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Objective:To study the predictive value of central venous-arterial CO 2 difference (Pv-aCO 2)/arterial-central venous O 2 difference (Ca-vO 2) ratio for progressive organ dysfunction in patients with septic shock after resuscitation. Methods:Septic shock patients receiving resuscitation in ICU were retrospectively enrolled from July 2018 to June 2019 at the First Affiliated Hospital Anhui Medical University. Hemodynamic and laboratory data were collected. Single and multivariate logistic regression model was constructed to explore the independent risk factors of progressive organ dysfunction. The predictive value of hemodynamic parameters to progression of organ dysfunction was determined using receiver operating characteristic (ROC)curve analysis.Results:A total of 99 patients were enrolled with 25 patients (25.25%) progressing to organ dysfunction. The norepinephrine dose [0.61 (0.27,1.42) μg·kg -1·min -1 vs. 0.91 (0.47,2.87) μg·kg -1·min -1], blood lactic acid [2.93 (1.77,5.88) mmol/L vs. 6.15 (2.56,8.59) mmol/L], Pv-aCO 2 [5.00 (3.98,7.85) mmHg(1 mmHg=0.133 kPa) vs. 7.00 (5.00,8.35) mmHg] and Pv-aCO 2/Ca-vO 2 [1.36(1.17,1.69) vs. 2.23 (1.83,2.78)] in patients with progressive organ dysfunction were significantly higher than those in patients without( P<0.05). Multivariate logistic regression analysis suggested that Pv-aCO 2/Ca-vO 2 ( OR=20.48,95 %CI 5.25-79.93, P<0.001) was independent risk factors for predicting organ dysfunction. The cutoff value of Pv-aCO 2/Ca-vO 2 was equal or more than 1.77 with a sensitivity of 80.00% and a specificity of 79.73%. Compared with those with Pv-aCO 2/Ca-vO 2<1.77, patients with Pv-aCO 2/Ca-vO 2≥1.77 had a greater probability of progressive organ dysfunction (47.37% vs. 8.20%, P<0.001). Conclusion:The progression of organ dysfunction in septic patients after resuscitation is associated with poor prognosis. Pv-aCO 2/Ca-vO 2 is a good indicator to evaluate oxygen metabolism and predict the progression of organ dysfunction.
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Objective@#To explore the status of PM 2.5 pollution in school classrooms and the student exposure level, and to provide basic data to safeguard the health of students.@*Methods@#This study continuously monitored the PM 2.5 levels of 16 naturally ventilated classrooms in eight primary and secondary schools in Jiamusi for one academic year using an online environmental monitoring instrument. At the same time, outdoor PM 2.5 data was captured for comparative research, and student exposure to PM 2.5 during school hours was evaluated.@*Results@#The average concentration of PM 2.5 in the classroom in the spring and autumn semesters was (26.93±24.7) and (31.85±30.37)μg/m 3, respectively, and the indoor/outdoor ratio ( I/O ) was 0.92 and 0.95, respectively, which indicated a strong correlation between them. The daily average concentration of all classrooms during both semesters was ( 28.93 ±26.85)μg/m 3, which was slightly higher than the average concentration of (27.53±26.53)μg/m 3 during the daytime when students were in school. In addition, the concentration on workdays was higher than that observed on weekends, and this was termed the "weekend effect". The indoor PM 2.5 concentration was lower on higher floors. The comprehensive exposure concentration of students during school was 28.48 μg/m 3 in spring semester and 31.87 μg/m 3 in autumn semester.@*Conclusion@#PM 2.5 levels in the classrooms varied according to time, the horizontal space, and the vertical space, and the level of indoor PM 2.5 pollution largely depended on outdoor pollution sources. Differences in PM 2.5 exposure were observed between.
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It provides a new approach to treat myelodysplastic syndromes when decitabine comes out.In order to improve the understanding of the role of decitabine and to provide a reference for the clinical treatment of middle-risk and high-risk myelodysplastic syndromes,this article mianly summarized drug combination,prognostic molecular markers,and reviewed the mechanism of action,main medication regimen in recent 5 years for the treatment of middle-risk and high-risk myelodysplastic syndromes with decitabine.
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As the fourth member of the globin family, cytoglobin ( CYGB) is a hypoxia-induced gene, and its expression is upregulated under hypoxia.CYGB is widely distributed in the living body and has a variety of physiological functions, such as anti-oxi-dative stress, anti-fibrosis, and neuroprotection.It also plays a protective role in cardiovascular disease, cancer, and other hypoxia-re-lated diseases.This article presents an overview on the structure and distribution of CYGB, its physiological functions of anti-fibrosis, anti-cancer and muscle regeneration, and the regulation and the mechanism of its expression under hypoxia.
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Objective:To explore the communication problems among nursing students in early clinical prac-tice, and to provide reference for clinical nursing education .Methods:Introspecting diary of the clinical communi-cation in nursing students were classified and analyzed by using qualitative research method .Results:5 themes were extracted as following: barriers for communication between nurses and patients , reflection on patient , nurse occupation , clinical teaching and critical reflection on public opinion .Conclusion:Introspecting diary is important to help teachers in teaching , to guide and cultivate nursing students to develop their interpersonal communication competence .
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Objective To explore the effects of sumatriptan on the modulation of calcitonin generelated peptide(CGRP) expression and its involving intracellular signaling transduction mechanisms in rat trigeminal ganglion(TG) after organ culture.Methods Using organ culture in vitro model,54 isolated TGs of SD rats were randomly divided into fresh group ( n =6 ),control group ( n =6 ) and experimental group (n =42,6 TGs for each subgroup).Experimental group included seven subgroups,which were respectively pretreated with four different concentrations of sumatriptan,specific inhibitors of extracellular signalregulated kinases 1/2 (ERK1/2) pathway (U0126 and PD98059 ),and the inhibitor of c-Jun N-terminal kinase (JNK) (SP600125).After co-cultured with above intervention agents for 24 h,CGRP-immunoreactivity (CGRP-ir) positive neurons and CGRP-mRNA expression levels were quantified by immunohistoehemistry stain and real-time polymerase chain reaction,respectively.Phosphorylated ERK1/2 (pERK1/2) and JNK (pJNK) proteins levels were determined by Western-blotting method.Results The CGRP-ir ( + ) neurons expression levels were significantly increased after 24 h organ culture.However,0.10 and 0.50 mg/ml concentrations of sumatriptan remarkably decreased the CGRP-ir ( + ) neurons expression levels.The positive cell percentage,positive optic area,integrated optical density,mean optical density and CGRP-mRNA expression level in TG were significantly reduced than control groups (tPCP =8.652,26.382; tarea =6.220,13.917; tIA =5.606,15.904; tM14 =2.661,21.748; tmRNA =8.032,15.675.P ＜ 0.05 ).The CGRP-mRNA expressions were significantly down-regulated after co-incubation with concentration of 0.50 mg/ml sumatriptan for 24 h in TG of SD rat ( P ＜0.05 ).The levels of pERK1/2 and pJNK protein kinase detected by Western-blotting were significantly reduced by 0.50 mg/ml concentration of sumatriptan,the degrees of which were closed to the ERK1/2 and JNK pathway specific blockers.Conclusion It suggests that the optimal concentration of sumatriptan significantly down-regulates CGRP over-expression via intracellular ERK1/2 and JNK signaling transduction pathways in TG after organ culture.
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The Chinese herbal medicine Tianma (Gastrodia elata) has been used for treating and preventing primary headache over thousands of years, but the exact pharmacological mechanism of the main bioactive ingredient gastrodin remains unclear. In present study, the effects of gastrodin on calcitonin gene-related peptide (CGRP) and phosphorylated extracellular signal-regulated kinase1/2 (pERK1/2) expression were observed in rat trigeminal ganglion (TG) after in vitro organ culture to explore the underlying intracellular mechanism of gastrodin on primary vascular-associated headache. CGRP-immunoreactivity (CGRP-ir) positive neurons count, positive area, mean optical density and integrated optical density by means of immunohistochemistry stain were compared at different concentrations of gastrodin, which was separately co-incubated with DMEM in SD rat TG for 24 hours. Only at 5 or 10 mmol L(-1) concentration, gastrodin demonstrated significantly concentration-dependent reduction of CGRP-ir (+) expression and its action closed to 1.2 mmol L(-1) sumatriptan succinate. While at 2.5, 20, and 40 mmol L(-1) concentration, gastrodin did not show remarkable effects on CGRP-ir (+) expression. The optimal concentration of gastrodin (5 and 10 mmol L(-1)) similarly inhibited CGRP-mRNA expression level separately compared with 1.2 mmol L(-1) sumatriptan succinate and 10 micromol L(-1) flunarizine hydrochloride, which was quantitatively analyzed by real-time PCR (RT-PCR). pERK1/2 level was examined by Western blotting after co-cultured with optimal concentration of gastrodin and effective specific ERK1/2 pathway inhibitors PD98059, U0126. The result indicated that gastrodin significantly reduced pERK1/2 protein actions similarly to ERK1/2 pathway specific blockade. It suggests ERK1/2 signaling transduction pathway may be involved in gastrodin intracellular mechanism. This study indicates gastrodin (5 and 10 mmol L(-1)) can remarkably reduce CGRP-ir (+) neuron, CGRP-mRNA and pERK1/2 expression level in cultured rat TG, with its actions similar to the effective concentration of sumatriptan succinate, flunarizine hydrochloride and specific ERK1/2 pathway blocker. The intracellular signaling transduction ERK1/2 pathway may be involved in the gastrodin reducing CGRP up-regulation in rat TG after organ culture.
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@#Objective To investigate the protective effect of berberine on acute hypoxia induced by sodium nitrite (NaNO2) in mice.MethodsThe animal model of acute hypoxia was established with NaNO2. Then the mice were treated with berberine by gavage in three different doses of 2.0 mg/kg, 4.0 mg/kg, and 8.0 mg/kg once everyday respectively for 6 days. The survival time according to the last breath, the breath time and open mouth times of animals were recorded. The superoxide dismutase (SOD), maleic dialdehyde (MDA), nitric oxide (NO) and lactic dehydrogenase (LDH) in brain tissue were tested. The pathological change was examined by HE staining.ResultsBerberine could significantly prolong the living time of acute hypoxia mice induced by NaNO2 and breath time after decapitation ( P<0.05, P<0.01), increase the activity of SOD and LDH, decrease the content of MDA and NO in brain tissue of hypoxia mice ( P<0.05, P<0.01). Under microscope, there were meningorrhagia, cellular necrosis in brain tissues of model animals, but no pathological changes found in berberine-treated animals.ConclusionBerberine has certain protective effect on acute hypoxia induced by NaNO2 in mice.
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@#Objective To observe the effect of panaxadiol saponins (PDS) on intellectual decline and cerebral lesion induced by destabilization of cervical vertebra in mice.Methods44 mice were randomly divided into the normal control group, model group, high PDS doses group and low PDS doses group with 11 animals in each group. The model of destabilization of cervical vertebra was established by operating and intraperitoneal injection of PDS performed in the PDS high doses group (14 mg/kg) and low doses group (7 mg/kg) once everyday for 50 days. The memory ability of mice was evaluated by the water-maze test and tittup platform experiment. 50 days later, all mice were executed and the activities of superoxide dismutase (SOD), lactic dehydrogenase (LDH) and the content of maleic dialdehyde (MDA), nitric oxide (NO) in encephalon were tested.ResultsIn the PDS groups, the incubation period and error times in water-maze test shortened significantly ( P<0.05), aod the reaction period in tittup platform experiment shortened and wrong times decreased obviously ( P<0.01) compared with the model group. The activities of SOD, LDH increased ( P<0.01), and the content of MDA and NO decreased ( P<0.01, P<0.05) in the PDS group compared with the model group.ConclusionPDS has certain protective and improving effect on the decline of memory ability and cerebral lesion induced by destabilization of cervical vertebra in mice.