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Objective:To retrospectively analyze the early mortality and related risk factors in adult patients with maintenance hemodialysis (MHD).Methods:Adult MHD patients from 2008 to 2018 were enrolled and divided into training data group and validation data group. In training data group, multivariate logistic regression was used to analyze the risk factors of early death within 120 days after hemodialysis and establish a prediction model. The receiver operating characteristic (ROC) curve was applied to evaluate the prediction ability of the model.Results:A total of 4 885 patients were included. The cumulative mortality within 120 days was 20.97/100 person years, and that within 365 days was 12.25/100 person years. A total of 3 603 patients in the training data group were analyzed. The following risk factors were correlated with early mortality (all P<0.05), including age at start of dialysis over 60 years old ( OR=1.792), non-chronic glomerulonephritis ( OR=2.214), cardio-cerebrovascular disease ( OR=2.695), plasma albumin less than 35 g/L ( OR=1.358), platelet count less than 120×10 9/L ( OR=2.194), serum creatinine less than 600 μmol/L ( OR=1.652), blood urea nitrogen over 30 mmol/L ( OR=1.887), blood phosphorus less than 1.13 mmol/L ( OR=1.783), pulse pressure over 55 mmHg(1 mmHg=0.133 kPa) ( OR=1.656), low density lipoprotein less than 1.5 mmol/L ( OR=1.873), and blood calcium over 2.5 mmol/L ( OR=1.876). Risk prediction model was established. The other 1 282 cases in the validation data group were verified. The area under ROC curve was 0.810, with sensitivity 85.7%, and specificity 62.5%. Conclusion:The mortality rate of adult MHD patients within 120 days after dialysis is high. The established prediction model can effectively predict the risk of early death.
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Objective To evaluate the effect of Critical Incident Reporting System on the quality of clinical anesthesia.Methods Anesthesia-related critical incidents happened in the perioperative period were reported in voluntary,anonymous,no punishment and confidential manners.The data was collected,classified and documented by assigned professionals on a regular basis from September 2012 to August 2016.The critical incidents were retrospectively analyzed after the risk was assessed.The 4-year reporting rate was collected.The risk of critical incidents was assessed using severity and probability analysis,and the critical incidents-inducing risk factors were analyzed.Results The 4-year reporting rate of critical incidents was 0.551％.From 1st to 4th year,the reporting rates were 0.729％,0.598％,0.819％ and 0.368％,respectively,and the incidence of injury incidents was 0.112％,0.106％,0.133％ and 0.031％,respectively.The reporting rate of critical incidents and incidence and reporting rate of the injury incidents showed a decreasing trend for 1st and 2nd year,significantly increased for 3rd year and decreased for 4th year (P＜0.05).The first three critical incident categories were equipment use and respiratory system-and workflowrelated incidents.Patient injury during surgery was considered an extremely high risk incident;the factor of the medical staff in the department of anesthesiology is the first critical incidents-inducing risk factor.Conclusion Critical Incident Reporting System can discover and correct the system-related risk and the inducing factors in the department of anesthesiology and is an effective method of improving the service quality of clinical anesthesia.
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Cardiac arrest in pregnancy is the emergency sereve case in clinic,which can threaten life and health of the fetus and pregnant women.Pregnancy cardiac arrest once happened,providing health care providers should start high quality chest compressions immediately,open the airway and commence ventilation,activate an emergency call system in which all providers in the maternal/neonatal resuscitation teams.We read from several aspects of 2014 the United States society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy in order to improve the cardiopulmonary resuscitation quality of pregnant women after cardiac arrest and optimize maternal and neonatal outcomes.
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Cardiac arrest in pregnancy is the emergency sereve case in clinic,which can threaten life and health of the fetus and pregnant women.Pregnancy cardiac arrest once happened,providing health care providers should start high quality chest compressions immediately,open the airway and commence ventilation,activate an emergency call system in which all providers in the maternal/neonatal resuscitation teams.We read from several aspects of 2014 the United States society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy in order to improve the cardiopulmonary resuscitation quality of pregnant women after cardiac arrest and optimize maternal and neonatal outcomes.
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Objective To investigate the expression of microRNA‐101 (miRNA‐101 ) in human gastric cancer ,and to explore its effects on proliferation ,migration and invasion of gastric cancer cell . Methods The expression of miRNA‐101 in 28 human gastric cancer tissues ,human gastric cell lines BGC‐823 , SGC‐7901 , MKN‐45 , AGS and human normal gastric epithelial cell line GES‐1 were determined by real time polymerase chain reaction (PCR) .Recombinant miRNA‐101 adenovirus vector was constructed . The effects of miRNA‐101 on gastric cancer proliferation was detected with cell proliferation assay .The ability of gastric cancer cell migration and invasion was assessed with Transwell assay .Gastric xenograft cancer model was established in BALB /c nude mice and the tumor size was compared .The t test was used for the statistical analysis .Results The expression of miRNA‐101 in gastric cancer tissues was 0 .661 ± 0 .396 ,which was lower than that of corresponding para carcinoma tissues (1 .128 ± 0 .697) ,and the difference was statistically significant (t = 10 .091 , P < 0 .01) .The expression of miRNA‐101 in normal gastric epithelial cell line GES‐1 was higher than those of gastric cancer cell lines BGC‐823 ,SGC‐7901 , MKN‐45 and AGS . There was significant suppression role of miRNA‐101 on MKN‐45 cells proliferation , and which also had inhibition role on cell migration and invasion of gastric cancer cell lines BGC‐823 ,SGC‐7901 ,MKN‐45 and AGS .At five weeks after MKN‐45 gastric xenograft cancer nude mice model established ,the tumor size of Ad‐miRNA‐101 group ((333 .56 ± 46 .71) mm3 ) was smaller than that of Ad‐enhanced green fluorescent protein (EGFP) group (806 .41 ± 51 .83) mm3 ,and the difference was statistically significant (t = 21 .431 , P < 0 .01 ) .Conclusion In gastric tissues and cells ,miRNA‐101 is a tumor suppressive miRNA and its downregulated expression involved in the genesis and development of gastric cancer ,which may be a new target of biological target therapy in gastric cancer .
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<p><b>OBJECTIVE</b>To identify the endophytic fungal strain PR35 separated from Paeonia delavayi and study chemical constituents of its secondary metabolites.</p><p><b>METHOD</b>The fungal strain PR35 was identified by morphological observation and ITS rDNA sequence analysis. Various chromatographic methods were adopted to separate and purify its secondary metabolites, and their structures were identified by physiochemical properties and spectral data</p><p><b>RESULT</b>The fungal strain PR35 was identified as Trichoderma longibrachiatum. Five compounds were separated from fermentation products of fungal strain PR35 and identified as 1-(2,6-dihydroxyphenyl)-3-hydroxybutan-1-one (1), 1-(2,6-dihydroxypheny) propan-1-one (2), 1-(2,4,6-trihydroxyphenyl) butan-1-one (3), 4-methoxy-1-naphthol (4), and cerevisterol (5). Among them, compounds 1-3 showed notable antifungal activities against Botrytis cinerea, Fusarium avenaceum and Hormodendrum compactum.</p><p><b>CONCLUSION</b>The endophytic fungus T. longibrachiatum was separated from the plant P. delavayi for the first time. Five compounds were first separated from endophytic fungus of P. delavayi. Among them, compound 4 was separated from microbial fermentation products for the first time.</p>
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DNA, Fungal , Genetics , DNA, Intergenic , Genetics , Endophytes , Classification , Genetics , Metabolism , Paeonia , Microbiology , Phylogeny , Trichoderma , Classification , Genetics , MetabolismABSTRACT
Objective To study the chemical constituents of Paeonia veitchii. Methods Isolation and purification were carried out on repeated silica gel column chromatography. The structures of the compounds were identified by physico-chemical properties and spectral analyses. Results Nine compounds were isolated and identified as paeoniflorin (Ⅰ), hydroxypaeoniflorin (Ⅱ), benzoylpaeoniflorin (Ⅲ), benzoylhydroxypaeoniflorin (Ⅳ), albiflorin (Ⅴ), paeonisothujone (Ⅵ), mudanpinoic acid A (Ⅶ), 2-hydroxybenzyl alcohol (Ⅷ), bis (2-hydroxybenzyl) ether (Ⅸ). Conclusion Compound Ⅸ is obtained from natural products for the first time. Compounds Ⅳ, Ⅵ-Ⅸ are isolated from this plant for the first time.