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Mucociliary clearance system is the primary innate defense mechanism of the lung. It plays a vital role in protecting airways from microbes and irritants infection. Mucociliary clearance system, which is mediated by the actions of airway and submucosal gland epithelial cells, plays a critical role in a multilayered defense system via secreting fluids, electrolytes, antimicrobial and anti-inflammatory proteins, and mucus onto airway surfaces. Changes in environment, drugs or diseases can lead to mucus overproduction and cilia dysfunction, which in turn decrease the rate of mucociliary clearance and enhance mucus gathering. The dysfunction of mucociliary clearance system often occurs in several respiratory diseases, such as primary ciliary dysfunction, cystic fibrosis, asthma and chronic obstructive pulmonary disease, which are characterized by goblet cell metaplasia, submucosal gland cell hypertrophy, mucus hypersecretion, cilia adhesion, lodging and loss, and airway obstruction.
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Humans , Mucociliary Clearance , Respiratory Tract Diseases , Pulmonary Disease, Chronic Obstructive/metabolism , Mucus/metabolism , Lung , Respiratory SystemABSTRACT
This study aims to investigate the effect of Astragali Radix-Curcumae Rhizoma(AC) combination on the proliferation, migration, and invasion of colon cancer HT-29 cells based on epithelial-mesenchymal transition(EMT). HT-29 cells were respectively treated with 0, 3, 6 and 12 g·kg~(-1) AC-containing serum for 48 h. The survival and growth of cells were measured by thiazole blue(MTT) colorimetry, and the proliferation, migration, and invasion of cells were detected by 5-ethynyl-2'-deoxyuridine(EdU) test and Transwell assay. Cell apoptosis was examined by flow cytometry. The BALB/c nude mouse model of subcutaneous colon cancer xenograft was established, and then model mice were classified into blank control group, 6 g·kg~(-1) AC group, and 12 g·kg~(-1) AC group. The tumor weight and volume of mice were recorded, and the histopathological morphology of the tumor was observed based on hematoxylin-eosin(HE) staining. The expression of apoptosis-associated proteins B-cell lymphoma-2-associated X protein(Bax), cysteine-aspartic acid protease-3(caspase-3), and cleaved caspase-3, and EMT-associated proteins E-cadherin, MMP9, MMP2 and vimentin in HT-29 cells and mouse tumor tissues after the treatment of AC was determined by Western blot. The results showed that cell survival rate and the number of cells at proliferation stage decreased compared with those in the blank control group. The number of migrating and invading cells reduced and the number of apoptotic cells increased in the administration groups compared with those in the blank control group. As for the in vivo experiment, compared with the blank control group, the administration groups had small tumors with low mass and shrinkage of cells and karyopycnosis in the tumor tissue, indicating that the AC combination may improve EMT. In addition, the expression of Bcl2 and E-cadherin increased and the expression of Bax, caspase-3, cleaved caspase-3, MMP9, MMP2, and vimentin decreased in HT-29 cells and tumor tissues in each administration group. In summary, the AC combination can significantly inhibit the proliferation, invasion, migration, and EMT of HT-29 cells in vivo and in vitro and promote the apoptosis of colon cancer cells.
Subject(s)
Humans , Animals , Mice , Caspase 3 , Matrix Metalloproteinase 2 , Matrix Metalloproteinase 9 , Vimentin , HT29 Cells , bcl-2-Associated X Protein , Colonic Neoplasms , Cell ProliferationABSTRACT
Objective@# To investigate the health-seeking delay in tuberculosis among school students in Yining City, Xinjiang Uygur Autonomous Region from 2009 to 2020, and analyze the influencing factors, so as to provide the evidence for reducing the health-seeking delay in tuberculosis among students in Yining City.@*Methods@#The demographic features and diagnosis of students with tuberculosis in Yining City from 2009 to 2020 were retrieved from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System, and the factors affecting the health-seeking delay in tuberculosis were identified using the multivariable logistic regression analysis.@*Results@#A total of 443 students with tuberculosis were reported in Yining City from 2009 to 2020, including 209 boys and 234 girls, with a male/female ratio of 1∶1.12. There were 29 primary school students ( 6.55% ), 81 junior high school students ( 18.28% ), 187 high school students ( 42.21% ) and 146 college students ( 32.96% ) reporting tuberculosis, and 394 cases ( 88.94% ) had locally registered residence. There were 287 students with health-seeking delay in tuberculosis ( 64.79% ), and the median duration of health-seeking delay was 35 ( interquartile range, 33 ) days. Multivariable logistic regression analysis showed that registered residence ( local, OR=1.899, 95%CI: 1.004-3.591 ) and origin of tuberculosis patients ( clinical consultation, OR=3.448, 95%CI: 1.755-6.775; recommendation for symptoms, OR=3.215, 95%CI: 1.161-8.900; tracking, OR=2.415, 95%CI: 1.269-4.596 ) and diagnostic results ( positive sputum smears, OR=3.081, 95%CI: 1.710-5.551 ) statistically correlated with health-seeking delay among students with tuberculosis.@*Conclusions@#The proportion of health-seeking delay in tuberculosis was high among students in Yining City from 2009 to 2020; registered residence, origin of tuberculosis patients and diagnostic results were associated.
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Objective To identify factors that affect the occurrence of tuberculosis (TB) in the elderly over 60 years old in Urumqi, and to provide a basis for the prevention and treatment of tuberculosis in the elderly. Methods A 1:2 matched case-control study was conducted using a self-designed questionnaire from April 2016 to April 2017 in Urumqi, China. A conditional logistic regression analysis was carried out to identify the influencing factors for the occurrence of TB in the elderly. Results A total of 575 valid questionnaires were collected in the present study, and the age range was 60-89 years old. There were 302 males, accounting for 52.5% of the total. Multivariate logistic regression model analysis showed that an increase of one person per 100 square meters in a home elevated the risk of the development of TB by 67% (odds ratio (OR) 1.67; 95% confidence interval (CI) 1.36-2.06; P<0.001). Family income level was also important, and the risk of TB development was 4.72 times higher in families with less than 5,000 CNY a month than those with monthly incomes over 10 000 CNY (OR 4.72; 95%CI 2.29-9.75; P<0.001). The risk was significantly higher among people going out more than 3 to 7 days a week compared to those going out 0 to 2 days a week (OR 4.53; 95%CI 2.72-7.53; P<0.001). Compared with people who were not in contact with TB patients, the risk increased among those who had TB contacts (OR 3.72; 95%CI 1.45-9.70; P=0.006). In addition, the risk of TB onset in hypertension patients was significantly decreased (OR 0.57; 95%CI 0.35-0.91; P=0.018). Conclusion In the present study five factors are found to be associated with the occurrence of TB among the elderly in Urumqi, China. The future TB control program should pay special attention to the elderly population with the above risk factors.
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Objective:To investigate the clinical effect of peroneal fracture line in the treatment of posterior Pilon fracture.Methods:The data of 26 patients treated with fibular fracture line from January 2017 to July 2019 were analyzed retrospectively, including 11 males and 15 females; the age ranged from 28 to 69 years, with an average of 42.2 years. There were 10 cases of falling injury, 9 cases of falling injury and 7 cases of traffic injury; all of them were fresh closed fibular fractures;According to Yu Guangrong's classification, there were 11 cases of type I, 8 cases of type II and 7 cases of type III; AGH was divided into 10 cases of type I, 5 cases of type IIa, 2 cases of type IIb, 5 cases of type IIIa and 4 cases of type IIIb. All cases were treated by opening the fibular fracture line through the posterolateral approach, the quality of fracture reduction was evaluated by Burwell Charnley radiological evaluation standard after operation; At the last follow-up, ankle function was evaluated by American Association of Foot and Ankle surgery (AOFAS) ankle and hindfoot scores.Results:All 26 patients were followed up for 12-23 months, with an average of 14.9 months; Bone healing was achieved in all fractures. The healing time was 3-6 months, with an average of 4.0 months. The quality of fracture reduction was evaluated according to the Burwell Charnley radiology evaluation standard after operation, including anatomical reduction in 23 cases and acceptable reduction in 3 cases. The anatomical reduction rate was 88% (23/26). At the last follow-up, AOFAS ankle and hindfoot scores ranged from 80 to 100, with an average of 89.9 points, of which 17 cases were excellent and 9 cases were good, and the excellent and good rate was 100%. At the last follow-up, no patient had complications such as reduction loss, skin necrosis, infection, internal fixation loosening or ankle stiffness.Conclusion:After the treatment of Pilon fractures via peroneal fracture line, the distal tibial articular surface and posterior ankle fracture gap can be fully exposed, which can be repositioned and fixed under direct vision, with high anatomical repositioning rate and good and safe clinical results.
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Objective:To investigate the expression of B7 homolog 4 (B7-H4) and its clinical significance in endometrial cancer.Methods:A total of 833 patients with endometrial cancer admitted to Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from 2009 to 2019, were enrolled. The expression of B7-H4, mismatch repair (MMR), p53, programmed cell death ligand 1 (PD-L1) protein, and CD 8+ T lymphocyte density in endometrial cancer tissues were detected by the EnVision two-step method of immunohistochemical staining. First-generation sequencing (Sanger method) was used to determine molecular subtyping of endometrial cancer. The χ2 test was used to compare the differences in positive expression rate of B7-H4 protein in endometrial cancer tissues with different clinicopathological features and molecular subtyping, PD-L1 protein expression, and CD 8+ T lymphocyte density. Survival analyses [including recurrence-free survival (RFS) and disease-specific survival (DSS)] were performed for 664 patients with follow-up time≥3 months, with a median follow-up time of 31 months (range: 4-121 months), and the Cox proportional hazards regression model was used to analyze the relevant factors affecting the prognosis of patients with endometrial cancer. Results:(1) The median age of 833 patients was 58 years (range: 25-88 years); pathological type: 595 with endometrioid carcinoma, 238 with non-endometrioid carcinoma; surgical-pathological staging: 542 cases at stage Ⅰ, 38 cases at stage Ⅱ, 173 cases at stage Ⅲ, and 45 cases at stage Ⅳ. Molecular subtyping was performed in 590 patients, including 50 with POLE mutation, 163 with mismatch repair defect (MMR-d) type, 246 with nospecific molecular change (NSMP) type, and 131 with p53 mutation subtype. (2) B7-H4 protein was expressed with brownish-yellow stainind in the cell membrane and cytoplasm of endometrial carcinoma, and the positivity rate of B7-H4 protein was 71.5% (596/833). The positivity rates of B7-H4 protein among patients with different age, surgical-pathological stage, tumor grade, pathological type, depth of muscular invasion, presence or absence of lymphovascular space invasion, and molecular subtype were significantly different (all P<0.05). The positivity rates of B7-H4 protein among patients with different PD-L1 protein expression and CD 8+ T lymphocyte density were not significantly different ( P>0.05). The 5-year RFS (83.9%) and DSS (87.3%) of B7-H4 protein-positive patients had an increasing trend compared with the 5-year RFS (77.2%) and DSS (78.1%) of B7-H4 protein-negative patients, but there were not statistically significant differences ( P=0.053, P=0.083). (3) Univariate analysis showed that the 5-year RFS and DSS of patients with different age, tumor grade, surgical-pathological stage, pathological type, depth of muscular invasion, lymphovascular space invasion, and molecular subtype were significantly different (all P<0.01). There were no significant differences in 5-year RFS ( P=0.184, P=0.113) and DSS ( P=0.549, P=0.247) among patients with different CD 8+ T lymphocyte density and PD-L1 protein expression. Further analysis according to molecular subtype, the results of CD 8+ T lymphocyte density and PD-L1 protein expression showed that the 5-year RFS and DSS of B7-H4 protein-positive patients were higher than those of B7-H4 protein-negative patients with NSMP subtype, low density of CD 8+ T lymphocyte and PD-L1 protein-negative endometrial carcinoma (all P<0.05), however, there was no significant difference in 5-year DSS between B7-H4 protein-positive patients and B7-H4 protein-negative patients with PD-L1 protein-negative endometrial cancer ( P=0.060). Multivariate analysis showed that positive expression of B7-H4 protein was an independent factor for 5-year RFS ( HR=0.27, 95% CI: 0.09-0.78, P=0.016) and DSS ( HR=0.16, 95% CI: 0.05-0.58, P=0.005) in patients with NSMP subtype endometrial carcinoma. In patients with low-density CD 8+ T lymphocytes endometrial cancer, positive expression of B7-H4 protein was an independent factor for 5-year RFS ( HR=0.45, 95% CI: 0.26-0.80, P=0.006), but it was not an independent factor for 5-year DSS. In patients with PD-L1 protein-negative endometrial cancer, B7-H4 protein was not an independent factor for 5-year RFS. Conclusion:B7-H4 protein expressed highly in endometrial carcinoma tissues, and its high expression is closely related to clinicopathological features, molecular subtype of p53 mutant and NSMP, and the favorable prognosis of patients with low density of CD 8+ T lymphocyte immunophenotype endometrial carcinoma.
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Objective@#To investigate the clinical characteristics, treatments, and prognostic factors among patients with gestational trophoblastic neoplasia (GTN) exhibiting brain metastases who underwent craniotomy. @*Methods@#Thirty-five patients with GTN who had brain metastases and subsequently underwent craniotomies between January 1990 and December 2018 at Peking Union Medical College Hospital were identified using the GTN database. Their clinical manifestations, treatments, outcomes, and prognostic factors were retrospectively analyzed. @*Results@#All 35 patients underwent decompressive craniotomy, hematoma removal, and metastatic tumor resection combined with multiagent chemotherapy. Eighty percent (28/35) achieved complete remission, 11.4% (4/35) achieved partial remission, and 8.6% (3/35) had progressive disease. Not counting 2 patients who were lost to follow-up, 81.8% of the patients (27/33) were alive after a median follow-up of 72 months. The 5-year overall survival rate was 80.4%. Univariate analysis revealed that a history of chemotherapy failure (p=0.020) and a >1-week interval between craniotomy and chemotherapy commencement (p=0.027) were adverse risk factors for survival. Multivariate analysis showed that previous chemotherapy failure remained an independent risk factor for poor survival (odds ratio=11.50; 95% confidence interval=1.55–85.15; p=0.017). @*Conclusion@#Decompressive craniotomy is a life-saving option if metastatic hemorrhage and intracranial hypertension produce a risk of cerebral hernia in patients with GTN who have brain metastases. Higher survival rates and improved prognoses can be achieved through perioperative multidisciplinary cooperation and timely standard postoperative chemotherapy.
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Endometrial cancer (EC) is the most common gynecologic malignancy. A significant number of patients are diagnosed during reproductive age in nowadays. The importance of fertility preservation for EC has become more evident than ever before in this patient population. Hormonal therapy for stage IA low-risk EC is reported efficient and safe. However, the recurrence rate is high and the pregnancy outcomes are not satisfactory. We report 2 patients at reproductive age who were diagnosed of endometrioid EC and underwent fertility preservation treatment. Both of them achieved complete remission but later developed carcinosarcoma. This unusual disease progression may imply the underling mechanism of hormonal resistance. Immunohistochemistry showed that the expression of E-cadherin gradually decreased from epithelium to mesenchymal components, whereas nuclear expression of β-catenin gradually increased. The mesenchymal marker vimentin was abnormally overexpressed in the epithelium. This indicates that epithelial-mesenchymal transition pathway may be involved in the EC cell evolution and hormonal resistance.
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Objective@#To evaluate the oncological and reproductive outcomes in patients with seromucinous borderline ovarian tumors (SMBOT) treated with fertility-sparing surgery (FSS). @*Methods@#We retrospectively reviewed the medical records of patients with SMBOT who underwent surgery between 2000 and 2019. A centralized histological review was performed and recurrence rates were compared between different surgical procedures. @*Results@#A total of 105 patients fulfilled the inclusion criteria, of whom 65 underwent FSS and 40 were treated with radical surgery. Fourteen patients had recurrent disease after a median follow-up time of 59.6 months (range: 22.1–256.8 months). All but one relapsed with SMBOT. There was no significant difference in disease-free survival (DFS) between the 2 groups (p=0.141). Multivariate analysis showed that only bilateral involvement was associated with increased recurrence (p=0.008). In the subgroup of patients treated with conservative surgery, there was no significant difference in DFS with regard to surgical procedures (ovarian cystectomy vs. salpingo-oophorectomy, p=0.487). Of the 12 patients in the FSS group who developed recurrence, 11 underwent a second round of FSS and all remained alive with no evidence of disease at the end of follow-up. Of 20 patients desiring pregnancy, 16 patients were successful and resulted in 17 term deliveries. @*Conclusion@#FSS is feasible for young patients who wish to preserve their fertility. Patients initially treated with ovarian cystectomy may be managed by close surveillance if post-operative imaging are negative. Repeat FSS remains a valuable alternative for young patients with recurrent SMBOT after thorough communication.
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Cell aging is an extremely complex process, which is characterized by mitochondrial structural dysfunction, telomere shortening, inflammatory microenvironment, protein homeostasis imbalance, epigenetic changes, abnormal DNA damage and repair, etc. Aging is usually accompanied by structural and functional damage of tissues and organs which further induces the occurrence and development of aging-related diseases. Aging includes physiological aging caused by increased age and pathological aging induced by a variety of factors. Noteworthy, as a target organ directly contacting with the outside air, lung is more prone to various stimuli, causing pathological premature aging which is lung aging. Studies have found that there is a certain proportion of senescent cells in the lungs of most chronic respiratory diseases. However, the underlying mechanism by which these senescent cells induce lung senescence and their role in chronic respiratory diseases is still obscure. This paper focuses on the causes and classification of lung aging, the internal mechanism of lung aging involved in chronic respiratory diseases, and the application of anti-aging treatments in chronic respiratory diseases. We hope to provide new research ideas and theoretical basis for the clinical prevention and treatment in chronic respiratory diseases.
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Humans , Aging/pathology , Cellular Senescence , Lung/pathology , Lung Diseases/pathology , Respiration Disorders/pathology , Telomere , Telomere ShorteningABSTRACT
Objective To investigate the prevalence and genetic variation of Theileria in yellow cattle in Xiangxi Autonomous Prefecture of Hunan Province. Methods A total of 184 blood specimens were collected from Fenghuang, Huanyuan and Baojing counties of Xiangxi Autonomous Prefecture during the period from August 2018 through August 2019, and were detect using PCR assay with the specific 18S ribosomal rRNA (18S rRNA) gene targeting Theileria. The gene sequences of positive specimens were aligned with the sequences recorded in GenBank, and a phylogenetic tree was created with Plasmodium ovale 18S rRNA as an outgroup. Results A total of 143 blood samples were positive for Theileria, with a mean detection rate of 77.7%. Theileria was prevalent in the blood samples from yellow cattle in all three counties, with detection rates of 85.0% in Fenghuang County, 88.3% in Huayuan County and 61.0% in Baojing County, respectively. There was no significant difference in the detection rate of Theileria between Xiangxi yellow cattle and normal yellow cattle (77.2% vs. 79.5%; χ2 = 0.08, P > 0.05), while the detection of Theileria was significantly lower in the housed yellow cattle than in free-range cattle (68.9% vs. 89.7%; χ2 = 22.36, P < 0.01). A total of 18 PCR positive samples were randomly selected for sequencing and analysis, and all samples showed more than 99.0% homology with T. luwenshuni isolates. Phylogenetic analysis showed that the 18 positive samples were clustered into the same branch with T. luwenshuni, but were far away from other isolates. Conclusions The prevalence of Theileria is high in yellow cattle from Xiangxi Autonomous Prefecture of Hunan Province, and T. luwenshuni may be the dominant parasite species.
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Objective:To investigate the correlation between amide proton transfer-weighted (APTw) values and Ki-67 labeling index of cervical squamous cell carcinoma.Methods:From October 2017 to December 2018, 24 patients with cervical squamous cell carcinoma [International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ-Ⅲ] were prospectively enrolled in Peking Union Medical College Hospital and underwent pelvic morphological MRI on a 3.0 T MR scanner, including three-dimensional turbo-spin-echo APTw imaging and DWI. The maximum diameters of the lesions, APTw values and ADC values on the slice with the maximum diameter of the lesion were independently measured by two radiologists. The ICC was computed to evaluate the inter-observer consistency. Ki-67 immunohistochemical expression status was assessed by one pathologist. The Pearson correlation analysis was performed between the APTw values, maximum diameters, ADC values and Ki-67 labeling index.Results:The APTw values of cervical squamous cell carcinoma were (2.9±0.5)%. Inter-observer ICC was 0.972 (95%CI 0.937-0.988). The APTw values were positively moderately correlated with Ki-67 labeling index [(61.9±18.7)%, r=0.532, P=0.008]. The maximum diameters of the lesions were (28.7±10.6) mm. The mean ADC values were (0.998±0.217)×10 -3 mm 2/s. No correlations were found between maximum diameters, ADC values and Ki-67 labeling index ( r=0.038, P=0.859; r=0.238, P=0.263). Conclusion:APTw values can partially reveal the proliferation status of cervical squamous cell carcinoma.
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Lower respiratory tract infection (LRTI) induced by respiratory syncytial virus (RSV) is an important cause of hospitalization for infants. Compared with adults, infants are more likely to cause serious respiratory diseases after RSV infection due to the specific immature airway structure and immune system. The balance of immune resistance and immune tolerance of the host is critical to effective virus clearance and disease control. This paper reviews the relationship between RSV infection and respiratory diseases in infancy, the influence factors of the high pathogenicity of RSV infection in early life, as well as the research progress of anti-RSV therapy, and expands the specific molecular events regulating immune resistance and immune tolerance. We expect to present new ideas for the prevention and treatment of RSV-related respiratory diseases in clinical practice.
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Humans , Infant , Respiration Disorders , Respiratory Syncytial Virus Infections , Respiratory Syncytial Viruses , Respiratory Tract InfectionsABSTRACT
Alzheimer disease (AD) is the most common type of dementia characterized by the progressive cognitive and social decline. Clinical drug targets have heavily focused on the amyloid hypothesis, with amyloid beta (Aβ), and tau proteins as key pathophysiologic markers of AD. However, no effective treatment has been developed so far, which prompts researchers to focus on other aspects of AD beyond Aβ, and tau proteins. Additionally, there is a mounting epidemiologic evidence that various environmental factors influence the development of dementia and that dementia etiology is likely heterogenous. In the past decades, new risk factors or potential etiologies have been widely studied. Here, we review several novel epidemiologic and clinical research developments that focus on sleep, hypoxia, diet, gut microbiota, and hearing impairment and their links to AD published in recent years. At the frontiers of AD research, these findings and updates could be worthy of further attention.
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Humans , Alzheimer Disease/etiology , Amyloid , Amyloid beta-Peptides , Risk Factors , tau ProteinsABSTRACT
Objective:To evaluate the efficacy and safety of the micro-crosslinked hyaluronic acid injected by Shuiguang Needle Injection in facial rejuvenation.Methods:Thirty-two patients were enrolled. In this split face study, micro-crosslinked hyaluronic acid and non-crosslinked hyaluronic acid were randomly applied in the treated side of the face. Procedure efficacy (judged by VISIA), complication and subjects＇ satisfaction were assessed before treatment, one month, two months and three months after treatment.Results:According to the VISIA, 32 cases were effective one month after treatment on the treatment side, accounting for 100%; 28 cases were effective three months after the end of treatment, accounting for 87.51%. On the control side, 28 cases were effective one month after treatment, accounting for 87.50%, and 7 cases were effective after three months, accounting for 21.88%. There was no statistically significant difference in complications between the left and right sides; 31 patients were satisfied on the treatment side, accounting for 96.88%, and 28 patients on the control side were satisfied, accounting for 87.50%.Conclusions:The micro-crosslinked hyaluronic acid injected by Shuiguang Needle Injection appears to be effective and durable for facial rejuvenation. And it has a low complication rate and high subject satisfaction.
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Objective: Many studies have shown that respiratory syncytial virus persistent infection may be the main cause of chronic respiratory pathology. However, the mechanism is unclear. Cystic fibrosis transmembrane conduction regulator (CFTR) is an apical membrane chloride channel, which is very important for the regulation of epithelial fluid, chloride ion, and bicarbonate transport. CFTR dysfunction will lead to changes in bronchial secretions and impair mucus clearance, which is related to airway inflammation. In our previous study, we observed the down-regulation of CFTR in airway epithelial cells in respiratory syncytial virus (RSV) infected mouse model. In this study, we further investigated the expression and function of CFTR by constructing an airway epithelial cell model of RSV persistent infection. Methods: 16HBE14o- cells were infected with RSV at 0.01 multiplicity of infection (MOI). The expression of CFTR was detected by real-time RT-PCR, immunofluorescence, and Western blotting. The intracellular chloride concentration was measured by N-(ethoxycarbonylmethyl)-6-methoxyquinolium bromide (MQAE) and the chloride current was measured by whole-cell patch clamp recording. Results:16HBE14o-cells infected with RSV were survived to successive passages of the third generation (G3), while the expression and function of CFTR was progressively decreased upon RSV infection from the first generation (G1) to G3. Exposure of 16HBE14o-cells to RSV led to the gradual increase of TGF-β1 as well as phosphorylation of Smad2 following progressive RSV infection. Disruption of TGF-β1 signaling by SB431542 prevented Smad2 phosphorylation and rescued the expression of CFTR. Conclusion:RSV infection can lead to defective CFTR function in airway epithelial cells, which may be mediated via activation of TGF-β1 signaling pathway.
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Objective:To conduct theoretical analysis and experimental research on peripherally inserted venous catheters, establish theoretical models of interaction between different materials catheters and simulated skin tissues, and test different catheters at the same time to provide theoretical basis and experimental basis for the optimization design.Methods:According to the mechanical properties of the catheter at 25 ℃ and 37 ℃, a finite element model of the catheter and simulate skin tissue was established. The relationship between catheter folds and material and structure during puncture was analyzed, and the stiffness, radiographic properties, etc. were tested experimentally.Results:The performance of the catheter at different temperatures is closely related to its material. The wrinkle situation of the catheter is related to the catheter material and the inclination of the wedge surface. The elastic modulus of the polyurethane (PU) catheter is about 500 MPa and 250 MPa, respectively at room temperature (25 ℃) and body temperature (37 ℃), which meets the clinical needs of high rigidity during puncture and soft material during indwelling. When the catheter structure is the same, the PU catheter is less prone to wrinkles than the fluorinated ethylene propylene copolymer (FEP) catheter. When the catheter material is the same, the smaller the inclination of the wedge surface, the less likely the catheter to wrinkle.Conclusions:Appropriately reducing the inclination of the wedge-shaped surface of the needle of peripherally inserted venous catheters can improve the success rate of puncture. The PU catheters have good mechanical properties, they are not prone to wrinkles during puncture, and their stiffness can be reduced at body temperature, which can not only increase the success rate of puncture, but also reduce the occurrence of complications. Therefore, PU catheters have a better clinical application prospect.
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Objective:To develop a quality assessment scale of ICU transitional care based on patient-reported outcomes and test its performance.Methods:According to the guidelines of patient-reported outcomes development process, the item pool was established combining with analysis of relevant literatures and patients′ experience and needs in ICU transitional period based on the grounded theory about ICU transitional care. Cognitive test of patients and Delphi expert correspondence were utilized to amend the initial scale before pretest. One hundred and seventy-seven patients who had been transferred from ICU to general ward from March to August 2019 in Tianjin Third Central Hospital were recruited by convenience sampling method for project analysis.Results:The active coefficient and authority degree of expert were above 0.90 and 0.785 respectively for the two rounds of expert enquiry. The final scale consisted of 28 items, from which 4 principal factors, which were preparation for self-care, communication and coordination, psychological support and health belief, respectively, were extracted by exploratory factor analysis, explaining 78.307% of total variance. The content validity index of each item was 0.769-1.000, and the scale-level content validity was 0.896. The Cronbach α coefficients of the 4 factors and the scale were 0.844, 0.793, 0.897, 0.681 and 0.807, respectively.Conclusions:The patient-reported outcomes scale measuring ICU transitional care quality has good reliability and validity and can be used as an auxiliary tool measuring ICU transitional care quality in clinic.
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Ultrasonic bubble detection has been widely used in predicting the risk of decompression sickness and evaluating the efficiency and safety of decompression procedures. Currently, the widely used SPENCER scale is conducted by using Doppler ultrasound to monitor the bubble signal in the precordial region of subjects. KM grading system is a computerized system based on Doppler ultrasound. The grading score can be converted into SPENCER bubble grading scale score and the bubble grading is precise and suitable for the motion status. On the basis of the above two methods, the KISMAN integrated severity score, extended SPENCER bubble grading and simplified Doppler bubble grading system were established. They not only coordinated analysis of Doppler ultrasound bubble detection results with other risk factors of decompression disease, but also convenient to use computer for processing detection results. With the in-depth application of Fourier technique and empirical mode decomposition in Doppler audio bubble signal detection, methods such as three-parameter fuzzy analysis and energy operator method are playing an important role in automatic bubble analysis. Optimization of detection technology and improvement of sensitivity and accuracy of automatic analysis are important development directions in the field of decompression bubble Doppler grating technology.
ABSTRACT
Objective:To compare the effect of interlocking intramedullary nail and locking plate in the treatment of varus proximal humeral fractures in the elderly.Method:A retrospective case-control study was conducted to analyze the clinical data of 46 elderly patients with varus proximal humeral fractures treated in Central Theater General Hospital of PLA from June 2016 to January 2019, including 27 males and 19 females, at age of 60-84 years［（71.9±5.7）years］. All fractures were fresh. Overall 25 patients were treated with interlocking intramedullary nail（intramedullary nail group）, and 21 patients were treated with locking plate（bone plate group）. The incision length, operation time, intraoperative bleeding and fracture healing time were compared between the two groups. Visual analogue scale（VAS）was used to evaluate the degree of pain relief at 1 week and 1 month after operation, and Constant-Murley score was used to evaluate the recovery of shoulder function at 1 month, 3 months and 1 year after operation. The cervical trunk angle was recorded at 2 days and 1 year after operation to judge whether there was a loss of cervical trunk angle. Postoperative complications were observed.Results:All patients were followed up for 12-32 months［（19.7±6.6）months］. The incision length［（7.1±0.6）cm］, operation time［（60.8±5.2）minutes］, intraoperative bleeding［（64.4±8.4）ml］and fracture healing time［（10.0±1.0）weeks］in intramedullary nail group were significantly less than those in bone plate group［（13.6±0.9）cm,（80.2±8.1）minutes,（151.0±15.2）ml,（11.0±1.5）weeks］（ P<0.05）. In both groups, the VAS decreased significantly over time, and markedly increased Constant-Murley score was detected as well（ P<0.05）. The VAS in intramedullary nail group［（2.8±0.2）points,（1.1±0.2）points］was significantly lower than that in bone plate group［（4.0±0.2）points,（1.5±0.1）points］at 1 week and 1 month after operation（ P<0.05）. The Constant-Murley score in intramedullary nail group［（59.9±6.9）points,（79.1±6.8）points］was higher than that in bone plate group［（50.1±8.5）points,（73.6±8.4）points］at 1 month and 3 months after operation（ P<0.05）, but the score showed no significant difference between intramedullary nail group［（89.1±5.3）points］and bone plate group［（86.4±6.4）points］at 1 year after operation（ P>0.05）. According to Constant-Murley score, 10 patients were evaluated as excellent and 15 patients as good in intramedullary nail group at 1 year after operation, with the excellent and good rate of 100%, while 8 patients were evaluated as excellent, 11 patients as good and 2 patients as fair in bone plate group at 1 year after operation, with the excellent and good rate of 91%（ P>0.05）. The cervical trunk angle in intramedullary nail group［（140.2±2.9）°,（139.6±2.3）°］had significant difference from that in bone plate group［（139.6±3.2）°,（138.8±3.3）°］at 2 days and 1 year after operation（ P<0.05）. In both groups, the cervical trunk angle had slight lost at 1 year after operation compared with that at 2 days after operation, but the difference was not statistically significant（ P>0.05）. In intramedullary nail group, 1 patient had subacromial impact. In bone plate group, 1 patient had screw cutting, 2 patients subacromial impact, and 2 patients delayed fracture healing. The incidence of complications in intramedullary nail group was 4%（1/25）, lower than 24%（5/21）in bone plate group（ P<0.05）. Conclusion:Compared with locking nail plate, interlocking intramedullary nail in the treatment of senile varus proximal humeral fracture has the advantages of small trauma, early fracture healing, less pain, early function recovery and less complications.