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【Objective】 To investigate the changes in cellular immunity (peripheral blood lymphocyte subsets) and humoral immunity (serum immunoglobulin and ferritin) status among children with thalassemia who received repeated transfusions in Yunnan. 【Methods】 Forty-six children with thalassemia who underwent repeated blood transfusions from January 2020 to October 2022 were selected as the observation group. Forty children with thalassemia who did not receive blood transfusion were included in control group 1, and 46 healthy children underwent physical examination were included in control group 2. The differences in lymphocyte subsets, serum immunoglobulin levels and ferritin concentrations were compared among the three groups. 【Results】 For lymphocyte subsets: CD3+, CD4+ and CD4+/CD8+ in the observation group was lower than the control group 1 and 2: 57.60±8.36 vs 64.57±7.56 vs 66.58±5.65, 33.16±5.67 vs 38.62±8.36 vs 38.62±6.41 and 1.49±0.09 vs 2.32±0.15 vs 2.13±0.16, respectively; CD16+ CD56+ in the observation group was lower than the control group 2: 11.21±5.06 vs 16.70±7.92; CD8+ in the observation group was higher than control group 1 and control group 2: 26.63± 1.75 vs 20.60±1.43 vs 18.92±0.84; CD19+ in the observation group was higher than the control group 2: 24.06±6.42 vs 19.67 ±8.42, P<0.05, but no significant difference was noticed between the two control groups(P>0.05). For serum immunoglobulin and ferritin: IgG and ferritin in the observation group were higher than control group 1 and control group 2: 10.59±3.88 vs 7.02±3.88 vs 5.58±1.98 and 2 037.37±1 377.59 vs 72.63±56.71 vs 59.48±33.88. IgA in the observation group was higher than the control group 2: 1.06±0.92 vs 0.39±0.32(P<0.05), but no significant difference was noticed between the two control groups (P>0.05). The difference of IgM and IgE between the three groups was not significant (P > 0. 05). 【Conclusion】 The proportion of lymphocyte subsets in thalassemia children with repeated blood transfusion was imbalanced,and the level of immunoglobulin in humoral immunity was abnormal.
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【Objective】 To analyze the effect of intravenous immunoglobulin(IVIG)-produced IgG antibody on the crossmatch incompatibility of neonates. 【Methods】 Blood type grouping, antibody screening, crossmatch, direct anti-globulin test, elution test, indirect antiglobulin test, and IVIG titer determination were conducted by microcolumn gel method. 【Results】 IgG anti-A were detected out in the elution test and free antibody test of 6 infants, and the titer of IgG anti-A contained in IVIG was 256, which led to the crossmatch incompatibility between infants and donors with the same type. 【Conclusion】 The hemolysis and crossmatch incompatibility in newborns, born to ABO-compatible mothers, may occur due to the IVIG-induced IgG antibodies. The O-type washed red blood cells should be selected for transfusion.
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Objective To investigate the effects of therapeutic hypothermia (TH) on myocardial Ca2+/calmodulin-dependent protein kinase Ⅱ (CaMK Ⅱ) and cell autophagy after cardiopulmonary resuscitation (CPR) in swine.Methods Twenty healthy male domestic swine weighing 33-40 kg were randomly (random number) divided into 3 groups:sham group (n=4),CPR group (n=8) and TH group (n=8).Sham animals only underwent general preparation without experiencing cardiac arrest and resuscitation.The animal model was established by 8 min of electrically induced ventricular fibrillation and then 5 min CPR in the CPR and TH groups.Successful resuscitation was regarded as an organized rhythm with a mean arterial pressure of greater than 50 mmHg for 5 min or more.After successful resuscitation,body temperature was decreased to 33 ℃ by a cooling blanket and then maintained until 24 h post-resuscitation,and followed by a rewarming at a rate of 1 ℃/h for 5 h in the TH group.A normal temperature was maintained by the blanket throughout the experiment in the sham and CPR groups.At 6,12,24 and 30 h after resuscitation,the values of stroke volume (SV) and global ejection fraction (GEF) were measured by PiCCO,and meanwhile the serum concentrations of cardiac troponin Ⅰ (cTnI) were measured by ELISA assay and the serum activities of creatine kinase-MB (CK-MB) were evaluated by an automatic biochemical analyzer.At 30 h after resuscitation,the animals were sacrificed and left ventricular myocardium was obtained for the determination ofCaMK Ⅱ,microtubule-associated protein light chain 3 Ⅱ (LC3 Ⅱ) and p62 expressions by Western blot.The variables were compared with One way analysis of variance and then the Bonferroni test among the three groups.Results Compared with the sham group,myocardial dysfunction and injury after resuscitation were observed in the CPR and TH groups,which were indicated by decreased SV and GEF and also increased cTnI concentration and CK-MB activity in serum (all P＜0.05).Compared with the CPR group,the values of SV and GEF were significantly increased at 6 h after resuscitation,and serum cTnI concentration and CK-MB activity were significantly decreased starting 12 h after resuscitation in the TH group [SV (mL):25.0±6.9 vs 31.9±3.3 at 6 h,26.7±5.1 vs 34.6±3.7 at 12 h,28.8±3.3 vs 35.7±3.2 at 24 h,29.2±5.2 vs 36.7±3.3 at 30 h;GEF (％):17.1±2.7 vs 19.9±1.8 at 6 h,18.7±1.9 vs 21.6±1.8 at 12 h,19.3±2.3 vs 23.0±2.4 at 24 h,21.0±1.7 vs 23.7±1.7 at 30 h;cTnI (pg/mL):564±51 vs 466±56 at 12 h,534±38 vs 427±60 at 24 h,476±55 vs 375±46 at 30 h;CK-MB (U/L):803±164 vs 652±76 at 12 h,693±96 vs 557±54 at 24 h,633±91 vs 480±77 at 30 h,all P＜0.05].Tissue detection indicated that the expression of CaMK Ⅱ and LC3 Ⅱ were increased while the expression of p62 was decreased in post-resuscitation myocardium in the CPR and TH groups compared with the sham group (all P＜0.05).However,the expression of CaMK Ⅱ and LC3 Ⅱ were decreased and the expression of p62 was increased in postresuscitation myocardium in the TH group compared to the CPR group (CaMK Ⅱ:0.73±0.06 vs 0.58±0.05;LC3 Ⅱ:0.69±0.09 vs 0.50±0.07;p62:0.40±0.07 vs 0.68±0.14,all P＜0.05).Conclusion The mechanism of TH alleviating post-resuscitation myocardial dysfunction and injury may be related to the inhibition of CaMK Ⅱ expression and cell autophagy.
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Objective To evaluate the effects of hypothermia on Ca2+∕calmodulin-dependent pro-tein kinase Ⅱ ( CaMKⅡ) and cell autophagy in brain tissues after cardiac arrest and cardiopulmonary re-suscitation ( CA-CPR) in swine. Methods Twenty-one healthy male white swine, weighing 33-40 kg, were divided into 3 groups using a random number table method: sham operation group ( group S, n=5) , CA-CPR group ( n=8) and hypothermia group ( group H, n=8) . The experimental model of CA-CPR was established in CA-CPR and H groups. The Swan-Ganz catheters were placed in the right femoral artery and vein to monitor the pressure of thoracic aorta and right atrium and body temperature and to collect blood sam-ples. A pacing catheter was advanced from the right external jugular vein into the right ventricle. Ventricu-lar fibrillation was induced by using a 1 mA alternating current through the pacing catheter. Once ventricular fibrillation was successfully induced, mechanical ventilation was discontinued for 8 min, and then CPR was initiated. Epinephrine 20 μg∕kg was intravenously injected at 2. 5 min of CPR, followed by repetition once every 3 min. Defibrillation was delivered at 5 min of CPR, and then spontaneous circulation was evaluated. If the spontaneous circulation was not restored, CPR was immediately resumed for 2 min, and then defibril-lation was delivered again. Mechanical ventilation was continued for 30 h after successful CPR. At 5 min af-ter successful resuscitation, body temperature was decreased to 33 ℃ by using a cooling blanket, then maintained at 33 ℃ until 24 h after resuscitation, and finally increased at a rate of 1℃∕h for 5 h in group H. The temperature was maintained at a normal level of 37. 5-38. 5 ℃ with the aid of a cooling blanket in S and CA-CPR groups. At 1, 6, 12, 24 and 30 h after resuscitation (T1-5), blood samples were collected from the femoral vein for measurement of the concentration of neuron specific enolase ( NSE) and S100βprotein in serum by enzyme-linked immunosorbent assay. Five animals in each group were then sacrificed, and brains were removed to determine the expression of CaMKⅡ, microtubule-associated protein 1 light chain 3 Ⅱ( LC3Ⅱ) and p62 in cerebral cortex by Western blot. Neurological deficit score was evaluated in the remaining three swine at 48, 72 and 96 h after resuscitation (T6-8) in CA-CPR and H groups. Results Compared with group S, the concentrations of NSE and S100β protein in serum were significantly in-creased at T1-5 , the expression of CaMKⅡand LC3Ⅱin cerebral cortex was up-regulated, and the expres-sion of p62 in cerebral cortex was down-regulated in CA-CPR and H groups (P<0. 05). Compared with group CA-CPR, the concentrations of NSE and S100βprotein in serum were significantly decreased at T3-5, the neurological deficit score was decreased at T6-8 , the expression of CaMKⅡand LC3Ⅱin cerebral cortex was down-regulated, and the expression of p62 in cerebral cortex was up-regulated in group H ( P<0. 05) . Conclusion The mechanism by which hypothermia alleviates brain injury after CA-CPR may be related to inhibiting CaMKⅡ activation and reducing cell autophagy in brain tissues of swine.
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Objective To investigate the effects of ultrasound-guided continuous thoracic paravertebral nerve block combined with general anesthesia on cardiac function and postoperative complications in elderly patients undergoing thoracotomy.Methods A total of 108 elderly patients who underwent thoracotomy in our hospital from January 2017 to December 2018 were randomly divided into the general anesthesia group(receiving general anesthesia)and the combination group (receiving ultrasound-guided continuous thoracic paravertebral nerve block combined with general anesthesia) (n=54,each group).The anesthesia effect was compared between the two groups.Results The excellence rate of anesthesia was higher in the combination group than in the general anesthesia group(90.7％ vs.72.2％,x2 =4.267,P =0.039).Stroke volume variability(SVV),stroke volume(SV),heart rate(HR) and mean artery pressure(MAP)had no significant difference between the two groups at T0(pre-anesthesia)(P＞0.05).At T1 (anesthesia),T2 (intraoperative tissue traction),and T3(postoperative suture),there were significant differences in SVV,SV,HR and MAP between the two groups(P＜0.05).The incidence of postoperative complications was lower in the combination group than in the general anesthesia group(7.4％ vs.22.2％,x2 =4.696,P=0.000).Conclusions Ultrasound-guided continuous thoracic paravertebral nerve block combined with general anesthesia has good anesthetic effects,minor influence on cardiac function and a low incidence of postoperative complications in elderly patients undergoing thoracotomy.
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Objective To investigate the effects of dexmedetomidine postconditioning on brain injury after cardiac arrest and resuscitation in a swine model.Methods Twenty-eight healthy male domestic pigs,weighing 36±2 kg,were randomized (random number) into 4 groups (n=7 each group):sham operation group (S group),cardiopulmonary resuscitation group (CPR group),low-dose dexmedetomidine postconditioning group (LDP group),and high-dose dexmedetomidine postconditioning group (HDP group).Animals in the S group only underwent the surgical preparation.In the other three groups,the experimental model was established by 8 mins of electrically induced ventricular fibrillation and then 5 mins of cardiopulmonary resuscitation.At 5 min after resuscitation,a loading dose of dexmedetomidine of 0.25 μg/kg was intravenously infused followed by continuous infusion at a rate of 0.25 μg/(kg·h) for 6 h in the LDP group,and a loading dose of dexmedetomidine of 0.5 μ.g/kg was infused followed by continuous infusion at a rate of 0.5 μg/(kg·h) for 6 h in the HDP group.The same amount of normal saline was administered in the S and CPR groups.At 1 h,3 h,6 h and 24 h after resuscitation,the levels of serum neuron specific enolase (NSE) and S100B protein were measured.At 24 h after resuscitation,neurologic deficit score (NSD) was evaluated.After that,the animals were euthanized and cerebral cortex was obtained for the determination of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6)and malondialdehyde (MDA) contents,superoxide dismutase (SOD) activity,cell apoptosis and caspase-3 expression.Results Compared with the S group,post-resuscitation neurologic dysfunction and brain injury were observed in the other three groups,which were indicated by significantly higher NDS and markedly greater levels of serum NSE and S 100B (all P＜0.05).Compared with the CPR group,the score of NDS at 24 h post-resuscitation were significantly lower and the levels of serum NSE and S100B at 6 h and 24 h post-resuscitation were significantly less in the LDP and HDP groups [NDS:194±26,103±16 vs 278±23 at 24 h;NSE (ng/mL):32.4±1.8,28.6±3.7 vs 36.2±2.8 at 6 h,39.9±4.2,35.1±1.5 vs 45.1±3.0 at 24 h;S100B (pg/mL):2 534±207,2 382±170 vs 2 825±113 at 6 h,3 719±164,3 246±176 vs 4 085±161 at 24 h,all P＜0.05].Compared with the LDP group,neurologic dysfunction and brain injury at 24 h postresuscitation were further significantly alleviated in the HDP group (all P＜0.05).Pathological analysis indicated that brain inflammation,oxidative stress and cell apoptosis were observed after resuscitation in the CPR,LDP and HDP groups.However,the contents of TNF-α,IL-6 and MDA were significantly lower while the activity of SOD was significantly higher,and cell apoptosis and caspase-3 expression were significantly reduced in the brain after resuscitation in the LDP and HDP groups compared with the CPR group (all P＜0.05).In addition,those pathological injuries mentioned above were further significantly alleviated in the brain after resuscitation in the HDP group compared to the LDP group (all P＜0.05).Conclusions Dexmedetomidine postconditioning significantly alleviated the severity of postresuscitation brain injury in a dose-dependent manner,in which the protection was produced possibly through reducing tissue inflammation,oxidative stress and cell apoptosis.
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Objective To evaluate the effect of mild hypothermia on inositol-requiring enzyme 1 (IRE1) signaling pathway during myocardial injury after cardiac arrest and resuscitation in swine.Methods Twenty-one healthy male white swine,weighing 33-41 kg,were divided into 3 groups using a random number table method:sham operation group (group S,n =5),cardiac arrest-cardiopulmonary resuscitation group (group CA-CPR,n=8),and mild hypothermia group (group MH,n=8).The model of cardiac arrest and resuscitation was established based on the previously reported method.The catheters placed in the left femoral artery and right internal jugular vein were connected to the PiCCO Monitor system,and another pacing catheter was advanced from the right external jugular vein into the right ventricle.Ventricular fibrillation was induced by using a 1 mA alternating current through the pacing catheter.Once ventricular fibrillation was successfully induced,mechanical ventilation was discontinued for 8 min,and then cardiopulmonary resuscitation was initiated.Epinephrine 20 μg/kg was administered at 2.5 min of resuscitation followed by repetition every 3 min.Defibrillation was delivered at 5 min of resuscitation,and then spontaneous circulation was evaluated.If return of spontaneous circulation was not achieved,cardiopulmonary resuscitation was immediately resumed for 2 min and then defibrillation was delivered again.Mechanical ventilation was continued for 30 h after successful resuscitation.Animals in group S only underwent surgical preparation without experiencing cardiac arrest and resuscitation.At 5 min after successful resuscitation,body temperature was cooled down to 33 ℃ by using a cooling blanket,and then maintained at this level until 24 h after resuscitation,followed by 5 h of re-warming at a rate of 1 ℃/h in group MH.The temperature was maintained at 37.5-38.5 ℃ with the aid of surface cooling blanket in the other two groups.At 1,6,12,24 and 30 h after resuscitation (T1-5),the values of stroke volume (SV) and global ejection fraction (GEF) were recorded,and meanwhile 2 ml of blood samples was obtained via the femoral vein to measure the concentration of serum cardiac troponin Ⅰ (cTnI) (by enzyme-linked immunosorbent assay) and activity of serum creatine kinase-MB (CK-MB) (by immunosuppression).The swine were sacrificed at 30 h after resuscitation,and then myocardial specimens from the left ventricle were obtained for determination of the expression of caspase-3 (by immunohistochemistry),cell apoptosis (by TUNEL),and expression of IRE1 and casepase-12 (by Western blot).Apoptosis index was calculated.Results Compared with group S,SV and GEF were significantly decreased and the serum CK-MB activity was increased at T1-5,the concentration of serum cTnI was increased at T2-5,the expression of IRE1,caspase-12 and caspase-3 in myocardium was up-regulated,and apoptosis index was increased in CA-CPR and MH groups (P＜0.05).Compared with group CA-CPR,the SV and GEF were significantly increased and the concentration of serum cTnI was decreased at T2-5,the activity of serum CK-MB was decreased at T3-5,the expression of IRE1,caspase-12 and caspase-3 in myocardium was down-regulated,and apoptosis index was decreased in group MH (P＜0.05).Conclusion The mechanism by which mild hypothermia mitigates myocardial injury after cardiac arrest and resuscitation may be related to inhibiting IRE1 signaling pathway in swine.
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Objective To evaluate the effect of dexmedetomidine on receptor-interacting protein 1 (RIP1) signaling pathway during brain injury after cardiac arrest and resuscitation in pigs.Methods Twenty-one healthy domestic male white pigs,weighing 33-41 kg,were divided into 3 groups (n =7 each) using a random number table method:sham operation group (group S),cardiac arrest-resuscitation group (group CA-R) and dexmedetomidine group (group D).Ventricular fibrillation was electrically induced and untreated for 8 min followed by 5 min of cardiopulmonary resuscitation to establish the model of brain injury after cardiac arrest and resuscitation in anesthetized domestic white pigs.Dexmedetomidine was infused via the femoral vein in a loading dose of 0.5 μg/kg at 5 min after successful resuscitation,followed by an infusion of 0.5 μg · kg-1 · h-1 for 6 h in group D.The equal volume of normal saline was given instead in S and CA-R groups.The concentrations of neuron-specific endase (NSE) and S-100β protein in serum were measured at 1,3,6 and 24 h after resuscitation (T1-4).Neurologic deficit score (NDS) was evaluated at T4.The animals were sacrificed at T4,brains were removed and cerebral cortex tissues were obtained for determination of the expression of RIP1,RIP3 and mixed lineage kinase domain-like protein (MLKL) by Western blot.Results Compared with group S,the serum concentrations of NSE and S-100β protein were significantly increased at T1-4,the NDS was increased at T4,and the expression of RIP1,R1P3 and MLKL in cerebral cortex tissues was up-regulated in CA-R and D groups (P＜0.05).Compared with group CA-R,the serum concentrations of NSE and S-100β protein were significantly decreased at T3,4,the NDS was decreased at T4,and the expression of RIP1,RIP3 and MLKL in cerebral cortex tissues was down-regulated in group D (P＜0.05).Conclusion The mechanism by which dexmedetomidine reduces brain injury after cardiac arrest and resuscitation may be related to inhibiting the activation of RIP 1 signaling pathway in pigs.
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Objective To analyze the effects of dexmedetomidine(Dex) on levels of inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods From April 2015 to April 2017,94 patients with acute exacerbations of COPD who received mechanical ventilation in Wenling Hospital Affiliated to Wenzhou Medical College were randomly divided into two groups according to the digital table,with 47 cases in each group. Group A was given Dex,and group B was given midazolam. The levels of TNF - α,IL - 1, hs - CRP between the two groups were compared. Results There were no statistically significant differences in TNF - α,IL - 1,hs - CRP between the two group before treatment (all P > 0. 05). One day after treatment,the levels of TNF - α,IL -1,hs - CRP in group A were (92. 99 ± 15. 25)ng/ L,(68. 63 ± 14. 53)ng/ L,(15. 44 ± 4. 92)mg/ L, respectively,which in group B were (150. 63 ± 20. 78)ng/ L,(91. 13 ± 12. 58)ng/ L,(19. 35 ± 5. 17)mg/ L,respec-tively,there were statistically significant differences between the two groups(t = 2. 736,2. 503,2. 421,P = 0. 008, 0. 012,0. 015). Three days after treatment,the levels of TNF - α,IL - 1,hs - CRP in group A were (73. 37 ± 11. 01)ng/ L,(51. 52 ± 9. 16) ng/ L, (14. 82 ± 3. 29) mg/ L, respectively, which in group B were (123. 80 ± 19. 62)ng/ L,(73. 46 ± 17. 36) ng/ L, (18. 77 ± 4. 02 ) mg/ L, respectively, there were statistically significant differences between the two groups(t = 2. 184,2. 354,2. 098,P = 0. 031,0. 022,0. 039). Five days after treatment, the levels of TNF - α,IL - 1,hs - CRP in group A were (63. 54 ± 13. 06)ng/ L,(34. 04 ± 8. 13) ng/ L,(13. 84 ± 4. 13)mg/ L,respectively,which in group B were (76. 63 ±17. 39)ng/ L,(50. 66 ± 9. 17)ng/ L,(14. 27 ± 3. 95)mg/ L, respectively,there were statistically significant differences between the two groups( t = 1. 906,2. 082,1. 834,P =0. 067,0. 041,0. 081). Compared with group B,the ICU time in group A was significantly decreased[(9. 27 ± 1. 63) d vs. (7. 16 ± 1. 21)d,t = 2. 215,P = 0. 031](t = 2. 215,P = 0. 031). There was no statistically significant difference in the incidence rate of multiple organ dysfunction syndrome between the two groups at 5 days after treatment (χ2 =2. 286,P = 0. 132). Conclusion Dex can effectively inhibit inflammation cytokines of the mechanical ventilation COPD patients in acute exacerbation,and can reduce the ICU time.
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Objective To investigate the effects of rapid hypothermia induced via esophagus on intestinal mucous injury in early stage after cardiopulmonary resuscitation (CPR) in a swine model of cardiac arrest.Methods Twenty-seven male domestic pigs weighing (36±2)kg were utilized.The animals were randomly crandom number divided into 3 groups (n=9 in each):normothermia group (NT group),surface cooling group (SC group),and esophageal cooling group (EC group).The pig model was established by 8 mins of untreated ventricular fibrillation and then 5 mins of CPR.At 5 mins after restoration of spontaneous circulation (ROSC),therapeutic hypothermia was applied by either an esophageal cooling device in the EC group or a surface cooling blanket in the SC group to reach a targeted temperature of 33 ℃ maintained for 24 h after ROSC,and then followed by warming up in a rate of 1 ℃ / hr for 5 hrs.A normal temperature of (38.0±0.5)℃ was maintained throughout the experiment in the NT group.The core temperature was continuously monitored during a period of 30 h after ROSC.At 3 h,6 h,12 h,24 h and 30 h after ROSC,intestinal fatty acid binding protein (IFABP) content and diamine oxidase (DAO) activity in serum were measured by ELISA.At 30 h after ROSC,the pigs were sacrificed,and then intestinal tissue was rapidly obtained for the determination of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) contents by ELISA,cell apoptosis by TUNEL,and caspase-3 expression by immunohistochemistry.Results The rate of temperature decrease was 2.8 ℃/h and the time required for target temperature was 102 min in the EC group,while the rate of temperature decrease was 1.5 /h and the time consumed for target temperature was 185 mins in the SC group,which suggested the efficacy of cooling was significantly better in the EC group than that in the SC group (both P＜0.05).Compared with the NT group,serum IFABP content and DAO activity were significantly decreased at 3 hrs after ROSC in the EC group and at 6 hrs after ROSC in the SC group.Compared with the SC group,serum IFABP content at 6 hrs after ROSC and DAO activity at 12 h after ROSC were significantly decreased in the EC group IFABP (pg/mL):(710±32) vs.(777±52) at 6 h,(870±49) vs.(960±64) at 12 h,(1 022±65)vs.(1 143±63) at 24 h,(882±71) vs.(1 006±45) at 30 h DAO (U/mL):(39.9±1.9) vs.(43.4±3.2) at 12 h,(30.6±2.4) vs.(34.0±3.1) at 24 h,(26.1±2.7) vs.(29.4±2.2) at 30 h,all P＜0.05.In the intestinal tissue,TNF-α and IL-6 contents were significantly reduced,and cell apoptosis index and caspase-3 expression were significantly decreased in the SC and EC groups compared with the NT group.Additionally,inflammatory response and cell apoptosis in intestinal tissue were further significantly lesser in the EC group compared with the SC group TNF-α (pg/mL):(721±94) vs.(922±125);IL-6(pg/mL):(454±69) vs.(697±132);Apoptotic index(％):(6.2±2.6)vs.(12.8±3.0);caspase-3 expression (IOD):(8.9±1.6) vs.(15.9±1.9),all P＜0.05.Conclusions In a swine model of cardiac arrest,rapid hypothermia could be successfully induced via esophagus and consequently produced a greater protective effect on post-resuscitation intestinal injury compared with the conventional surface cooling.The protective mechanisms are associated with the inhibition of inflammatory response and cell apoptosis.
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Objective To investigate the role of the plan-do-check-action(PDCA) cycle in the quality management of intravenous infusion devices.Methods Based on the self-controlled design and cross-sectional study, the application of intravenous infusion devices before and after the implementation of PDCA cycle was investigated and compared, and the role of PDCA cycle in intravenous infusion device was evaluated.ResultsThe patients treated with intravenous infusion of 38 departments were investigated (1 152 cases in stage P and 1 140 cases in stage C).After the application of PDCA cycle,the accuracy rate of intravenous infusion device use increased from 93.2％ to 97.4％ (χ2=13.030, P<0.001).The accuracy rate of needle indwelling (98.6％ vs.95.7％, χ2=8.894, P=0.003) and central venous catheter use (87.5％ vs.38.9％, χ2=12.963, P<0.001) significantly increased after the application of PDCA cycle.Conclusion The PDCA cycle can remarkably improve the management quality of intravenous infusion devices.
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Objective:To observe the effects of isobavachalcone (IBC)on the proliferation and apoptosis of tongue squamous cell carcinoma Tca-8113 cells,and to explore their mechanisms. Methods:The Tca8113 cells cultured in vitro were divided into control group and different doses (0, 10, 20,40, 80 μmol · L-1 )of IBC groups.The inhibitory rates of cell proliferation were detected by MTT method.The apoptosis was detected by flow cytometry.Western blotting method was used to detect the expressions of Akt,p-Akt,Erk,p-Erk,Bax, Bcl-2 and Caspase-3 proteins in the Tca8113 cells in various groups.Results:The MTT results showed that the inhibitory rates of proliferation of Tca8113 cells were increased in a concentration-and time-dependent manner;the IC50 at 12,24 and 48 h were (285.13±8.97), (132.40±7.76),and (58.56±5.93)μmol·L-1 ,respectively;and there were significant differences between different time points (P 0.05 ).The expression levels of Caspase-3 in Tca8113 cells in 40 μmol·L-1 IBC group at 48 h were increased compared with control group (P <0.05).Conclusion:IBC could inhibit the proliferation and induce the apoptosis of Tca8113 cells;Akt and Erk signaling pathway may be the pathway of IBC to induce the apoptosis of tumor cells.
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<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) subtypes and genotypes in southern Zhejiang province, and to determine whether RSV genotypes are correlated with the disease severity of lower respiratory tract infection (LRTI).</p><p><b>METHOD</b>Nasopharyngeal secretions (NPS) from children under 5 years of age who were hospitalized with LRTI during 5 consecutive seasons from July 1, 2009 to June 30, 2014 were collected. RSV antigen was determined using direct immunofluorescence (DIF). Two hundred strains of RSV were randomly selected from each epidemic season. RNA was extracted and identified as subtype A or B by using reverse transcription-polymerase chain reaction (RT-PCR), and randomly selected strains of the full length attachment (G) genes of both subtype A and subtype B were amplified by PCR and sequencing. Clinical data were collected, and the disease severity between different genotypes were compared simultaneously.</p><p><b>RESULT</b>Of the total 1 000 randomly selected RSV positive samples, 462 (46.2%) and 538 (53.8%) samples were identified as subtype A and B, respectively. It was found that subtype B predominated in the 2009-2010 and 2012-2014 epidemic seasons and subtype A in 2010-2012 epidemic seasons. A total of 112 strains of complete sequences of G genes were obtained, including four subtype A genotypes NA1, NA4, GA2 and ON1, and six subtype B genotypes BA8-10, BA-C, CB1, and GB2. Phylogenetic analysis revealed that 39/52 (75.0%) subtype A strains were classified as NA1 genotype, followed by ON1 genotype (10/52,19.2%) and 44/60 (73.3%) subtype B strains were classified as BA9 genotype, followed by BA8 genotype (6/60,10.0%). BA9 was the predominant genotype among subtype B except 2010-2011 epidemic season, while NA1 was the predominant genotype among subtype A except 2013-2014 epidemic season. Only ON1 and BA9 genotypes were checked out during 2013-2014 epidemic season. There was statistically significant difference in the average severity score of illness in 39 cases infected with NA1 genotype (4.154) and 44 cases of BA9 genotype (3.341) (U=642.500, P<0.05). Furthermore, in the rate of oxygen uptake, the percentage of those infected with NA1 genotype (33.3%) was higher than those infected with BA9 genotype (13.6%) (χ2=4.544, P<0.05). However, there were no significant difference in the age, clinical symptoms, the percentage of intensive care unit admission, length of hospitalization and the outcome of the disease between NA1 and BA9 infection.</p><p><b>CONCLUSION</b>The shift of predominant RSV subtype from 2009 to 2014 were B-A-A-B-B in the southern areas of Zhejiang province. Multiple genotypes co-circulated during five RSV epidemic seasons. NA1 and BA9 genotypes were the predominant genotypes of subtype A and B, respectively. Compared with infection with BA9 genotype, NA1 genotype infection was associated with more severe disease and proportion of patients needed oxygen therapy was higher.</p>
Subject(s)
Child, Preschool , Humans , Infant , China , Epidemiology , Genotype , Hospitalization , Nasopharynx , Phylogeny , Polymerase Chain Reaction , Respiratory Syncytial Virus Infections , Epidemiology , Respiratory Syncytial Virus, Human , Genetics , Respiratory Tract Infections , Epidemiology , SeasonsABSTRACT
<p><b>BACKGROUND</b>Breast cancer 2 (BRCA2) is an important breast cancer-susceptibility gene. Promoter polymorphisms in BRCA2 may affect its transcription and be associated with cancer prognosis.</p><p><b>METHODS</b>We identified five polymorphisms of the BRCA2 promoter region by in silico searching and direct sequencing: -254A/G (rs3092989), -908A/G (rs206117), -1134A/G (rs206115), -1144C/T (rs206116), and -1260CTTAGA/- (rs3072036). The -908A/G, -1134A/G, -1144C/T, and -1260CTTAGA/- polymorphisms were genotyped by direct sequencing in 491 breast cancer patients, and the -254A/G polymorphism was genotyped by Sequenom.</p><p><b>RESULTS</b>The -1144C/T polymorphism was associated with clinical outcome. Carriers of the TT genotype had longer disease-free intervals (DFIs, P = 0.029), especially among patients with sporadic unilateral breast cancer (P = 0.010). Linkage disequilibrium (LD) analysis showed that all the five single nucleotide polymorphisms (SNPs) were in LD (D' > 0.8). Carriers of haplotypes containing the -1144T allele showed longer DFIs (P = 0.049), and the result was more significant in patients with sporadic unilateral cancer (P = 0.018). There were no significant associations between the other polymorphisms and DFI.</p><p><b>CONCLUSIONS</b>The results of this study suggest that homozygosity for the BRCA2 T(-1144) allele is associated with a longer DFI in Chinese women with breast cancer. Further functional studies are warranted to clarify this relationship.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Asian People , Genetics , Breast Neoplasms , Genetics , Pathology , Genetic Predisposition to Disease , Genetics , Genotype , Haplotypes , Linkage Disequilibrium , Polymorphism, Single Nucleotide , Genetics , Promoter Regions, Genetic , GeneticsABSTRACT
Objective To observe the expressions ofα-catulin and E-cadherin in tongue squamous cell carcinoma (TSCC)tissue, and to explore their relationship with the occurrence and development of TSCC.Methods The expressions ofα-catulin and E-cadherin in 55 cases of TSCC tissue and 10 cases of normal tongue tissue were examined by immunohistochemistry SP method. The relationship between the expressions and the clinicopathological characteristics and the relevance of the expressions ofα-catulin and E-cadherin in TSCC tissue were analyzed.Results The positive expression rates ofα-catulin in TSCC tissue and normal tongue tissue were 69.09% and 20.00%,respectively,and there was difference between them (P<0.01).The expression ofα-catulin was correlated to the histological differentiation,clinical stage and lymph node metastases of TSCC (P<0.05).The positive expression rates of E-cadherin in TSCC tissue and normal tongue tissue were 38.18% and 80.00%,respectively, and there was significant difference between them (P< 0.01 ). The expression of E-cadherin was correlated to the clinical stage and lymph node metastases of TSCC (P<0.05 ). There was a negative correlation between the expressions ofα-catulin and E-cadherin in TSCC tissue (r=-0.466,P<0.01). Conclusion The expressions ofα-catulin and E-cadherin may be associated with the occurrence and development of TSCC,and they could be used as the parameters which predict the malignant degree and prognosis of TSCC.
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Objective To explore the influencing factors of gastrointestinal bleeding(GB) in secondary prevention patients with cerebral ischemic stroke(CIS).Methods A total of 616 patients were divided into bleeding group and control group according to the status (yes,no) of suffering GB during the 2years follow-up.Single factor analysis and Logistic regression analysis was used to explore the influencing factors of GB in CIS patients.Results The proportion of age≥65,a history of GB,gastric disease,renal insufficiency,sudden onset,NIHSS ≥12 and CIS ≥2 in the bleeding group was significantly higher than that in the control group (P ＜ 0.05) ; The proportion of combined with statins,proton pump inhibitors and gastric mucosal protective agent in the bleeding group was significantly lower than that in the control group (P ＜0.05) ; The Logistic regression analysis showed that age≥65,a history of GB,gastric disease,renal insufficiency,sudden onset,NIHSS≥12 and the times of CIS≥2 were risk factors of GB; however,combined with statins,proton pump inhibitors were protective factors.Conclusions Aging,a history of GB,gastric disease,sudden onset,higher NIHSS score and the times of CIS ≥ 2 were the risk factors of GB,combined with statins and proton pump inhibitors could reduce the risk of GB.
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Objective To investigate the effects of dexamethasone on expressions of epithelial neutrophil activating protein-78 (ENA-78) and transforming growth factor- beta 1 (TGF-β1) in neutrophil of asthma rats.Methods Thirty male SD rats were randomly divided into three groups on average, including asthma group, control group and dexamethasone treated group. In this experiment, the rat model of asthma were established by sentization and challenge with ovalbumin. Blood neutrophil were isolated and purified. The expression of ENA-78 was detected by flow cytometry. The expression of TGF-β1 was detected by immunohistochemical method in blood neutrophil and bronchial wall. Results Expression of ENA-78 in blood neutrophil in dexamethasone treated group(71.82 ±8. 87 mean fluorescence intensity)was lower than that in asthma group, but higher than that in control group(all P ＜0. 01). And expressions of TGF-β1 protein in dexamethasone treated group(0. 173 ± 0. 014,0. 202 ± 0. 019 optical density, respectively) was lower than that in asthma group(all P ＜0. 01) ,but higher than that in control group(all P ＜0. 01). There were significant positive correlation between ENA-78 expression at blood neutrophil and numbers of total inflammation cells in bronchoalveolar lavage fluid (n = 29, γ = 0. 762, P ＜ 0. 01). Conclusion The beneficial effect of glucocorticoid(dexamethasone) on airway inflammation in asthma rats could be at least in part due to their direct inhibitory effect on ENA-78 and TGF-β1 protein generation by neutrophil.
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Objective To observe the expressions of grouth-related oncogen (GRO)α, epithelial neutrophil activating protein-78 (ENA-78) and neutrophil-activating peptide-2 (NAP-2) of rat asthma. And to investigate the role of neutrophil in the pathogenesis of asthma exacerbation. Methods In this experi-ment, the rat model of asthma were randomly divided into two groups on average, including asthma group and control group. Levels of ENA-78 at blood neutrophil were detected by flow cytometry method. The ex-pressions of GROα protein at bronchial wall and NAP-2 protein at blood neutrophil were detected by immuno-histochemieal method. Results Levels of GROα, ENA-78 and NAP-2 proteins in asthma group [0.138 ±0.009(A value), 97.65±13.99(MFI), 0.198±0.016(A value), respectively]were significantly higher than those in control group[0.077±0.010(A value), 50.79±8.66(MFI), 0.079±0.015(A value), re-spectively], all P < 0.01. Conclusion Levels of GROα, ENA-78 and NAP-2 were increased at rat asth-ma. They may be participate in inflammation of asthma exacerbation. Neutrophil may promote inflammatory cells influxing into airway wall via increasing synthesis of CXC chemotactic factors.
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Objectives To explore the effects of follow-up health edueation of cardio-vascular patients outside hospital on their compliance with doctor's advices.Methods Eighty cardio-vagcular patients were selected and divided randomly into the control group and the follow-up group with 40 cases in each group.The patients of the control group were siren instmcfons only before leaving hospital while those of the follow-up group received follow-up health education as well as the leaving-hospitsl insuuctions.Investigations were carried out one year after follow-up health education in the two groups' compliance with doctor's advices including their thempeutic changes of lifestyle,re-admittance to hospital and mortality.Results Signitlcant differences were found between the follow-up gtonp and the control group in respect of the pationts' compliance with doctor's advices,re-admittance to hospital and mortality,P＜0.01,P＜0.05.The complialice with doctor's advices in the follow-up group Wag obviously better than that of the control group.Conclusions The follow-up health education can be an effective way for promoting the cardio-vascular patients' compliance with doctor's advice after leaving hospital.
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Objective To investigate epidemic status and explore the influential factors of pulmonary tuberculosis (PTB) in the servicemen of armed forces and to provide reference basis for control and prevention. Methods According to the questionnaire, the test of PPD (purified protein derivative), X-ray checking and sputum bacteria culture method had been used. A 1∶1 matched case-control study was carried out in the servicemen with 162 cases and 162 controls. Odds ratios (ORs) were calculated for the relevant factors. Results The prevalence rate of activated tuberculosis, the bacteriological positive prevalence rate, the smear positive prevalence rate and PPD positive reaction rate respectively were 176.66/105, 33.12/105, 22.08/105 and 34.31%. The prevalence rate of officers was obviously higher than that of soldiers, and the army resident in the countryside was higher than that in the city. The prevalence rate of high training intensity was higher than that of low training intensity. With the increasing of the age and time duration in army, the prevalence rate of pulmonary tuberculosis and the positive rate of PPD reaction presented a ascending tendency. Single factor conditional logistic regression analysis showed that the occurrence of PTB was closely associated with training intensity, body mass index, the number of scar, housing condition, the contact history of infection source, area of enrollment and character, their ORs value were 5.12, 0.37, 0.42, 0.51, 1.82, 0.57 and 1.63 respectively (P