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Objective:To summarize the relevant evidence for the management of fixation in traumatic spinal cord injury patients, which provides a reference for the clinical care and care of patients.Methods:A systematic search was conducted for evidence related to spinal injuries from domestic and foreign databases, relevant guideline websites, etc. The types of literature were best practice, expert consensus, systematic review, evidence summary, clinical decision-making, etc. The search time was from the establishment of databases to January 31, 2022. Three researchers used the Multidimensional Systematic Review Tool to evaluate systematic review literature. Five researchers used the guideline research and evaluation tool AGREE Ⅱ to evaluate clinical practice guidelines, and used the Australian JBI Evidence-Based Health Care Center (2016) to evaluate expert consensus and expert opinion with the authenticity evaluation tool for expert opinions and professional consensus articles. And extracted and summarized evidence according to the subject.Results:Finally, 10 articles were included, including 4 clinical decision-making, 4 guidelines and 2 systematic evaluations. The 30 pieces of evidence include the assessment, prevention, cervical spinal fixation, and management after traumatic spinal cord injury.Conclusions:The evidence emphasizes the importance of standardized assessment of cervical risk factors in all emergency adult patients with traumatic spinal cord injury. In the emergency department, we need to improve the ability of spinal evaluation and fixation in patients with penetrating neck injury, optimize the timeliness process of emergency trauma, reduce the occurrence of potential complications, and improve patient outcomes.
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Objective: To investigate the diagnosis value of myocardial work (MW) in evaluating left ventricular global systolic function among acute myocardial infarction (AMI) patients with preserved ejection fraction (LVEF). Methods: This study was a diagnostic trial in a prospective case-control design. AMI patients with preserved LVEF were enrolled as AMI(LVEF>50%) group and age and sex-matched healthy individuals undergoing healthy checkup in our hospital were collected as control group. Two-dimensional dynamic images, including standard apical two-chamber, long-axis and four-chamber views in 3 consecutive cardiac cycles were acquired. General clinical data, routine echocardiography and myocardial work parameters were obtained from all subjects. The indices were compared between the two groups. Intra-observer and inter-observer repeatability of myocardial work parameters were evaluated by intra-group correlation coefficient (ICC). Receiver operator characteristic (ROC) curve was used to determine the diagnostic value of global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE) and global work index (GWI) on the reduction of left ventricular global systolic function in AMI(LVEF>50%) group. Results: There were 30 patients in AMI(LVEF>50%) group, the age was (67.3±9.7)years, and 14 cases were female(46.7%). Thirty participants were included in the control group, the age was (68.1±8.6)years, and 12 cases were female (40.0%). Compared with the control group, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septum thickness (IVSD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak early diastolic velocity of mitral orifice/tissue Doppler velocity of posterior mitral annulus (E/e), left ventricular mass (LVM), left ventricular mass index (LVMI) were significantly higher, while E and e values were significantly lower in AMI (LVEF>50%) group (all P<0.05). Compared with the control group, GCW ((1 145.9±440.1)mmHg% (1 mmHg=0.133 kPa) vs. (1 425.7±355.4)mmHg%), GWE ((80.9±9.5)% vs. (87.3±5.5)%), GWI ((1 001.3±416.2)mmHg% vs. (1 247.6±341.7)mmHg%) and the absolute value of long axis integral strain (GLS) ((8.5±3.4)% vs. (11.4±3.7)%) were significantly lower, while peak strain dispersion(PSD)((101.3±66.4)ms vs. (74.7±31.9)ms) was significantly higher in AMI(LVEF>50%) group (P all<0 05). There was no significant difference in GWW((177.2±71.1)mmHg% vs. (155.7±64.6)mmHg%) between the two groups (P>0.05). The reproducibility of GCW, GWW, GWE and GWI within and between observers were satisfactory (all ICC>0.75). ROC curve analysis showed that all four parameters, GCW, GWW, GWE, and GWI, could be used for the diagnosis of reduced left ventricular systolic function in patients with AMI (LVEF>50%), and their areas under the ROC curve were 0.896,0.929,0.808,0.862. Conclusion: Myocardial work assessment is valuable on diagnosing left ventricular global systolic function reduction in AMI patients with preserved LVEF.
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Female , Humans , Myocardial Infarction/diagnostic imaging , Reproducibility of Results , Stroke Volume , Systole , Ventricular Function, LeftABSTRACT
A growing number of studies have identified sex differences in response to general anesthesia; however, the underlying neural mechanisms are unclear. The medial preoptic area (MPA), an important sexually dimorphic structure and a critical hub for regulating consciousness transition, is enriched with estrogen receptor alpha (ERα), particularly in neuronal clusters that participate in regulating sleep. We found that male mice were more sensitive to sevoflurane. Pharmacological inhibition of ERα in the MPA abolished the sex differences in sevoflurane anesthesia, in particular by extending the induction time and facilitating emergence in males but not in females. Suppression of ERα in vitro inhibited GABAergic and glutamatergic neurons of the MPA in males but not in females. Furthermore, ERα knockdown in GABAergic neurons of the male MPA was sufficient to eliminate sex differences during sevoflurane anesthesia. Collectively, MPA ERα positively regulates the activity of MPA GABAergic neurons in males but not in females, which contributes to the sex difference of mice in sevoflurane anesthesia.
Subject(s)
Animals , Female , Male , Mice , Anesthesia , Estrogen Receptor alpha/metabolism , Preoptic Area , Sevoflurane/pharmacology , Sex CharacteristicsABSTRACT
The lateral hypothalamic area (LHA) plays a pivotal role in regulating consciousness transition, in which orexinergic neurons, GABAergic neurons, and melanin-concentrating hormone neurons are involved. Glutamatergic neurons have a large population in the LHA, but their anesthesia-related effect has not been explored. Here, we found that genetic ablation of LHA glutamatergic neurons shortened the induction time and prolonged the recovery time of isoflurane anesthesia in mice. In contrast, chemogenetic activation of LHA glutamatergic neurons increased the time to anesthesia and decreased the time to recovery. Optogenetic activation of LHA glutamatergic neurons during the maintenance of anesthesia reduced the burst suppression pattern of the electroencephalogram (EEG) and shifted EEG features to an arousal pattern. Photostimulation of LHA glutamatergic projections to the lateral habenula (LHb) also facilitated the emergence from anesthesia and the transition of anesthesia depth to a lighter level. Collectively, LHA glutamatergic neurons and their projections to the LHb regulate anesthetic potency and EEG features.
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OBJECTIVES@#The study aimed at identifying salivary microbiota in caries-free Chinese preschool children using high-throughput sequencing.@*METHODS@#Saliva samples were obtained from 35 caries-free preschool children (18 boys and 17 girls) with primary dentition, and 16S ribosomal DNA (rDNA) V3-V4 hypervariable regions of the microorganisms were analyzed using Illumina MiSeq.@*RESULTS@#At 97% similarity level, all of these reads were clustered into 334 operational taxonomic units (OTUs). Among these, five phyla (Firmicutes, Proteobacteria, Actinobacteria, Bacteroidetes, and Candidate division TM7) and 13 genera (@*CONCLUSIONS@#Our results revealed the diversity and composition of salivary microbiota in caries-free preschool children, with little difference between male and female subjects. Identity of the core microbiome, coupled with prediction of gene function, deepens our understanding of oral microbiota in caries-free populations and provides basic information for associating salivary microecology and oral health.
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Objective@#To compare T-cell receptor (TCR) β chain complementarity-determining region 3 (CDR3) in the patients with coexistence of HBsAg and HBsAb and other HBV infected patients. @*Methods@#The clonotype and diversity of CDR3 in blood of group cases (positive HBsAg and HBsAb) (n=11), control 1 (negative HBsAg and positive HBsAb) (n=10) and control 2 (positive HBsAg and negative HBsAb) (n=10) were analyzed by high-throughput TCR sequencing with Illumina HiseqX10. @*Results@#In the case group, the overlap rate of 6.28% (0.25%, 13.10%) was detected between any two samples, which was significantly lower than the overlap rate of 10.49% (6.20%，17.30%) seen in control 1 group (P=0.008). In control 2 group, the overlap rate of 2.60% (0.13%，13.69%) was significantly lower than control 1 group (P=0.001). There was no difference between case group and control 2 group. After pairwise comparison between the three groups, the frequency of clonotype TRBV7-2/TRBD1/TRBJ2-1 in case group was higher than that of control 1 group (P=0.029), the frequency of TRBV7-3/TRBD1/TRBJ2-7 in case group was lower than that of control 1 group (P=0.031). The difference of TRBV5-8 was significant in comparing case group with control 1 group (P=0.047). There were 14 clonotypes which had differences between case group and control 2 group in frequency. TRBV28was significant in comparing case group with control 2 group (P=0.028). For diversity, there was no difference among the three groups. @*Conclusion@#Clonotype TRBV7-2/TRBD1/TRBJ2-1, TRBV7-3/TRBD1/TRBJ2-7 and TRBV5-8 were associated with coexistence of HBsAg and HBsAb, but the diversity was not associated with TCR β chain CDR3.
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This article summarized the evidence-based nursing program of rewarming in 41 adult patients with traumatic hypothermia.According to the principle of PICO,the clinical problems were clarified.The related literatures were collected through searching the databases of Cochrane Library,EMBASE,CINAHL,PubMed,CBM,CNKI,VIP Resource Library and Wanfang Database,and were evaluated.The evidence-based nursing program of rewarming was formulated,including the establishment and implementation of rewarming standards,clinical application of rewarming,and continuous monitoring of rewarming process.A total of 41 adult patients with traumatic hypothermia were applied with evidence-based nursing program,and achieved satisfactory results.The evidence-based nursing program of rewarming improved standards of clinical nursing practice,and promoted nurses' professional capacity as well as quality of clinical specialty nursing.
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Objective To analyze the level of satisfaction and its influencing factors in emergency patients, and to improve the satisfaction level of emergency patients. Methods The patients who visited the emergency department with the triage number ended with 1 from August 1 to August 15, 2015 in Second Affiliated Hospital of Zhejiang University School of Medicine were selected by the method of convenience and equidistant sampling, to take the Press Ganey′s Patient Satisfaction Questionnaires which were collected and analyzed at the end of the patient's emergency treatment. Results A total of 200 cases were investigated. Patient experience overall satisfaction was (91.64 ± 8.74) points. There were no significant differences in satisfaction between the gender, age, place of residence, the investigator, the clinic department, the time to wait, whether the first visit and the previous stay in hospital (P>0.05). The correlation between the satisfaction score and the patient's education, prognosis was less (r=-0.251,0.262, P =0.009,0.018) , but more higher correlated with the service attitude of ancillary hospital staff, nursing staff in the provision of nursing instructions, nursing staff can protect the privacy, the waiting time of the triage and the doctor′s explanation of the treatment of the disease (r=0.79-0.84, P<0.05). Conclusions The service attitude of the ancillary hospital staff, nursing staff in the provision of care instructions and privacy protection, and the waiting time of the triage and the doctor′s explanation of the treatment are the most important factors influencing the patients′ satisfaction in emergency department which also will be the key content for us to improve the patients′experience and satisfaction inemergency patients.
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Objective To evaluate the clinical effects of multiple rewarming interventions in adult hypothermia trauma patients.Methods A systematic search of Cochrane Library,PubMed,EMBASE,Scopus,CINAHL,Chinese Biomedical Literature Database (CBM),Chinese Knowledge Infrastructure (CNKI),VIP and Wan Fang Database was carried out to identify all randomized controlled trials(RCTs) and controlled clinical trials(CCTs) that explored the effects of rewarming interventions in adult hypothermia trauma patients.The quality of the literature was evaluated using JBI 2008 RCT and quasi-experimental study evaluation criteria.Data and network plot were analyzed and drawn by ADDIS 1.16.7 software.Results Totally 6 RCTs and 1 quasi-experimental design were included,involving 10 interventions and 619 patients.There was statistically significant difference in body temperature after rewarming between the warm blankets and the forced-air blankets in all rewarming measures.The results of the top three interventions were carbon-fiber heating blanket(set to 42℃),forced-air blankets,warmed intravenous fluids plus blanket which resulted from the primary outcome indicators.The incidence of chills and cold discomfort decreased with the use of forced-air blankets and chemical heat pad as compared with traditional warm blankets,while the heart rate of the patients who used chemical heating pads and continuous heating of carbon fiber blanket were declined more than those used normal blankets.Conclusion The effects of carbon-fiber heating blanket which set to 42°C was the best method in all rewarming interventions.But this conclusion still requires randomized controlled trials with larger sample size to further verify.
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Objective: To preliminarily ascertain the anti-gastric cancer active parts from the roots of Ferula ferulaeoide and to study its GC-MS fingerprint Methods: The inhibitory effects of different extraction from the roots of F. ferulaeoide on the cell proliferation of SGC-7901 cells were determined with MTT colorimetric method. GC-MS fingerprint of in vitro anti-gastric cancer active parts from F. ferulaeoide was investigated and analyzed by GC-MS and principal component analysis (PCA). Results: The chloroform extract showed the best inhibition on the growth of SGC-7901 cells. The method on GC-MS fingerprint of in vitro anti-gastric cancer active parts from F. ferulaeoide was established, showing 28 common characteristic peaks. The PCA demonstrated that the common peaks 1, 2, 4, 6, 7, 8, 9, 12, 21, 22, and 23 were connected closely with the in vitro anti-gastric cancer activity, and the seven compounds were 3-methoxy-1,2-propanediol, D-limonene, L-borneol acetate, terpinyl acetate, 1,5,9-undecatriene, 2,6,10-trimethyl, α-cedrene, and a-bergsmotene, β-cedrene, 8-epi-γ-eudesmol, γ-eudesmol, hinesol. Totally 28 common compounds of 10 batches of samples accounted for over 92% of the volatile contents, and the similarity of the GC-MS fingerprints from the 10 batches of samples was over 0.90. Conclusion: The chloroform extract from the roots of F. ferulaeoides with potential inhibitory effect on gastric cancer SGC-7901 cells is tentatively confirmed, and needs further to verify by animal cells in vivo. The method of GC-MS fingerprinting is rapid, simple, and accurate with good reproducibility and stability, and can be used to control the quality of active parts of F. ferulaeoides.
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<p><b>OBJECTIVE</b>To evaluate the microtensile bond strength and bond interface of total-etch or self-etch adhesives to normal dentin and caries-affected dentin.</p><p><b>METHODS</b>A total of 20 molars with occlusal caries lesion were used. The caries-affected dentin was obtained by removing the caries-infected dentin under the guidance of the caries detector. Beyond the level of caries-affected dentin all the enamel and partial dentin were removed. The adhesive systems, two total-etch adhesives (All-Bond 2, Prime&Bond NT) and two self-etch adhesives (Clearfil SE Bond, Xeno III) were applied respectively under the instructions of manufacturers. A block of composite resin was build up superficially. All the teeth were sectioned to obtain bar-shaped specimens with bonded surface area about 0.9 mm x 0.9 mm. The specimens were divided into normal dentin group and caries-affected dentin group via stereomicroscope. The bond strength was tested in a microtensile tester with a crosshead speed of 1 mm/min. The mean values of bond strength were compared using two-way ANOVA. The bonding interface between the dentin and adhesives was qualitatively evaluated under the observation of scanning electron microscope (SEM).</p><p><b>RESULTS</b>Two-way ANOVA revealed a significant influence of both the type of dentin and the adhesive systems tested on microtensile bond strength values. All the adhesives attained higher strength in normal dentin. In normal dentin, there was no significant difference between total-etch and self-etch adhesives. In caries-affected dentin, bond strength of Xeno III was significantly lower than the others. For SEM, the hybrid layer in caries-affected dentin was thicker but more porous than that in normal dentin. Compared with normal dentin, there was fewer resin tag exhibited in caries-affected dentin and no lateral branches were observed.</p><p><b>CONCLUSIONS</b>The total-etch adhesive had higher bond strength than self-etch adhesive systems in caries-affected dentin.</p>
Subject(s)
Adult , Humans , Middle Aged , Acid Etching, Dental , Dental Caries , Therapeutics , Dentin , Dentin-Bonding Agents , Classification , Tensile Strength , Tooth Demineralization , TherapeuticsABSTRACT
<p><b>BACKGROUND</b>The wet-bonding technique is recommended for the one-bottle dentin adhesive systems, but the moisture concept varies widely among the instructions of manufacturers as well as among investigators. The aim of this study was to evaluate the effects of different dentin surface moisture on the microtensile bond strength(s) of an ethanol/water-based adhesive system and an acetone-based system to dentin.</p><p><b>METHODS</b>Forty intact human premolars extracted for orthodontic reasons were used. Superficial occlusal flat dentin surfaces of these premolars were exposed, finished with wet 600-grit silicon carbide paper. Under four wet and dry conditions (overwet, blot dry, one-second dry and desiccated), resin composite was bonded to dentin by using Single Bond (SB) or Prime & Bond NT (PB) according to the manufacturers' instructions. The teeth were longitudinally sectioned in the "x" and "y" directions to obtain bonded beams with a cross-sectional area of 0.81 mm(2) with a slow-speed diamond saw. The bonded specimens were tested in tension at a crosshead speed of 1 mm/min until failure of the bonds. Failure modes were observed with a scanning electron microscope. The mean bond strengths were analyzed by one-way ANOVA and Turkey's test.</p><p><b>RESULTS</b>The bond strength of the overwet/SB, blot dry/SB, one-second dry/SB and desiccated/SB groups was 10.87 MPa, 22.47 MPa, 24.91 MPa and 12.99 MPa, respectively. The bond strength of the overwet/PB, blot dry/PB, one-second dry/PB and desiccated/PB groups was 10.02 MPa, 20.67 MPa, 21.82 MPa and 10.09 MPa, respectively. For both SB and PB, the blot dry group and one-second dry group revealed significantly higher bond strengths than the overwet and desiccated groups (P < 0.05).</p><p><b>CONCLUSIONS</b>In order to achieve the highest bond strength to dentin, keeping the dentin surface in an appropriately moist condition is critical for the one-bottle dentin adhesive systems with ethanol/water or acetone solvent.</p>
Subject(s)
Adolescent , Adult , Humans , Dental Bonding , Dentin-Bonding Agents , Pharmacology , Solvents , Tensile Strength , WaterABSTRACT
Herpes virus entry mediator (HVEM) is a newly discovered member of the tumor necrosis factor receptor (TNFR) superfamily that has a role in herpes simplex virus entry, in T cell activation and in tumor immunity. We generated mAb against HVEM and detected soluble HVEM (SHVEM) in the sera of patients with various autoimmune diseases. HVEM was constitutively expressed on CD4(+)and CD8(+)T cells, CD19(+)B cells, CD14(+)monocytes, neutrophils and dendritic cells. In three-way MLR, mAb 122 and 139 were agonists and mAb 108 had blocking activity. An ELISA was developed to detect sHVEM in patient sera. sHVEM levels were elevated in sera of patients with allergic asthma, atopic dermatitis and rheumatoid arthritis. The mAbs discussed here may be useful for studies of the role of HVEM in immune responses. Detection of soluble HVEM might have diagnostic and prognostic value in certain immunological disorders.
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Animals , Female , Humans , Mice , Antibodies, Monoclonal/immunology , Antibody Specificity , Arthritis, Rheumatoid/blood , Asthma/blood , Autoimmune Diseases/blood , Cell Division , Cell Line , Dermatitis, Atopic/blood , Flow Cytometry , Hypersensitivity/blood , Lymphocyte Culture Test, Mixed , Mice, Inbred BALB C , Receptors, Tumor Necrosis Factor/blood , Receptors, Tumor Necrosis Factor, Member 14 , Receptors, Virus/blood , SolubilityABSTRACT
Objective:To evaluate the cytotoxicity of different dental bonding agents to human dental pulp cells. Methods:Four dental bonding agents(Prime & Bond NT,Single Bond,Xeno Ⅲ and iBond) were diluted with the culture medium by a ratio of 1∶1 000,1∶2 000 and 1∶4 000(v/v), and the fourth passage of dental pulp cells were then exposed to agent dilutions for 12, 24 and 48 h respectively, then the morphological changes of pulp cells were observed with microscopy and cytotoxicity was analyzed with modified 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay.Results:There was significant influence of the type of dental bonding agents,exposure time and concentration on the cell morphology. Total-etch system was more toxic than self-etch system.Conclusion:Dental bonding agents are toxic to pulp cells,Single Bond is the strongest cytotoxic agent among the 4 adhesive agents.