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Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.
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Objective:To investigate the characteristics of ischemic myocardial contracture after asphyxia-induced cardiac arrest (CA).Methods:Asphyxia and ventricular fibrillation (VF) induced cardiac arrest model was established. Thirty-one male Wistar rats were randomly(random number) assigned to the sham, asphyxia and VF groups. Electrocardiogram and blood pressure during CA stage were recorded. Arterial blood was drawn for blood gas analysis at 0 min after CA. The length and width of the heart were measured at 0,2,4,6 and 8 min after CA. The myocardial ATP contents were measured at 0 and 8 min after CA.Results:Compared with the VF group, the time of CA induction was longer in the asphyxia group[ (237±20 ) s vs (3±1) s, P<0.05]. At 0 min after CA, severe hypoxemia, carbon dioxide retention and acidosis had occurred in the asphyxia group, while these indexes in the VF group were basically normal. The length and width of the heart in the asphyxia group decreased gradually after CA, the myocardial contracture reached the limit around 6 min after CA, while the cardiac morphology of the VF group did not change significantly during the observation period of 8 min after CA. Myocardial ATP content in the asphyxia group decreased significantly at 0 min after CA ( P<0.05), while the difference between the VF group and the sham group was not statistically significant ( P>0.05). Conclusions:Myocardial contracture occurrs in the early stage of asphyxia CA, which may be related to ATP consumption in the asphyxia stage.
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Objective To investigate the characteristics of myocardial injury and its underlying mechanism in rats resuscitated from cardiac arrest. Methods Forty-two male Wistar rats were randomly(random number) assigned into the post-resuscitation (PR) 4 h, PR 24 h, PR 48 h, and sham groups. Ventricular fibrillation was induced by transcutaneous electrical epicardium stimulation and untreated for 6 min, followed by cardiopulmonary resuscitation (CPR). Myocardial function, glucose metabolism, myocardial ultrastructure, the status of mitochondrial permeability transition pore (MPTP) and mitochondrial membrane potential (MMP) were evaluated at different time points. Results Myocardial dysfunction was found at 4 h after restoration of spontaneous circulation (ROSC). The ejection fraction and cardiac output were decreased (all P<0.01), the diastole left ventricular posterior wall became thicker (P<0.01), and the end-diastolic volume was reduced (P<0.05). However, cardiac function was recovered almost completely at 48 h after ROSC. The PR 4 h group had a higher SUVmax, a more obvious decreased absorbance, and a lower MMP than the sham group (all P<0.01), but no statistically significant differences were noted between the PR 48 h group and the sham group (P>0.05). At 4 h and 24 h after ROSC, the mitochondria was swollen and the mitochondrial crista was sparse, but the myocardial ultrastructure was complete. Conclusions Post resuscitation myocardial dysfunction occurs after ROSC and the myocardial dysfunction is completely reversible at 48 h after ROSC, which may be related to the reversibility of myocardial injury and the gradual recovery of mitochondrial structure and function.
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Objective To determine the relationship between brain injury and cerebral glucose metabolism in rat model of cardiac arrest. Methods Asphyxia-induced cardiac arrest model was established. Forty-two male Wistar rats were randomly assigned to sham or experimental groups. Rats in the CA4,CA6 and CA8 group were treated with cardiopulmonary resuscitation(CPR) 4 min, 6 min and 8 min after cardiac arrest, respectively. The maximum standardized uptake value (SUVmax) of glucose was detected by PET, and neural defi cit score (NDS) were evaluated at 24 h and 72 h after ROSC. The numbers of injured neurons and apoptotic cells and the protein level of hexokinase I (HXK I) were measured at 72 h after ROSC. Results SUVmax, NDS and the level of HXK I were all decreased after ROSC, and interestingly, this declination of these markers was correlated with the prolongation of the duration of CA, the longer duration of CA the more declination of these biomarkers. Accordingly, the number of injured neurons and apoptotic cells increased were correlated with duration of CA, and thus CA8 group had greater numbers of those cells than CA6 group and CA4 group (P<0.05),and CA6 group had greater numbers of those cells than CA4 group(P<0.05). In addition, the SUVmaxwas positively correlated with NDS(P<0.05), and negatively correlated with the numbers of injured neurons and apoptotic index(P<0.05). Conclusions The degree of brain injury is associated with cerebral glucose metabolism, and PET may become a novel method to assess the severity of brain damage after CA.
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Twenty eight polycystic ovarian syndrome (PCOS) patients complicated with insulin resistance, whose testosterone and luteinizing hormone levels were normal, received metformin treatment (500 mg b.i.d) for 3 months.Blood anti-Müllerian hormone (AMH) levels, endocrine and metabolic parameters were measured before and after treatment.The mean levels of AMH were not significantly changed after 3 months of treatment [(8.4±3.2) vs.(8.5±3.2) μg/L, P=0.148].However, the BMI[(27.6±4.1) vs.(29.3±4.4)kg/m2], fast glucose[(5.32±0.47) vs.(5.55±0.71)mmol/L], fast insulin [(93.3±17.8) vs.(147.7±44.1)pmol/L] and homeostasis model assessment of insulin resistance (HOMA-IR) (3.17±0.71 vs.5.27±1.85) were significantly decreased after treatment (all P<0.05).The results indicate that metformin treatment may not significantly affect serum AMH levels, although it can improve the insulin resistance and reduce the BMI value in PCOS patients.
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Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) in Zhejiang and to analysis factors associated with outcomes for providing evidence on improving the success rate of cardiopulmonary resuscitation (CPR). Methods Clinical data of 493 patients with OHCA collected from the emergency department (ED) of Zhejiang Provincial People's Hospital, Ningbo Emergency Medical Service Center and Shaoxing Emergency Medical Service Center from January 2012 to August 2016 were analyzed retrospectively. All the data were recorded following the Utstein style included causes of arrest, location of arrest, first arrest rhythm, witnessed by bystanders, bystander CPR, pre-hospital defibrillation, pre-hospital intubation, pre-hospital epinephrine administration, emergency medical services (EMS) response time, return of spontaneous circulation (ROSC) at scene/enroute, ROSC at ED, admission to hospital, survival to hospital discharge and neurological outcomes at discharge. Factors associated with 30 days survival rate of patients with OHCA were analyzed. Results 493 patients were enrolled, of whom 342 were male and 151 were female. The average age was (58.8±21.4) years. The causes of arrests consisted of cardiac etiology (219 cases), trauma (155 cases), respiratory disease (22 cases), drowning (19 cases), electrocution (8 cases) and others (70 cases). Most of the events occurred at home (65.1%) and public places (22.7%). 55.2% patients were witnessed by bystanders while bystander CPR was performed in only 2.6% cases. Asystole was the predominant rhythm (78.7%) observed by the ambulance crew at the arrest site while only 5.5% first arrest rhythms were ventricular fibrillation/ventricular tachycardia (VF/VT). Only 6.9% patients underwent pre-hospital defibrillation. Pre-hospital intubations were attempted in 16.4% patients. Epinephrine was administered in 56.4% patients at scene or in ambulances. EMS response time was (13.6±8.0) minutes. 4.5% patients had ROSC at scene/enroute and 7.7% had ROSC at ED. Only 9.7% patients were admitted to hospital and 1.2% discharged alive. 0.8% patients were still in hospital on 30th day. The 30-day survival rate was 2.0% (10/493) and only 0.8% patients had neurologically favorable survivals [with the cerebral performance category (CPC) score of 1 or 2]. Witnessed by bystanders (3.31% vs. 0.45%), VF/VT as the first arrest rhythm (7.41% vs. 1.72%), bystander CPR (15.38% vs. 1.67%), pre-hospital defibrillation (8.82% vs. 1.53%) and EMS response time < 10 minutes (3.57% vs. 0.74%) could improve 30-day survival rate of OHCA significantly (all P < 0.05). Conclusion Resuscitation survival of OHCA in Zhejiang province was unsatisfactory. Improvements are required in series aspects of OHCA survival chain.
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Since the United States released the first AHA CPR guidelines in 1966 since,CPR tech-nology in the world successfully rescued tens of thousands of cardiac arrest patients.After 50 years of devel-opment,CPR technology has become one of the dying patient in cardiac arrest and basic rescue techniques, have a significant impact on emergency aid,particularly released in 2000 CPR and ECC guidelines:evi-dence based medicine and global experts The recommendations become a strong support for the clinical treat-ment regimen.Thus,with the progress of the study to update the guidelines every five years,the medical profession has become concerned about the release point.October 2015 AHA in 《Circulation》journal re-leased new CPR guidelines,the new guidelines more streamlined processes,promote rapid response.The chain of survival outside the hospital and into the hospital,so that treatment mechanism more flexible.Con-firmed the single rescue operation sequence,sure the high quality of the BLS is the solid foundation of ACLS,and further stressed the importance of ACLS team.The purpose of this combined edition 2010 CPR Guidelines 2015 on the basis of new guidelines for comparative analysis,familiar with and master the new CPR guidelines change,so that medical staff better grasp CPR techniques,more scientific and effective res-cue cardiac arrest patients,improve Cardiopulmonary resuscitation success rate.
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Objective To investigate the clinical effect of early use of enteral nutrition therapy in elderly diabetic patients suffering from severe lower respiratory tract infection.Methods A prospective,randomized,open,controlled trial was conducted.Patients aged ≥ 60 years old with diabetes mellitus complicated by severe lower respiratory tract infection admitted to Department of Geriatrics of the Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from July 2013 to June 2015 were enrolled,and they were divided into the observation group (nasogastric tube infusion of fresubin) and control group (ordinary liquid diet) according to the random number table method,with 60 patients in each group.Nutritional status,inflammation state and immunological indexes before treatment (0 day) and 4,7,14 days after treatment,the outcome of the disease and the nutrition related complications were compared between two groups.Results After treatment,serum albumin (ALB),pro-albumin (PA),immunoglobulin A and G (IgA,IgG) were significantly increased compared with those before treatment in both groups [at 7 days,ALB (g/L):28.37 ± 0.40 vs.26.72 ± 0.37 in control group,29.12 ± 0.25 vs.26.86 ± 0.26 in observation group;PA (mg/L):53.80 ± 6.28 vs.43.76 ± 6.93 in control group,58.46 ± 8.70 vs.44.68 ± 7.33 in observation group;IgG (g/L):11.62±4.72 vs.9.98±3.71 in control group,13.36±4.58 vs.9.88±3.27 in observation group;IgA (g/L):2.31 ±0.35 vs.1.50±0.39 in control group,3.07±0.48 vs.1.37±0.29 in observation group;all P ＜ 0.05].Compared with the control group,the level of PA in observation group was significantly increased from 7 days on (mg/L:58.46 ± 8.70 vs.53.80 ± 6.28,P ＜ 0.05),while ALB,IgG,IgA levels in observation group increased at 14 days [ALB (g/L):33.24 ± 0.45 vs.30.76±0.79,IgG (g/L):15.03 ±3.73 vs.11.45 ±2.83,IgA (g/L):3.56±0.32 vs.2.50±0.16,all P ＜ 0.05].The levels of C-reactive protein (CRP) and procalcitonin (PCT) in both groups gradually lowered,but they were significantly lower in observation group than those in the control group from 4 days on [CRP (mg/L):17.72±4.23 vs.20.96±5.83,PCT (ng/L):123±37 vs.257±88,both P ＜ 0.05],up to 14 days.The hospital mortality rate of the observation group was lowered compared with that of the control group (6.67％ vs.8.89％),and the duration of mechanical ventilation was significantly shortened (hours:145.00±19.39 vs.193.00± 18.97,P ＜ 0.05),insulin dosage was also significantly decreased (U:33.52 ± 5.74 vs.49.71 ± 6.99,P ＜ 0.05).There was no significant difference in the incidence of abdominal distension,diarrhea and reflux of gastric contents between the two groups,and they were relieved after treatment and had no influence on further enteral nutrition therapy.Conclusion Early administration of the complicated enteral nutrition in elderly diabetic patients with severe lower respiratory tract infection cannot only decrease the levels of pro-inflammatory factors in patients,but also shorten the duration of mechanical ventilation,enhance immunity,improve the curative effect with little influence on the blood glucose level.
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Objective To investigate the effect of lung protective and ventilatory management strategies for brain death donors on eligibility and availability of lungs for transplantation.Method The clinical data of two brain dead patients who accepted lung protective ventilatory management strategies from Feb.2015 to Mar.2015 were retrospectively analyzed.Two cases of brain-dead patients,due to severe cerebral trauma,accepted the aggressive lung protective ventilatory management strategies and airway management for 9 days and 4 days respectively.PaO2/FiO2,chest imaging manifestations,surface of the lung harvested and pulmonary rehabilitation of recipients after operation were observed.Result Two lung recipients were liberated from ventilation and pulmonary function improved significantly after double lung transplantation.Conclusion The application of lung protective ventilatory strategies in potential organ donors with brain death can increase the number of eligible and harvested lungs.
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Objective To evaluate the effect on salvage treatment of sudden deafness with comprehensive Chinese medicine therapy. Methods Fifty-three sudden deafness patients failing in conventional western medicine treatment were given comprehensive Chinese medicine therapy, and the salvage treatment followed by oral use of Chinese medicine, intravenous injection of Chinese patent medicine, acupoint injection, ear acupoint plastering, acupoint application, acupuncture, sound healing, and massage. The therapeutic effect and the relief of major accompanying symptoms were evaluated after treatment, and the relationship of disease course with clinical efficacy was also investigated. Results (1) After treatment, 4 cases were cured, 9 were markedly effective, 13 were effective, 27 were ineffective, and the total effective rate was 49.06%. (2) Except for the 2 excluded cases, the major accompanying symptoms such as tinnitus, auricular distress, and vertigo were relieved to various degrees in other cases. ( 3) Twenty-two patients had a course of disease within 14 days, and the total effective rate for them was 72.73%. A total effective rate of 32.26% was achieved in 31 cases with disease course over 14 days. It is indicated that the therapeutic effect for patients with a disease course less than 14 days was superior to that with a disease course over 14 days (P<0.01). Conclusion Comprehensive Chinese medicine therapy exerts inspiring therapeutic effect on salvage treatment of sudden deafness, and earlier intervention results into better effect.
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Objective To explore the serum anti-Mullerian hormone (AMH) level in women of childbearing age with normal menstrual cycles. Methods A total of 1 423 women with regular menstrual cycles were selected and divided into 5 groups according to their ages, i.e.≤25, 26-30, 31-35, 36-40,≥41 years. Their serum levels of AMH were measured, and the relationship between AMH and age was analyzed. Results The serum AMH levels of 5 groups according to ages (≤25, 26-30, 31-35, 36-40, ≥41 years) were 3.62, 3.10, 2.27, 1.07, 0.45μg/L, respectively. The comparison of serum AMH levels in different age groups had significant difference (P<0.01). Serum AMH level declined with increasing age,and dropped significantly after 36. The serum AMH level and age showed a negative correlation with significant difference (r=-0.374, P<0.01). Quadratic regression of logAMH proximally reflected the relationship between AMH and age. Conclusion AMH determination for women of childbearing age could provide reference for the evaluation of ovarian function.
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Objective To evaluate the early diagnostic values of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) in patients with ventilator associated pneumonia (VAP).Methods A total of 112 clinical suspicion VAP ventilator-associated pneumonia (VAP) patients accepted from January 2008 through December 2010 were enrolled for prospective and observational study.Two independent intensivists without aware of the results of the sTREM-1 assay separately made diagnosis of VAP present or absent depending on the clinical symptoms and results of microbial culture.Patients were categorized into two groups:VAP group (n =74) and non-VAP group (n =38).The levels of sTREM-1 in broncho-alveolar lavage fluid (BALF) collected with Gibot method in unemployment of bronchoscope and in serum were measured by enzyme-linked immunosorbent assay (ELISA) on the first day of suspected diagnosis.Comparison of sTREM-1 level between BALF and serum was made by t-test and Receiver Operating Characteristic (ROC) curve.Results A total of 112 clinical suspicion VAP patients admitted from January 2008 through December 2010 were enrolled for prospective and observational study.Two independent intensivists without aware of the results of the sTREM-1 assay made diagnosis of VAP present or absent depending on the clinical symptoms and results of microbial culture.Patients were categorized into two groups:VAP group (n =74) and non-VAP group (n =38).The levels of sTREM-1 in broncho-alveolar lavage fluid (BALF) collected with Gibot method in unemployment of bronchoscope and in serum were measured by enzyme-linked immunosorbent assay (ELISA) on the first day of suspected diagnosis.Comparison of sTREM-1 level between BALF and serum was made by t-test and Receiver Operating Characteristic (ROC) curve.Conlclusions In suspected VAP patients,measurement of sTREM-1 levels in BALF and in serum could help identify VAP in early stage.
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Objective To investigate the coagulant function of Thrombomodulin-Protein C-EPCR System in rats with hemorrhagic shock in virto study.Methods In this study,30 rats were divided into three groups,with each group 10 rats:control group,the sham shock group,hemorrhagic shock group.Hemorrhagic shock model was subjected to computer-controlled arterial hemorrhage to 40 mm Hg for 60 min The rat blood serum samples were obtained from rats in sham shock group and shock group after maintaining 3 hours,and fetal bovine serum (FBS) was used as control group.Then medium contained fore-mentioned serums cultured with SV40-transformed aortic rat endothelial cells for 6 hours,12 hours and 18hours.The messenger RNA (mRNA) expression of thrombmodulin (TM),Endothelial cell protein C receptor in the SV40-transformed aortic rat endothelial cells which were treated with serums were detected by reverse-transcription polymerase chain reaction.Results Compared to control group,SVARECs were incubated for 6hrs with shock serum,the mRNA expression of TF,TM and t-PA was significantly higher,and continued elevating at the time of 18 hours (P ＜ 0.01).Conclusions Serums from hemorrhagic shock rats upregulate TMmRNA EPCRmRNA expression on the endothelial cells surface.It is suggested that Thrombomodulin-Protein C-EPCR System pay a key role of anticoagulation,the protection of endothelial function.
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Objective To investigate the methods used for evaluating the severity of the patients with acute pancreatitis induced by hyperlipidemia in order to find out some simple and practical biomarkers for predicting the severity of the illness.Methods Sixty-two patients with acute pancreatitis resulted from hyperlipidemia were selected from the in-patients of our hospital from January 2007 to July 2011 and were divided into two groups,namely the mild acute pancreatitis group(MAP,n =32)and the severe acute pancreatitis group(SAP,n =30)as per the Chinese Acute Pancreatitis Guideline.Two groups were comparable verified by the test of homogeneity of variance after grouping.Arterial blood gas analyses were done immediately after admission:Venous blood was taken from forearm for determining renal function and blood coagulation at 6 o＇lock of next day after admission.The data of base excess(BE),creatinine(CR),C-reactive protein(CRP),fibrin(FIB)and D-Dmmer(D-D)were documented.The contrast CT imaging of pancreas was done within 48 hours after admission in all patients.APACHE Ⅱ scores and computed tomography severity index(CTSI)were calculated.The differences in BE,CR,CRP,FIB and D-D between 2 groups were analyzed by using t-test,and the correlation among them and APACHE Ⅱ score and CTSI were analyzed by Spearman test done with SPSS 18.0 software.As BE ＜-4.5 mnol/L,CR ＞ 120μmol/L,CRP ＞ 100 mg/L,FIB ＞5.5 g/L and D-D 800 ng/L were set respectively as a positive screening criterion,positive prediction value(PPV),negative prediction value(NPV),sensitivity and specificity of each marker and combined markers were calculated after they were set at different positive scales in order to get the optimal predictors for evaluating the severity of acute pancreatitis induced by hyperlipidemia.Results The absolute values of BE,CR,CRP,FIB and D-D in group SAP were much higher than those in group MAP(P ＜ 0.01).Each of them had good correlation with APACHE Ⅱ score and CTSI,especially BE and D-D more significant.Each of them used separately for predicting the severity of acute pancreatitis showed PPV and NPV with high specificity but the sensitivity was hot high.The joint use of BE,CR and CRP,and joint use of FIB and D-D could be more valid as PPV and NPV with high specificity for predicting the severity of acute pancreatitis,but the sensitivity decreased.Conclusions BE,CR,CRP,FIB and D-D were good biomarkers for quickly and accurately evaluating and predicting the severity of the acute pancreatitis caused by hyperlipidemia.
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In plants, proteins with A20/AN1 zinc finger domain are involved in stress responses, named as "Stress Associated Protein" (SAP) gene family. Based on Expressed Sequence Tag (EST) sequences information in Badila Saccharum officinarum mature related cDNA library, we cloned an SAP gene from sugarcane full length cDNA library, named ShSAP1 (GenBank: Accession No. HM991960). To characterize ShSAP1, we analyzed its genome structure and expression pattern. Southern blot analysis showed ShSAP1 was present as one or two copy in the genome of Badila. Comparison of ShSAP1 1 008 bp full length cDNA with a genomic frangment (2 241 bp) generated by PCR amplification and sequencing, revealed the presence of two introns (202 bp and 1 052 bp) located in the 5'UTR region. Semiquantitative RT-PCR analysis found ShSAP1 expressed in leaves, roots and stalk in mature sugarcane. Compared with immature stems, ShSAP1 expressed higher in mature stalk. ShSAP1 was induced by different types of treatments, such as salt (200 mmol/L NaCl), drought (10% PEG 6 000), GA3 (200 mg/L), ABA (100 micromol/L) and ET (1 mmol/L) during sugarcane seedling stage. These results indicated that ShSAP1 may function in sugarcane maturation and abiotic stress response processes.
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Amino Acid Sequence , Cloning, Molecular , Gene Expression Regulation, Plant , Molecular Sequence Data , Plant Proteins , Genetics , Saccharum , Genetics , Metabolism , Stress, Physiological , Genetics , Zinc Fingers , GeneticsABSTRACT
BACKGROUND:Bone marrow derived mesenchymal stem cells (BMSCs) will be homing to the lesions after balloon injury in the inflammatory reaction process.However,the molecular mechanism of transforming growth factor-β1 (TGF-β1) to promote BMSC into smooth muscle-like cell remains unclear.OBJECTIVE:To investigate the BMSC differentiation rate under different TGF-β1 levels after acute vascular injury.DESIGN,TIME AND SETTING:A randomized controlled animal experiment and in vitro induced cell observation were performed at the SPF Laboratory Animal Center and Laboratory of Tissue Engineering,Ninth People's Hospital of Shanghai Jiao Tong University Medical School between January 2008 and May 2009.MATERIALS:A total of 24 male SD rats were randomly divided into normal control and model groups with 12 animals in each group.In addition,6 4-weak-old male SD rats were used to prepare BMSCs.METHODS:Model of acute carotid artery injury was established in model group.Serum of normal control group and model group after 1,3,7 days of injury to detect TGF-β1 level after the vascular injury by ABC-ELISA.The BMSCs after one passage were cultured at a density of (1.0-3.0)×10~5 cells/100 mm in culture dish,and divided into two groups:in routine culture group,cells were cultured in high-glucose DMEM containing 20% fetal bovine serum;in TGF-β1 group,cells were induced by different concentrations of TGF-β1 (1,3,5 and 10 μg/L) based on routine culture for 1 week.MAIN OUTCOME MEASURES:Serum TGF-β1 level after the vascular injury;,cell morphological changes by inverted phase contrast microscopy;smooth muscle α-actin expression.RESULTS:The normal serum TGF-β1 level in rat was low,but increased rapidly after 1 day of injury,reached its peak at 3 days,and declined gradually but did not return to the basic level till day 7.After 1 week of induction,BMSCs were confluent,forming peak valley appearance.Immunocytochemistry showed that compared with routine culture,the rate differentiation of smooth muscle-like cell was significantly increased in cells stimulated by TGF-β1,especially 5 and 10 μg/L TGF-β1 (P ＜ 0.01).Real-time quantitative PCR results were similar to immunocytochemistry.CONCLUSION:Serum TGF-β1 level increased after acute vascular injury and peaked at day 3.In vitro,a similar concentration of TGF-β1 could induce cultured BMSC to differentiate into smooth muscle-like cells.
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Objective To treat scalp lacerations by using the hair apposition technique (HAT) and to compare the HAT with standard suturing in a controlled prospective trial. Method Fifty patients with scalp lacerations were treated either by HAT or by standard suturing. Two groups were evaluated in consumed times for operation, pain sores, and complications. Results There were 30 HAT patients and 20 patients treated with suturing. The took shorter operation time consumed[(3.33 vs. (6.05 t = 4.85.P < 0.01], and HAT produced significantly lower pain score [(1.73vs. (3.20t = 4.01,P < 0.01]. There was a trend that more and more patients were willing to have HAT performed. Conclusions The advantages of HAT include a shorter time consumed for operation, less pain, satisfactory wound healing, and high acceptance by patients. HAT is acceptable for treating scalp lacerations in emergency room.
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BACKGROUND: Previous studies demonstrated that adventitia fibroblasts exhibit important role in the hyperplasia of newly born endomembrane after blood vessel injury. However, the mechanism regarding phenotypic transition of adventitia fibroblasts in vitro remains unclear. OBJECTIVE: To observe effect of peroxisome proliferators-activated receptor ?agonist (PPAR ?) on phenotypic transition of adventitia fibroblasts induced by transforming growth factor ?1 (TGF-?1) in vitro, as well as the expression of collagen protein Ⅰ. DESIGN, TIME AND SETTING: A randomized grouping control experiment was performed at the Tissue Engineering Laboratory of Ninth Affiliated Hospital of Shanghai Jiao Tong Medical College between July 2007 and October 2008. MATERIALS: The aorta thoracica's adventitial fibroblasts were cultured from Sprague Dawley rats, with 2-month-old, weighing 120 g. The TGF-?1 was supplied by American GenWay Biotech Company. The rosiglitazone power was purchased from Beijing Comens Chemical Co., Ltd. METHODS: The experiment was divided into 3 groups: In the TGF-?1 group, fibroblasts was induced with TGF-?1 with different concentrations (3, 5, 10, 15 ?g/L) for 48 hours; in the rosiglitazone group, fibroblasts was induced with rosiglitazone (5, 10, 30, 50 ?mol/L) for 45 minutes followed by co-culture with 10 ?g/L TGF-?1 for 48 hours. There was no intervention measure in the control group. MAIN OUTCOME MEASURES: The phenotypic transition of fibroblasts was measured by ?-smooth muscle actin, the expression of smooth muscle ? 2-actin, as well as collagen type Ⅰ was determined by protein immunoblotting. RESULTS: Compared with the control group, 5 ?g/L TGF-?1 could significantly stimulate the changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ?2-actin and collagen type Ⅰ, which reach a peak level when treated with 10 ?g/L TGF-?1 (P 0.05). Compared with control group, 30 ?mol/L rosiglitazone could significantly inhibit changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ? 2-actin and collagen type Ⅰ(P
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Objective To analyse the relationship between the psychological factors and effect of reduce blood pressure. To study the influence of the psychological factors in therapeutic effect of reduce blood pressure. Methods While using reduce blood pressure drug, behavioral intervention and biofeedback technique were used to analyse the relationship between the psychological factors and the effect of reduce blood pressure. Results The change values were positive correlation with the psychological factors and the reduce blood pressure. The change data of Te, E, Hy significantly affected the change data of blood pressure. Conclusion Behavioral intervention and biofeedback technique could increase the effect of reduce blood pressure drug in aged hypertension, improve their psychological quality of life.
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Objectives:To observe the changes in metabolism of fatty acids in breast cancer cells and the effects of inhibiting fatty acid synthase(FAS) on the growth of breast cancer cells. Methods:By RT PCR,the expression of FAS mRNA in breast cancer cell line was examined.The growth inhibition of breast cancer cells by specific FAS inhibitor, cerulenin, was determined by MTT assay.Flow cytometric analysis was used to study the changes of cell cycle. Results:FAS mRNA expression in MCF 7 cells was high.We found that cerulenin caused dose and time dependent inhibition of growth of MCF 7 cells.The growth inhibition of MCF 7 after 48 hours exposure of cerulenin at 2.5,5,10 and 20 mg/L was ( 43.47 ?4.58)%,(62.92?2.68)%,(81.93?0.91)% and (67.7?12.27)%( P