city residence, 21 years old and above, and having a HIV infection risk self- assessment in college appeared as related factors. Sexual health education should be strengthened to reduce unprotective sex behavior and to promote HIV infection risk self-assessment among the college students.
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BACKGROUND: Cardiac valve replacement provides an effective therapeutic means for valvular heart disease. Compared with thoracotomy surgery, interventional treatment, typified by transcatheter aortic valve implantation, has the advantages of minor trauma and rapid recovery. At present, the transcatheter aortic valve replacement is rarely applied in clinical practice. Existing studies mainly focus on the changes of physiological conditions after surgery, while little is reported on the transcatheter aortic valve models. OBJECTIVE: To explore the deformation and stress distribution features of the transcatheter aortic valve, and to verify its working performance. METHODS: The finite element geometric model and mathematical model of the aortic valve, including the aortic valve, blood vessel wall, blood and stent, were established. The fluid structure interaction analysis was carried out by the immersion boundary method, and the effective orifice area index was calculated to verify the performance of the model. RESULTS AND CONCLUSION: During the course of blood shock, the valve leaflets were curl, and the maximum deformation occurred at 1/4 and 3/4 of the valve leaflet free edge. The largest equivalent stress of the aortic valve model was on the stent, but it is almost unformed. The stress concentration of the valve leaflets was located at the curved site of the free edge and the suture points of the leaflets and stents, where a damage easily occurred. The dynamic flow experiments show that the process of the simulation model deformation and effective orifice area index are close to the experimental results. Therefore, the simulation model is reasonable and effective.
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Objective To explore the clinical value of Dynamic testing of serum cortisol (COR) and procalcitonin (PCT) in the prediction and prognosis of sepsis after burn.Methods 122adult patients with severe burns who were treated by our unit from September 2014to November 2017were selected and retrospective analyzed.According to the diagnosis criteria of sepsis and the prognosis, the patients were divided into nonsepsis group, sepsis survival group and sepsis death group.The serum COR and PCT level in 1-20days after burn were continuously and dynamically monitored and measured using an automated electrochemical method and immunofluorescence method respectively.Results The serum COR levels in sepsis patients were significantly higher than those in non-sepsis group from the sixth day after burns (P<0.05) , and the serum PCT levels were significantly higher than those in the non-sepsis group from the 7th day after burn (P<0.05) .From the 11th day after burn, the serum COR and PCT levels in the sepsis death group were significantly higher than those in the sepsis survival group (P<0.05);the serum PCT levels in the sepsis death group were significantly higher than those in the sepsis survival group from the 15th day after the burn (P<0.05) .The serum COR levels in the sepsis-dead group decreased linearly, and the serum COR levels were significantly lower than those in the sepsis survival group (P<0.05) .Conclusion The combined testing of serum COR and PCT can be used as an early predictor of post burn sepsis, The Dynamic testing of serum COR and PCT levels in the important clinical application value in the evaluation of prognosis of sepsis after burn.
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Objective To investigate the effect of resistance training on the rehabilitation of hand joint in patients with rheumatoid arthritis. Methods Selecting 66 cases of the stable phase of rheumatoid arthritis (ra) patients in a rheumatoid immunology outpatient of a general hospital in Beijing during October 2016 to March 2017 ,33 patients were randomly divided into control group and 33 patients into intervention group by using random number. Exercise instruction of routine finger operation in control group;The intervention group was guided by trained nurses with finger exercises and resistance training. Two groups of patients were tested before and after 3 months of exercise, and both hands were tested and the patients were recorded with their hands. The patients were evaluated by the Signals of Functional Impairment(SOFI). Results Before exercise, the grip strength, morning stiffness time, SOFI score in the control group were:60.0(43.0,100.5) mmHg(1 mmHg=0.133 kPa), 45.0(30.0,60.0)min,2.0(1.0,3.0),and in the intervention group they were:85.0(49.3,108.7) mmHg,45.0(30.0,60.0) min,2.0(1.0,3.0),the differences between two groups of had no statistical significance (Z=-1.488,-0.609,-0.118, P>0.05). After three months of exercise, the grip strength, morning stiffness time, SOFI score in the control group were:60.0 (40.5,102.7) mmHg,30.0(10.0,45.0) min,1.0(1.0,2.0),and in the intervention group they were:89.5(56.0, 119.0) mmHg,10.0(5.0,15.0) min,1.0(0.0,1.0),the differences between two groupshad statistical significance (Z=-2.412,-3.668,-2.998,P<0.05).This showed that the grip strength was significantly increased compared with the control group,while the morning stiffness of the intervention group was significantly lower than the control group, and SOFI was significantly reduced compared with the control group, and all the differences were statistically significant. The results also showed that in the control group, the grip force did not change significantly three months later, and the difference was not statistically significant ( P>0.05), but in the intervention group, the grip strength was significantly higher three months later, and the morning stiffness and SOFI were significantly reduced in the group, and the differences were statistically significant (Z=-4.865,-5.508,-4.711, P<0.05). Conclusions The effect of anti-resistance training on the function of hand joint in rheumatoid arthritis patients is better than that of conventional finger operation, especially in improving the grip strength.
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Objective To explore whether exendin-4 inhibits AR42J cells and its mechanism.Methods AR42J cells were treated with exendin-4 under multiple concentrations(1,5,10 pmol/L) at 24,48,72,96,120 h to assess its cell viability by MTT assay and got the IC-50 and time points.Then checking whether exendin-4 could induce the AR42Jcells apoptosis by setting normal control (NC) group,exendin-4 (Ex-4) group and Ex-4+ z-VAD-fmk (apoptosis inhibitor) group,and exploring whether 3-MA which is autophagy inhibitor could inhibit the AR42J cells apoptosis induced by exendin-4 by setting NC group,Ex-4 group and Ex-4+3-MA group.Cell viability was analyzed by MTT and the cells apoptosis was detected by flow cytometry and the protein levels of caspase-3,LC3 and p62 were studied by Western blot.Results Concentration of 10 pmol/L exendin-4 and and time point 72 h were selected for the further study.z-VAD-fmk pretreatment can significantly inhibit the cell viability of exendin-4 by (81.2±3.3)％ vs.(49.4±3.0)％ (P＜0.05).Flow cytometry showed that exendin-4 could induce the AR42J cells apoptosis by (28.2± 1.4)％ vs.(3.6±0.8)％,and increased the caspase-3 level by Western blot,which both can be reversed by (79.1 ±2.3) ％ vs.(49.8±2.5)％ (P＜0.05) when the cells were treated for 72 h,as was apoptosis ratio by (14.5±2.1)％ vs.(29.2±3.2)％.Western blot showed that exendin-4 can upregulate protein levels of LC3B-Ⅱ,p62 和 caspase-3 and 3-MA,and pretreatment can inhibit the upregulation of LC3B-Ⅱ and caspase-3 but further increased the upregulation of p62 induced by exendin-4.Conclusions Exendin-4 can induce AR42J cells apoptosis and 3-MA pretreating can inhibit exendin-4 cytotoxicity through downregulating autophagy.So auto phagy inhibitor 3-MA could potentially extenuate the cytotoxicity of exendin-4 in pancreatic acinar cells.
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Herpesvirus infections in Cervidae are a serious threat affecting some deer species worldwide. In our attempt to identify malignant catarrhal fever-associated herpesviruses in deer herds, ten gammaherpesviral DNA fragments were identified in five species of deer in herds in China by using a pan-herpesvirus polymerase chain reaction assay targeting viral DNA polymerase. Notably, in sambar (Rusa unicolor), a novel gamma-2 herpesvirus was identified that showed a close relationship with fallow deer lymphotropic herpesvirus (LHV), while the other fragments were phylogenetically grouped together with Elk-LHV. Determination of whether these viruses have any clinical implication in these deer species should be undertaken urgently.
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Animals , Cattle , China , Deer , DNA , DNA, Viral , Herpesviridae Infections , Herpesviridae , Malignant Catarrh , Polymerase Chain ReactionABSTRACT
Objective To examine the expression and analyze the significance of autophagy-related gene microtubule-associated protein 1 light chain 3 (MAP1-LC3,LC3),p62 and lysosorne-associated membrane protein 2 (LAMP-2) in pancreatic tissues of mice with acute pancreatitis (AP).Methods Twenty mice were randomized into AP group and control group,and the number of mice was equal between two groups.AP group was intra-peritoneally injected by 20％ L-arginine solution (two injections of 4 g/kg body weight,every 1 h) in the dosage of 4 g/l kg twice every 1 hour to establish AP model,while control group was administered with equal volume of normal saline by intra-peritoneal injection.All the mice were euthanized at 24 hour after the last injection.Pancreatic histopathological changes were measured.In addition,the protein expressions of LC3,p62 and LAMP-2 were detected by Western blot.Results No obvious pathological changes were observed in control group.Pancreatic acinar edema,structure destruction,missing,the obvious widening of interlobular septum,small interlobular septum and acinar septum,and the necrosis of acinar cells at different degrees were observed in AP group.The pathological score for tissue edema,hemorrhage,necrosis and inflammation in AP group was 3.13 ± 0.50,2.83 ± 0.32,3.25 ± 0.46 and 3.16 ± 0.47,respectively,which was all 0 in control group.The differences were statistically significant between AP group and control group (P ＜ 0.01).In AP group,the ratio of LC3-Ⅱ/LC3-Ⅰ,p62 and LAMP-2 protein in pancreatic tissue were 1.16 ± 0.08,0.94 ± 0.04 and 0.35 ± 0.04,respectively,which were 0.24 ± 0.02,0.34 ± 0.03 and 0.95 ± 0.03 in control group.The ratio of LC3-Ⅱ/LC3-Ⅰ and p62 protein in pancreatic tissue in AP group were much higher than those in control group,while LAMP-2 in AP group was lower than that in control group,and there was statistically significant difference between two groups (all P ＜0.01).Conclusions Intraperitoneal injection of L-arginine could induce acute pancreatitis,and autophagy is impaired,which was associated with decreased LAMP-2 protein expression.
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Objective To explore the effect of finger exercises and cognitive training on cognitive function, ability of daily living and quality of life of elderly patients with mild cognitive impairment. Methods About 90 elderly patients with mild cognitive impairment were randomly divided into experimental group and control group. In the experimental group finger exercises and cognitive training were implemented, and the control group was given routine care and health education. 3 months and 6 months after the intervention, the two groups were compared in respect of the cognitive function, ability of daily living and quality of life. Results The difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between the two groups 3 month and 6 month after the intervention (P<0.05). Pairwise comparison done at three time points (before intervention, 3 months and 6 months after intervention) in the experimental group showed that the difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between before intervention and 3 months after intervention, before intervention and 6 months after intervention. Conclusion The finger exercises and cognitive training in elderly patients with mild cognitive impairment can effectively strengthen the cognitive function and ability of daily living, and improve the quality of life.
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Objective To explore the alteration and effect of autophagy in pancreas tissue of rat injected by exenatide.Methods Diabetes model rats were induced by two-month high-sugar and high-fat diet and streptozotocin injection (35 mg/kg) in normal rats.50 SD male rats were divided into four groups according to the principle of complete random design,namely normal control group (n=10),normal exenatide-injected group (n=10),diabetes-model control group (n=l5) and diabetes-model exenatide-injected group (n=15).Rats in exenatide-injected groups were subcutaneously injected with exenatide respectively in 5 μg/kg dose each time,twice a day,at 8 a.m.and 6 p.m.Animal weights were weighted weekly and the dose of exenatide was adjusted according to current weight.Rats in the two control groups were injected with the corresponding amount of saline.Mter 10 weeks of treatment,all rats were killed and pancreatic tissues were disposed.Immunohistochemistry was used to measure the expression of GLP-1R in pancreatic tissues.Western blot was used to test the expressions of LC3-Ⅰ,LC3-Ⅱ and p62 in pancreatic tissues,and LC3-Ⅱ/Ⅰ ratio and p62 were compared between any two groups.All specimens were stained with hematoxylin-eosin (HE).The data were expressed as means ± standard deviation and were analyzed by unpaired Student t test using SPSS 18.0 statistics software.P value ＜0.05 was considered to be statistically significant for all tests.Results The pancreatic tissues from 13 rats (6 from the normal exenatide-injected group and 7 from the diabetes-model exenatide-injected group) appeared pathological changes such as gland structure damage,pancreatic cells atrophy and cells compartment broadening.The expressions of GLP-1R,LC3-Ⅱ and p62,and LC3B-Ⅱ/Ⅰ ratio in the two exenatide-injected groups were higher than those in the respective control group,and the differences had statistical significance (P＜0.05).Conclusions Long-term subcutaneous injection of exenatide can upregulate the expression of GLP-1R in rat pancreatic acinar cells and may induce the impaiment of autophagy flux in rat pancreatic cell.
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OBJECTIVE@#To explore the regulatory effect of microRNA-141 (miR-141) on expression of high mobility group protein B1 (HMGB1) in mouse hepatoma carcinoma cell line (hepal-6 cells). @*METHODS@#The hepal-6 cells were divided into 4 groups: a miR-141 mimic group, a miR-141 mimic control group, a miR-141 inhibitor group and a miR-141 inhibitor control group. The miR-141 was transfected into hepal-6 cells with lipofectamine 2000. The levels of miR-141 and HMGB1 mRNA in the hepal-6 cells were detected by quantitative real-time PCR (qRT-PCR), and then HMGB1 protein was examined by Western blot. The regulatory effect of miR-141 on 3'-UTR of candidate target gene (HMGB1) was determined by dual-luciferase reporter assay. @*RESULTS@#Compared with the control group, the level of miR-141 was up-regulated in the miR-141 mimic group, while down-regulated in the miR-141 inhibitor group. Moreover, the levels of HMGB1 mRNA and protein decreased in the miR-141 mimic group, while increased in the miR-141 inhibitor group. The dual-luciferase reporter assay showed that miR-141 could target the 3'-UTR of HMGB1 gene. @*CONCLUSION@#MiR-141 can up-regulate the expression of HMGB1 protein at the post-transcriptional level by targeting to the specific sequence of 3'-UTR of HMGB1 gene, which suggests that HMGB1 gene may be a target gene of miR-141.
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Animals , Mice , 3' Untranslated Regions , Carcinoma, Hepatocellular , Cell Line, Tumor , Down-Regulation , Gene Expression Regulation, Neoplastic , HMGB1 Protein , Liver Neoplasms , Luciferases , MicroRNAs , RNA, Messenger , Real-Time Polymerase Chain Reaction , Transfection , Up-RegulationABSTRACT
The strategy of optimizing anesthetic management was carried out in all the patients un?dergoing thoracic surgery in our hospital from January 1, 2012: the patients were monitored using routine electrocardiogram combined with invasive arterial blood pressure monitoring, double?lumen central venous catheter pathway was established, and when severe bradycardia ( heart rate0?05) , and the incidence of cardiac arrest was decreased by 45% after optimizing anesthetic management. In conclusion, the strategy of optimizing anesthetic management is helpful in decreasing the occurrence of cardiac arrest during thoracic surgery.
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Objective To explore the writing quality and rational use of drugs for outpatient prescription of western medicine in Yanqing District Hospital of Beijing.Methods From January 2011 to December 2015, 12 000 prescriptions of western medicine were selected randomly.The prescriptions were analyzed by Excel and the Pareto diagram analysis was used to find out the main reasons of irrational prescription.Results From 2011 to 2015, the basic indicators of prescription of western medicine were reasonable:the average number of drugs on each pre-scription was 2.31,the utilization rate of injections was 15.91%,the utilization rate of essential drugs was 38.00%, the utilization rate of antibacterial was 14.56%.The unreasonable rate of prescription was 6.32%,and the main irra-tional reason were dosage inappropriate,indications inappropriate,inappropriate selection of drugs and combination therapy was not suitable.Conclusion By prescription review,we have listed the problems,and provide the basis for rational drug use and improvement measures.
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Objective To investigate the clinical efficacy of pancreaticoduodenectomy (PD) and duodenumpreserving pancreatic head resection (DPPHR,including Beger,Frey and Berne procedures)for the treatment of chronic pancreatitis (CP) with mass in the head of the pancreas.Methods The clinical data of 48 patients with CP who were admitted to the Armed Police Corps Hospital of Hunan province(13) and the Third Xiangya Hospital of Central South University (35) between January 2007 and December 2013 were retrospectively analyzed.The operation methods were selected according to clinical symptoms,imaging findings and intraoperative pathological examinations.Twenty-three patients receiving PD (Whipple procedure or pylorus-preserving PD) were allocated into PD group and 25 receiving DPPHR (Beger,Frey and Berne procedures) were allocated into DPPHR group.The operation time,volume of intraoperative blood loss,rate of postoperative pain relief,changes of pancreatic endocrine and exocrine function,complications,duration of hospital stay and hospital expenses in the 2 groups were analyzed.Patients were followed up by telephone interview and outpatient examination up to September 2014.Measurement data with normal distribution were presented as (x) ± s.Comparison between groups was analyzed using the t test.Count data were analyzed using chi-square test or Fisher exact probability.Results Of the 23 patients in the PD group,15 patients received Whipple procedure and 8 patients received pylorus preserving PD.Of 25 patients in the DPPHR group,8 patients received Beger procedure,13 patients received Frey procedure and 4 patients received Berne procedure.The operation time and volume of intraoperative blood loss were (5.5 ± 0.4) hours,(372 ± 174) mL in the PD group,and (4.2 ± 0.6) hours,(272 ± 114) mL in the DPPHR group,showing significant differences between the 2 groups (t =8.712,2.375,P ＜ 0.05).Three patients had massive hemorrhage in the PD group and 2 patients receiving Beger procedure had massive hemorrhage due to portal vein injury,with no significant difference (x2=0.010,P ＞ 0.05).The intraoperative pathologic examinations of frozen section showed chronic inflammation in all pancreatic tissue samples with fibrous tissue proliferations.Overall pain relief rate was 95.7％ (22/23) in the PD group,including 20 complete remissions and 2 partial remissions,and overall pain relief rate was 92.0％ (23/25) in the PD group,including 18 complete remissions and 5 partial remissions,which were no different in overall pain relief rate (x2 =0.000,P ＞ 0.05).The morbidity of postoperative diabetes mellitus and dyspepsia with fatty diarrhea were 38.9％ (7/18) and 35.7％ (5/14) in the PD group,which were no different from 9.5％ (2/21) and 20.0％ (3/15) in the DPPHR group (x2=3.200,0.281,P ＞0.05).The incidence of postoperative complication was 30.4％ (7/23) in the PD group,including 1 case of intra-abdominal hemorrhage,pancreatic fistula and localized peritonitis,1 case of pancreatic fistula,2 cases of biliary fistula,3 cases of delayed gastric emptying.Patients with pancreatic fistula and biliary fistula recovered after 1-week sufficient drainage.The incidence of postoperative complication was 4.0％ (1/25) in the DPPHR group,including 1 case of pancreatic fistula,showing significant difference in incidence of postoperative complication (x2=4.274,P ＜ 0.05).The duration of postoperative stay and hospital expense were (12.4 ± 2.5) days and (57 751 ± 6 772) yuan in the PD group,which were significantly different from (8.2 ± 1.8) days and (49 109 ± 6 168)yuan in the DPPHR group (t =6.576,4.645,P ＜ 0.05).Forty-eight patients were followed up with a median time of 51.6 months (9.0-92.0 months).Of the 2 patients died,1 patient who underwent Frey procedure died 3 months after diagnosis of pancreatic cancer due to epigastric pain at postoperative month 6,the other died 2 years later due to cardiovascular disease.Among 48 patients with follow-up,1 received biliary-intestine drainage 6 months later and other patients had no recurrence or canceration.Conclusions DPPHR is safe and effective for chronic pancreatitis with mass in the head of the pancreas,having advantages such as shorter duration of operation,less intraoperative hemorrhage,faster postoperative recover,shorter duration of hospital stay and delayed hypofunction of pancreatic endocrine and exocrine function.But DPPHR cannot completely replace PD,It is necessary to master indications for all kinds of operations and choose proper operative approaches based on lesion characteristics.
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Objective To observe levels of the serum albumin and their association with prognosis in children with hand-foot-and-mouth disease (HFMD) . Methods A total of 122 HFMD children admitted from 2011 to 2013 were selected and divided into three groups:common group (n=57), severe group (n=52) and critical group (n=13). Serum albumin levels, blood glucose levels, peripheral blood white cell counts of the children in the three groups were compared within 24 hours of admis-sion. Moreover, the incidence of hypoalbuminemia and mortality of the children were analyzed in each group. Results In critical group, serum albumin levels were signiifcantly decreased while blood glucose levels and peripheral blood white cell counts were signiifcantly increased than those in the severe group and common group, and the differences were all statistically signiifcant (all P0.05). There was no hypoalbuminemia and death in severe group and common group. The percentage of hypoalbuminemia and mortality of children in critical group were higher than those in the other two groups (all P<0.01). Conclusions The mortality was extremely high in children with critical HFMD. The decrease of serum albumin levels was a high risk factor for death in children with critical HFMD. Early and dynamic monitoring serum albu-min levels may be helpful in evaluation of disease condition and prognosis of HFMD.