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Objective:To explore the application value of two-dimensional speckle tracking echocardiography (2D-STE) in measuring the global longitudinal peak strain of the right atrium (PRAGLS) in normal fetuses and evaluating PRAGLS in assessing right atrial function in fetuses with moderate and severe tricuspid regurgitation (TR).Methods:A total of 25 fetuses diagnosed with moderate and severe TR, who underwent fetal echocardiography at Run Run Shaw Hospital, Zhejiang University College of Medicine between October 2020 and May 2022, were selected as the case group. Their gestational age ranged from 25.00(24.00, 30.00)weeks. Additionally, 100 normal singleton fetuses were chosen as the control group, with a gestational age of 25.83(23.00, 28.75)weeks. Standard basal or apical four-chamber clips were acquired and inputted into TOMTEC-ARENA offline cardiac analysis software for analysis. The fetal PRAGLS values of the two groups were obtained, as well as the routine obstetric ultrasound measurements and fetal echocardiographic parameters of both groups: fetal heart rate (FHR), biparietal diameter (BPD), femur length (FL), aortic annulus inner diameter (AO), pulmonary annulus inner diameter (PA), PA/AO ratio, right atrial end-systolic length (RAESL), right atrial end-systolic diameter (RAESD), right atrial end-systolic area (RAESA), right ventricular end-diastolic diameter (RVEDD), and tricuspid annular plane systolic excursion (TAPSE). The peak TR velocity and pressure gradient were simultaneously measured in the case group.The differences in fetal PRAGLS and other parameters between the two groups were compared and analyzed. The correlation between fetal PRAGLS and gestational age (GA) and routine measurements was assessed for both groups. Intra- and inter-observer repeatability tests were conducted using the intragroup correlation coefficient (ICC).Results:A significant difference in PRAGLS was observed between the two groups ( t=11.55, P<0.01). The TAPSE difference between the two groups was also statistically significant ( Z=3.45, P=0.01). Notable differences were found in AO, PA, PA/AO, RAESL, RAESD, and RAESA between the two groups (all P<0.05), but no significant differences were identified in age, GA, FHR, BPD, FL, and RVEDD between the two groups (all P>0.05). PRAGLS in the control group exhibited a moderate negative correlation with GA ( r=-0.47, P<0.01) and were correlated with BPD, FL, AO, PA, RAESL, RAESD, RAESA, and RVEDD ( r=-0.50, -0.46, -0.39, -0.43, -0.45, -0.36, -0.43, -0.32, all P<0.05). No significant correlation was observed with maternal age, FHR, PA/AO, and TAPSE (all P>0.05). No significant correlation between PRAGLS and GA or other conventional parameters was found in the case group (all P>0.05). The inter-measurer and intra-measurer ICC of PRAGLS in the control group were 0.87 and 0.79, respectively, while the inter-measurer and intra-measurer ICC of PRAGLS in the case group were 0.94 and 0.97, respectively, demonstrating good consistency. Conclusions:2D-STE exhibits strong feasibility and reproducibility in assessing fetal atrial function.Fetuses with moderate and severe TR display decreased PRAGLS, suggesting impaired right atrial reservoir function. Right atrial strain introduces a novel method for evaluating fetal cardiac function.
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Objective@#To summarize the measures and experience of treatment in mass extremely severe burn patients.@*Methods@#The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment.@*Results@#Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients.@*Conclusions@#Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.
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OBJECTIVE:To observe clinical efficacy and safety of salmeterol fluticasone combined with tiotropium bromide in the treatment of COPD via different inhalation devices.METHODS:Eighty COPD patients were selected from our hospital during Jan.2014 to Jan.2015,and then divided into trial group and control group according to random number table,with 40 cases in each group.Both groups were given Salmeterol fluticasone inhalant 500 μg,bid+Tiotropium bromide inhalant 18 μg,qd.Control group was given medicine via inhalation device coming with medicine,while trial group was given medicine via gas compression type ultrasonic spray inhalator.Both groups were treated for 1 year.Blood concentration of medicine 0.5 h after medication,mMRC score and COPD acsessment test (CAT) score 3,6,9 months after treatment,the times of acute exacerbation during treatment,FEV1％ before and af ter treatment were all observed in 2 groups.The occurrence of ADR was recorded.RESULTS:Four cases withdrew from trial group and 1 case from control group.After medication,there was no statistical significance in blood concentration of fluticasone,salmeterol and tiotropium bromide between 2 groups (P＞0.05).0.5 h after medication,mMRC score of trial group was slightly lower than that of control group,without statistical significance (P＞0.05);CAT score of it was significantly lower than that of control group,with statistical significance (P＜0.05).The times of acute exacerbation in trial group during treatment was significantly less than control group,with statistical significance (P＜0.05).The decrease of FEV1％ in trial group was slightly lower than control group,without statistical significance (P＞0.05).The incidence of ADR in trial group was significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:For COPD patients,salmeterol fluticasone combined with tiotropium bromide via gas compression type ultrasonic spray inhalator is better than inhalation device coming with medicine in clinical efficacy and safety.
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BACKGROUND:LL37, the only antimicrobial peptide of the cathelicidin family identified from the human, not only promotes the proliferation of endothelial cel s, but also plays an important role in angiogenesis and re-epithelialization. OBJECTIVE:To construct a recombinant adenovirus overexpressing human antimicrobial peptide LL37 gene, and to detect the expression and secretion of LL37 after transfected into the canine vaginal epithelial cells. METHODS:The cDNA encoding LL37 was amplified by PCR. Recombinant adenovirus expression plasmid encoding LL37 and green fluorescent protein (EGFP) was constructed, and identified using restriction endonuclease technology and DNA sequencing method. Adenovirus particles were generated by cotransfecting the 293-packaging cel line. The adenovirus were col ected, amplified and concentrated, and viral titers were determined by end-point dilution assay by applying serial dilutions of the purified viruses to 293 cel s. Primary cultured canine vaginal epithelial cel s were transfected by the recombinant adenovirus. The transfection efficacy was observed by fluorescence microscope, and the cultured supernatant was col ected to determine the expression of LL37 by ELISA method at 1, 2, 3, 5 and 7 days after transfection. RESULTS AND CONCLUSION:The adenovirus vector GV314-LL37 with the titer of 3×109 pfu/mL was successful y constructed and identified by DNA sequencing methods. Canine vaginal epithelial cel s were successful y isolated and cultured and grew stably. After transfection, vaginal epithelial cel s could express the EGFP and LL37 efficiently in a time-dependent manner detected by fluorescence microscope and ELISA method. The transfection efficacy of EGFP reached to 89%at 72 hours. The level of LL37 in the cel culture supernatant in the transfection group was significantly higher than that in the control group, the highest expression of LL37 was found at 3 days that lasting for 7 days. In conclusion, the recombinant adenovirus overexpressing human antimicrobial peptide LL37 gene is successful y constructed, which can express and secrete LL37 after transfected into canine vaginal epithelial cel s, providing a foundation for constructing the tissue-engineered vagina possessing anti-infection and neovascularization.
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Objective To study the correlation between the expressions of Bcl-2 and Caspase-3 in intestinal epithe-lial and inflammatory cells of lamina propria and the staging and pathogenesis of ulcerative colitis (UC). Methods The pathomorphological changes of 25 samples of UC in the active phase and remission phase and 25 samples of control were ob-served under microscope. The expressions of Bcl-2 and Caspase-3 were detected by immunohistochemistry SP method. The correlations between expressions of Bcl-2, Caspase-3 and UC staging were analyzed. Results There were no significant dif-ferences in expressions of Bcl-2 and Caspase-3 in intestinal epithelial cells between three groups (P>0.05). The expression of Bcl-2 in inflammatory cells of lamina propria was significantly higher in active UC group than that of normal control group (P＜0.05), no significant difference between UC remission group and normal control group (P>0.05). There was a higher positive expression of Caspase-3 in inflammatory cells of lamina propria in UC remission group. There was correlation be-tween Bcl-2, Caspase-3 and UC staging (r=0.371 and 0.4453 respectively). Conclusion The expression levels of Bcl-2 and Caspase-3 were related with pathogenesis of UC. The detection of expression levels of Bcl-2 and Caspase-3 has a cer-tain application value in UC staging.
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Objective To study the correlation between TCM differentiation of syndromes typing for ulcerative colitis (UC) and expressions of Bax and Caspase-3.Methods 50 patients with UC were divided into 2 groups according to TCM syndrome differentiation including dampness-heat internal accumulation syndrome group (25cases),deficiency of spleen and stomach syndrome group (25cases).Immunohistochemistry was used to study expression of Bax and Caspase-3 in colonic mucosas and compare with the normal group (25cases).Results The expressions of Bax were highest in dampness-heat internal accumulation syndrome group (4.56±1.58).The expressions of Bax of deficiency of spleen and stomach syndrome group were lower than dampness-heat internal accumulation syndrome group(3.28± 1.14)scores.There were significant differences between the three groups (P＜0.05).However,There were no significant difference between dampness-heat internal accumulation syndrome group and deficiency of spleen and stomach syndrome group in terms of the Caspase-3expressions (P＞0.05).In addition,Caspase-3 and Bax were positively related in each group(r=0.23and 0.21).Conclusion The high expressions of Bax,Caspase-3 in ulcerative colitis were closely related to TCM typing according to syndrome differentiation.Caspase-3 and Bax were adjustment in apoptosis.The detection of expression of Bax,Caspase-3 is helpful to the TCM syndrome differentiation and to the selection of treatment plan.At the same time,it can provide more important experiment basses for the pathogenesis of ulcerative colitis.
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Objective We investigated urinary incontinence (UI) among patients of the Gynecological Department of Renmin Hospital of Wuhan University,to observe characteristics of women with UI in our province,and to analyze preliminary factors affecting their treatment.Methods We evaluated 15 300 patients treated for UI from August 2009 to April 2011,using site information and questionnaires.We also compared them to 66 825 other gynecology outpatients at our hospital over the same period.Results We found that the incidence of UI tended to increase with age,and was associated with body mass index,parturition,and surgery history.But 54.63％ (8358/15 300) of them refused surgical treatment.Of these 8358 patients,29.78％ (2489/8358) because of economic factors,25.83％ (2159/8358) because of mental stress,and 24.30％ (2031/8358) because of lack of faith in the efficacy of surgical treatment,20.09％ (1679/8358) did so because of knowing little of the disease.Conclusions UI is inconvenient to patients,and seriously affects their physical and mental health. Many patients refuse surgical treatment.Medical staff should attempt to educate patients better with regard to treatment,and to offer them help to improve the quality of their lives.
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Objective To explore the effect of lipid raft on cervical cancer cell growth and its mechanisms Methods HeLa cells in logarithmic phase were divided into three groups including control group, lipid raft interference agent group,and NADPH oxidase inhibitors group.Cells were treated with fre sh medium,3 μmol/L Apocynin and 1 mmol/L M-beta CD, respectively, for 24 h.Cell survival rate was detected using the MTT method, and the HIF-1α level was examined by Western-blot. Results Cell growths of the lipid raft interference agent group and NADPH oxidase inhibitors group were significantly slower than control group,(0.612±0.051 vs 0.984±0.034,0.591 ±0.074 vs 0.984±0.034,t=4.062,P＜0.05).HIF-1α expression in the lipid raft interference agent group and NADPH oxidase inhibitors group was also significantly reduced compared with control group (1.79±0.14 vs 2.56±0.22 and 1.54±0.12 vs 2.56±0.22) and the difference was significant (t=2.423,P＜0.05). Conclusion Lipid raft-NADPH oxidase pathway may activate HIF-1α and downstream protocarcinogenic gene expression to promote the growth of cervical cancer cells. The inhibitors of lipid raft and NADPH oxidase may become a new research direction for cervical cancer chemotherapy.
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Objective: To investigate the antimotion sickness effects of ginsenosides combined with dexamethasone in rats. Methods: Fifty SD rats were randomly divided into 5 groups: normal saline, scopolamine-treated, ginsenosides-treated, dexamethasone-treated and ginsenosides plus dexamethasone-treated groups. There were 10 rats in each group. The rats in each group were fed with corresponding ingredients respectively, and then the rats were exposed to abnormal acceleration for one hour. The motion sickness index, the level of kaolin consumption and the course and time of spontaneous activity were observed. Results: The motion sickness index and the level of kaolin consumption of acceleration-exposed rats in ginsenosides plus dexamethasone-treated group were significantly lower than those in normal saline group. And the course and time of spontaneous activity of acceleration-exposed rats in ginsenosides plus dexamethasone-treated group were significantly higher than those in normal saline group. The level of body weight increment of acceleration-exposed rats in ginsenosides plus dexamethasone-treated group was significantly higher than that in dexamethasone-treated group. Conclusion: Ginsenosides combined with dexamethasone can significantly increase tolerance to acceleration of rats, and the drug combination can decrease side effects of methylprednisolone, such as body weight loss.
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The designed experiment of nutrition survey is set up in the medical teaching in order to make the medical students realize the seriousness and the creativity of the scientific research and to improve their interest and ability of the scientific research.