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Objective:To explore the factors influencing the extubation time of patients in a persistent vegetative state (PVS) after tracheotomy so as to provide a theoretical basis for early extubation for such patients.Methods:Clinical data were collected on PVS patients after a tracheotomy. The cases were divided into an extubation group and a difficult extubation group according to whether the extubation was successful or not. Version 22.0 of the SPSS software was used to evaluate univariate and multivariate logistic regressions analyzing the factors influencing the success of extubation.Results:The single-factor analysis revealed significant differences between the groups in terms of average age, nursing level, nutrition, swallowing function, hypoalbuminemia and incubation time. Gender, brain injury, stroke, ischemic anoxic encephalopathy and lung infection were not, however, significant predictors. The multivariate logistic regression analysis highlighted nutritional mode, swallowing function, intubation time, pulmonary infection, full-time care and age as independent predictors of extubation success.Conclusions:Intermittent oral to esophageal tube feeding and full-time care are protective factors for extubation of patients in a PVS after a tracheotomy. Swallowing disorders, intubation for more than 30 days, pulmonary infection and greater age are risk factors for unsuccessful extubation. Nutritional support, swallowing function training and intensive nursing can effectively improve the success rate of extubation.
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Background Oxidative stress is a main cause of age-related macular degeneration (AMD).Lutein has a preventive role for AMD, but its antioxidant mechanism remains unclear.Objective Present study was to investigate the effect of lutein on oxidative stress of Müller cells and its signaling pathway.Methods Human Müller cells (human Müller cell strain) were cultured, and the cells at logarithmimic growth phase were incubated in 96 well plate overnightly.Oxidative stress cell models were established by adding 160 μmol/L H2O2, a median lethal dose for Müller cells.The models were divided into the model control group and 12.5,25.0,50.0 mg/L lutein groups,and the different concentrations of lutein were used to culture the cells for 24 hours, respectively.The routine cultured cells served as the blank control group.Growth of the cells was assayed by MTT method (absorbancy);the reactive oxygen species (ROS) content in the cells was assayed by flow cytometry;the mRNA and protein levels of nuclear factor-E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in the cells were detected by quantitative real-time PCR and Western blot, respectively.Results The inhibitory effects on the cells were gradually enhanced with the increase of H2O2 concentrations,showing a significant difference among the groups (F =43.890,P＜0.01).A significant difference was found in apoptotic rate of the cells among the blank control group,model control group and 12.5,25.0,50.0 mg/L lutein groups (F =346.770, P =0.000) , and the apoptosis rate was significant elevated with the increase of lutein dose (all at P＜0.05).The ROS contents in the cells were 1.92±0.18,64.89±2.86,52.70±2.80,32.61 ±4.20 and 5.68 ± 1.35 in the blank control group, model control group and 12.5,25.0,50.0 mg/L group, respectively, with significant difference among the groups (F =324.900, P =0.000), and the ROS content was gradually reduced as the increase of lutein dose (all at P＜0.05).The relative mRNA and protein expressions of Nrf2 and HO-1 were remarkedly higher in the 12.5,25.0,50.0 mg/L lutein groups than those in the model control group (F =236.960,242.620,186.830,263.120, all at P =0.000) , and no significant difference was seen in the relative expression level of nuclear Nrf2 protein among the groups (F =1.790, P =0.210).Conclusions Lutein can induce the expression of antioxidant enzymes by inducing the expression of nuclear translocation of Nrf2 and consequently inhibit the oxidative stress status.
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Background Oxidative stress is a pathophysiological process of retina,so it is very important to explore a protective way against retinal oxidative stress.Studies determined that extract of ginkgo biloba (EGb) has antioxidant,anti-apoptosis,anti-thrombosis and anti-inflammatory effects,however,the effect of EGb on human Müller cells in oxidative stress is still below understood.Objective This study was to investigate the protection of EGb against oxidative stress of human retinal Müller cells induced by As2O3 in vitro.Methods Human retinal Müllercell line was cultured in DMEM/F12 with 10％ fetal bovine serum (FBS),2 μmol/L glutamine and 1％ antibiotics.As2O3 solution at the final concentration 5 mg/L was added in the medium for 24 hours to establish oxidative models,and then the EGb with the final concentrations of 5,10 and 20 mg/L was used to cell models for 24 hours,respectively.Cell viability was detected by MTT assay,and reactive oxygen species (ROS) levels in the cells were detected with CM-H2DCFDA fluorescent probe.The relative expression levels of caspase-3 mRNA in cytoplasm and cell nuclei were assayed by reverse-transcription PCR (RT-PCR),and the expressions of Nrf2 protein were quantitatively detected by Western blot.Results Müller cells adhered well 24 hours after cultured.At 6-7 days after culture,Müller cell body was large with abundant cytoplasm and mosaic-like arrangement.However,floating cells were seen after As2 O3 treatment.Cell viability (absorbance) was significantly different among the normal culture group,As2 O3-treated group,As2 O3 + 5 mg/L EGb group,As2 O3 + 10 mg/L EGb group and As2 O3 + 20 mg/L EGb group,with the strongest viability in the normal culture group and the weakest viability in the As2 O3-treated groups (F=163.57,P =0.00).The fluorescence intensity of ROS was the weakest in the normal culture group and the strongest in the As2 O3-treated group and was gradually weakened with the increase of EGb doses,showing a remarkable difference among the groups (F =4 013.61,P =0.00).The relative expression level of caspase-3 mRNA in the cells was gradually reduced with the increase of EGb doses,with a statistically significant difference among the groups (F =2 199.72,P =0.00).In addition,no considerable difference was seen in the expression level of Nrf2 protein (grey scale) in cytoplasm among the groups (F=15.42,P=0.40);while in the nuclei,the expression levels of Nrf2 protein were 100.01 ±0.04,46.59±0.63,54.51 ±0.62,59.93 ±0.17 and 67.60±0.24 in the normal culture group,As2 O3-treated group and As2O3+5 mg/L EGb group,As2O3+10 mg/L EGb group,As2O3+20 mg/L EGb group respectively,with a significant difference among them (F=7 271.72,P=0.00).Conclusions EGb can protect human retinal Müller cells against As2O3-induced damage in a dose-dependant manner by antioxidant and antiapoptotic effects in vitro,and the activities occur primarily in cell nucleus.
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Objective To explore the early diagnosis value of C‐reactive protein (CRP) and procalcitonin (PCT ) for bacterial in‐fectious pneumonia of children .Methods A total of 101 children with bacterial infectious pneumonia ,64 children with non‐bacterial infectious pneumonia and 73 children with non‐infectious disease were selected in bacterial infectious pneumonia group ,non‐bacterial infectious pneumonia group and non‐infectious disease group respectively .Serum PCT and CRP levels were measured before treat‐ment in the three groups .With sputum culture results as gold standard for the diagnosis of bacterial infectious pneumonia ,the sensi‐tivity ,specificity ,positive predictive value ,negative predictive value ,Youden index and diagnostic accuracy of PCT ,CRP ,PCT /CRP series test and parallel test were calculated for bacterial infectious pneumonia diagnosis .Results The levels of PCT and CRP of children in bacterial infectious pneumonia group were significant higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group(P < 0 .05) .The sensitivity ,specificity ,positive predictive value ,negative predictive value , Youden index and diagnostic accuracy of PCT ( ≥ 0 .5 ng/mL as the best intercept point) for bacterial infectious pneumonia diagno‐sis were 0 .743 ,0 .719 ,0 .806 ,0 .639 ,0 .461 and 0 .733 .And the same values for PCT /CRP series test were 0 .604 ,0 .875 ,0 .884 , 0 .583 ,0 .479 and 0 .709 respectively .All the values were higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group except sensitivity .Conclusion The combination of PCT and PCT /CRP series test is ideal method for early diagnosis of bacterial infectious pneumonia with high sensitivity and specificity .